Barriers for introducing HIV testing among tuberculosis patients in Jogjakarta, Indonesia: a qualitative study

Mahendradhata, Yodi; Ahmad, Riris Andono; Lefèvre, Pierre; Boelaert, Marleen; Van der Stuyft, Patrick
January 2008
BMC Public Health;2008, Vol. 8 Issue 1, p385
Academic Journal
Background: HIV and HIV-TB co-infection are slowly increasing in Indonesia. WHO recommends HIV testing among TB patients as a key response to the dual HIV-TB epidemic. Concerns over potential negative impacts to TB control and lack of operational clarity have hindered progress. We investigated the barriers and opportunities for introducing HIV testing perceived by TB patients and providers in Jogjakarta, Indonesia. Methods: We offered Voluntary Counselling and Testing (VCT) to TB patients in parallel to a HIV prevalence survey. We conducted in-depth interviews with 33 TB patients, 3 specialist physicians and 3 disease control managers. We also conducted 4 Focus Group Discussions (FGDs) with nurses. All interviews and FGDs were recorded and data analysis was supported by the QSR N6® software. Results: Patients' and providers' knowledge regarding HIV was poor. The main barriers perceived by patients were: burden for accessing VCT and fear of knowing the test results. Stigma caused concerns among providers, but did not play much role in patients' attitude towards VCT. The main barriers perceived by providers were communication, patients feeling offended, stigmatization and additional burden. Conclusion: Introduction of HIV testing among TB patients in Indonesia should be accompanied by patient and provider education as well as providing conditions for effective communication.


Related Articles

  • The Emerging Crisis of Drug-Resistant Tuberculosis in South Africa: Lessons from New York City. Murphy, Richard A. // Clinical Infectious Diseases;6/1/2008, Vol. 46 Issue 11, p1729 

    Multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis have emerged as important infections in South Africa among patients infected with human immunodeficiency virus (HIV). In the face of this new epidemic, South Africa must rededicate itself to the task of tuberculosis...

  • Effect of Tuberculosis on the Survival of Women Infected with Human Immunodeficiency Virus. H López-Gatell; SR Cole; NA Hessol; AL French; RM Greenblatt; S Landesman; S Preston-Martin; K Anastos // American Journal of Epidemiology;Apr2007, Vol. 165 Issue 10, p1134 

    Evidence regarding the effect of tuberculosis (TB) disease on progression of human immunodeficiency virus (HIV) disease is inconclusive. The authors estimated the effect of time-varying incident TB on time to acquired immunodeficiency syndrome (AIDS)-related mortality using a joint marginal...

  • High rates of HIV in surgical patients in Soweto, South Africa: impact on resource utilisation and recommendations for HIV testing. Martinson, Neil A.; Omar, Tanvier; Gray, Glenda E.; Vermaak, Jacobus S.; Badicel, Maria; Degiannis, Elias; Steyn, Jan; McIntyre, James A.; Smith, Martin // Transactions of the Royal Society of Tropical Medicine & Hygiene;Feb2007, Vol. 101 Issue 2, p176 

    Summary: Interactions between HIV and surgical diseases are relatively poorly described in high HIV prevalence settings. We report HIV prevalence and its associations in a prospective study of adults admitted to surgical units in Soweto, South Africa. Voluntary counselling and testing (VCT) for...

  • Public Health Care Practitioner's Reflections on Tuberculosis Patient's Perspectives on Factors Influencing their Adherence to the Directly Observed Treatment Short-Course. Naidoo, Pamela // Open Public Health Journal;Jan2009, Vol. 2, p33 

    The high prevalence of tuberculosis (TB) in South Africa is well established. TB, Human Immunodeficiency Virus (HIV), and Auto Immune Deficiency Syndrome (AIDS) co-exist, which contributes to the high incidence, prevalence, and recurrent infection rate of TB. Despite the implementation of the...

  • High Rates of Clinical and Subclinical Tuberculosis among HIV-Infected Ambulatory Subjects in Tanzania. Mtei, Lillian; Matee, Mecky; Herfort, Oliver; Bakari, Muhammad; Horsburgh, C. Robert; Waddell, Richard; Cole, Bernard F.; Vuola, Jenni M.; Tvaroha, Susan; Kreiswirth, Barry; Pallangyo, Kisali; von Reyn, C. Fordham // Clinical Infectious Diseases;5/15/2005, Vol. 40 Issue 10, p1500 

    Background. We sought to determine the prevalence of active tuberculosis among ambulatory HIV-infected persons in Tanzania with CD4 cell counts of ⩾200 cells/mm³ and a bacille Calmette-Guérin vaccination scat Methods. Subjects who volunteered for a tuberculosis booster vaccine trial...

  • Predictors of antiretroviral treatment-associated tuberculosis in Ethiopia: a nested case-control study. Mesfin, N.; Deribew, A.; Yami, A.; Solomon, T.; Geertruyden, J. P. Van; Colebunders, R. // International Journal of STD & AIDS;Feb2012, Vol. 23 Issue 2, p94 

    Little is known about the predictors of antiretroviral treatment (ART)-associated tuberculosis (TB) in developing nations. The objective of this study was to determine predictors of ART-associated TB in adults with HIV infection at Jimma University Hospital, Ethiopia. A nested case-control study...

  • Outcome of HIV infected children with culture confirmed tuberculosis. Hesseling, A. C.; Westra, A. E.; Werschkull, H.; Donald, P. R.; Beyers, N.; Hussey, G. D.; El-Sadr, W.; Simon Schaaf, H. // Archives of Disease in Childhood;Nov2005, Vol. 90 Issue 11, p1171 

    Background: Tuberculosis (TB) is an important disease in human immunodeficiency virus (HIV) infected children living in regions where TB is endemic. There are limited data on the outcome of culture confirmed TB in HIV infected children. Aims and Methods: To describe the outcome on TB therapy and...

  • Immune restoration disease and changes in CD4+ T-cell count in HIV- infected patients during highly active antiretroviral therapy at Zewditu memorial hospital, Addis Ababa, Ethiopia. Huruy, Kahsay; Kassu, Afework; Mulu, Andargachew; Wondie, Yemataw // AIDS Research & Therapy;2010, Vol. 7, p46 

    Background: Highly active antiretroviral therapy (HAART) improves the immune function and decreases morbidity, mortality and opportunistic infections (OIs) in HIV-infected patients. However, since the use of HAART, immune restoration disease (IRD) has been described in association with many OIs....

  • BCG vaccine.  // Reactions Weekly;3/28/2009, Issue 1245, p8 

    The article describes several cases of human immunodeficiency virus (HIV)-positive infants who developed Bacillus Calmette-Guérin (BCG) infections after receiving a BCG vaccine. One of the patients, an 11-month-old infant, had enlarged, matted axillary lymph nodes, pneumonia, oral candidiasis...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics