Analisis Pengelolaan Rekam Medis Khusus Pasien HIV di Rumah Sakit Umum X Kota Bandung

Latar Belakang: Rumah Sakit X adalah salah satu fasilitas pepelayanan kesehatan di Bandung yang memiliki klinik Voluntary Counselling and Testing VCT. Jumlah kunjungan pasien di klinik ini meningkat secara signifikan pada triwulan akhir 2021 sebanyak 53 pasien dan dilanjutkan pada triwulan awal 2021 sebanyak 102 pasien. Sehingga intensitas pepelayanan yang diberikan kepada pasien semakin tinggi dan berdampak pada peningkatan jumlah dokumen rekam medis pasien yang dihasilkan oleh klinik VCT. Tujuan: Tujuan penelitian ini adalah mendeskripsikan pengelolaan dokumen rekam medis pasien di klinik VCT. Metode: Jenis penelitian ini menggunakan metode kualitatif dengan pendekatan deskriptif, cara pengumpulan data pengumpulan dengan wawancara dan observasi. Hasil: Hasil penelitian menunjukan bahwa sistem pencatatan dilakukan berdasarkan formulir khusus dari Menteri kesehatan namun pengisian nya masih belum optimal. Penyimpanan rekam medis masih kurang menjaga aspek keamanan dan kerahasiaan. Kesimpulan: Pelaporan kasus HIV sudah sesuai dengan peraturan Menteri Kesehatan yaitu dengan aplikasi sistem informasi HIV/AIDS dan IMS (SIHA).

Determining the Dynamics of HIV Voluntary Counselling and Testing Uptake among the Rural and Urban Communities of Nakuru District, Kenya

<p>Globally, it is estimated that over 40 million people are living with HIV/AIDS with 67% of these coming from Sub Sahara Africa. While the epidemic has been receiving increasing attention towards and more emphasis placed on access to care and treatment, these efforts are bound to become unsustainable due to a high rate of new infections. In 2007, for every HIV patient who was put on drugs six others became infected with the virus. Voluntary testing and counselling (VCT) has been suggested as the most effective intervention that could reverse this rate of infection. Its utilization in Africa and many parts of the world has however, been at an all time low. In Kenya where populations of over 1.4 million people are living with the HIV/AID virus, less than 20% of the total population knows their status. The aim of this study is, therefore, to establish and document the dynamics of VCT uptake in Nakuru district of Kenya with a view to suggesting measures to increase this uptake. The main objectives of the study were to identify factors that influence VCT uptake and determine the levels of knowledge and prevailing attitudes on HIV testing. The role that gender plays in VCT utilization was also explored. This was a cross sectional study in which a mixed research method methodology employing quantitative and qualitative data collection methods was used. Quantitative data was collected using a structured questionnaire while qualitative data was collected using focus group discussions and key informant interviews. The target population was residents of Nakuru aged 16-60. 480 distributed completed the structured questionnaire out which 422 were completed and returned. Six focus group discussions and five key informant interviews were carried out. The research found that the awareness regarding HIV and VCT among the community members is relatively high. However, there are still a significant proportion of people who hold misconceptions about the disease and the testing service. This may partially explain why people opted not to take the test for the virus. Further, a majority of the people wanted to take up the test but both social and health system barriers such as gender inequality, the cost of taking the service, service operational hours, accessibility; misconceptions about the disease are barriers to the utilization of the service. The study recommends the adoption of more pro-active model of testing which could include mobile and home-based testing to help remove most of these barriers and therefore lead to an increased uptake. Moreover promotional activities targeting couples, providing the service beyond the current normal working hours weekdays and weekends, strengthening the general public health facility to help win back the trust of the service consumer and provision of youth-friendly voluntary counselling and testing for HIV (VCT) service are recommended.</p>

Determining the Dynamics of HIV Voluntary Counselling and Testing Uptake among the Rural and Urban Communities of Nakuru District, Kenya

<p>Globally, it is estimated that over 40 million people are living with HIV/AIDS with 67% of these coming from Sub Sahara Africa. While the epidemic has been receiving increasing attention towards and more emphasis placed on access to care and treatment, these efforts are bound to become unsustainable due to a high rate of new infections. In 2007, for every HIV patient who was put on drugs six others became infected with the virus. Voluntary testing and counselling (VCT) has been suggested as the most effective intervention that could reverse this rate of infection. Its utilization in Africa and many parts of the world has however, been at an all time low. In Kenya where populations of over 1.4 million people are living with the HIV/AID virus, less than 20% of the total population knows their status. The aim of this study is, therefore, to establish and document the dynamics of VCT uptake in Nakuru district of Kenya with a view to suggesting measures to increase this uptake. The main objectives of the study were to identify factors that influence VCT uptake and determine the levels of knowledge and prevailing attitudes on HIV testing. The role that gender plays in VCT utilization was also explored. This was a cross sectional study in which a mixed research method methodology employing quantitative and qualitative data collection methods was used. Quantitative data was collected using a structured questionnaire while qualitative data was collected using focus group discussions and key informant interviews. The target population was residents of Nakuru aged 16-60. 480 distributed completed the structured questionnaire out which 422 were completed and returned. Six focus group discussions and five key informant interviews were carried out. The research found that the awareness regarding HIV and VCT among the community members is relatively high. However, there are still a significant proportion of people who hold misconceptions about the disease and the testing service. This may partially explain why people opted not to take the test for the virus. Further, a majority of the people wanted to take up the test but both social and health system barriers such as gender inequality, the cost of taking the service, service operational hours, accessibility; misconceptions about the disease are barriers to the utilization of the service. The study recommends the adoption of more pro-active model of testing which could include mobile and home-based testing to help remove most of these barriers and therefore lead to an increased uptake. Moreover promotional activities targeting couples, providing the service beyond the current normal working hours weekdays and weekends, strengthening the general public health facility to help win back the trust of the service consumer and provision of youth-friendly voluntary counselling and testing for HIV (VCT) service are recommended.</p>

Recommendations for collection and integration of community-based testing and linkage to care data into national surveillance, monitoring and evaluation systems for HIV, viral hepatitis and sexually transmitted infections: results from the INTEGRATE Joint Action

Background National testing strategy, including monitoring and evaluation, is critical in responding to HIV, sexually transmitted infections, and viral hepatitis. Community-based voluntary counselling and testing contributes to early HIV diagnoses among key populations. Countries providing community-based testing, should integrate some core data on testing and linkage to care in these services into national surveillance and monitoring and evaluation systems. This study aimed to support the integration of community-based voluntary counselling and testing data into respective national surveillance and M&E systems for those infections. Methods Preliminary consensus on indicators for the integration of community-based voluntary counselling and testing data into respective national surveillance and monitoring and evaluation systems was reached. Pilot studies were conducted in Estonia, Poland, Serbia, Slovakia, Slovenia and Spain. After pilot activities were implemented, the final consensus on indicators was reached. An analysis of the facilitators and barriers faced during pilot studies was conducted to inform the final recommendations for implementation. Results The minimum set of six indicators to be integrated into national surveillance and monitoring and evaluation systems were: number of tests, number of clients tested, reactivity rate for tests and clients, positivity (active infection) rates for tests and clients, linkage to care rates for clients with reactive and/or positive test result, proportion of all new diagnoses in a country with first reactive test result at community-based voluntary counselling and testing service. Seven additional indicators were identified. Each indicator should be disaggregated by key population, sex and age group. A list of 10 recommendations for the collection and integration of community-based voluntary counselling and testing data into national surveillance and monitoring and evaluation systems for HIV, sexually transmitted infections and viral hepatitis was identified. Conclusions Integration of some community-based voluntary counselling and testing monitoring and evaluation data into national surveillance and monitoring and evaluation systems in all pilot countries was achieved. The recommendations will support such integration in other European countries. European Centre for Prevention and Control of Diseases included questions from the minimum list of indicators into their Dublin Declaration questionnaire 2020 to contribute to evidence based community testing policies in European countries.

Integration of community-based testing data into national HIV surveillance in Poland, Serbia and Slovakia within the framework of INTEGRATE project

Background Community-based voluntary counselling and testing contributes to early HIV diagnoses among key populations. Testing data from such decentralized services is however often not standardized nor linked to national surveillance systems. This study aimed to support the integration of community testing data into respective national surveillance and monitoring and evaluation systems for those infections. We present results from three national pilots, focused on improved data collection and transfer. Methods Within the Joint Action INTEGRATE different pilot activities were planned and implemented according to the local context. In Slovakia, standardised data collection tools were implemented in three community testing services. The data generated was used to calculate the proposed indicators. In Poland, positive test results from the community testing database were linked to the national case-based surveillance database using confirmatory test number, to improve the completeness of behavioural data in the national database. In Serbia, voluntary counselling and testing forms were improved enabling identification of community-based testing. A system to generate unique client identifiers was initiated in the National registry of HIV cases to monitor linkage to care. Results All three sites were able to estimate most of the agreed indicators. In Slovakia during the study period 675 people were tested for HIV, 410 for hepatitis C and 457 for syphilis, with reactivity rates of 0.4, 2.5 and 1.8%, respectively. For HIV, 66.7% of reactive cases were confirmed and linked to care. In Poland, 28.9% of the community testing sites’ records were linked to the national surveillance database (and accounted for 14.3% of all new diagnoses registered here during 2017–2018). Reactivity rate ranged between 1.9% and 2.1%. In Serbia, 80 persons were tested at community sites, from which two had a reactive HIV test result. By linking unique client identifiers from voluntary counselling and testing and National Registry of HIV cases databases, linkage to care within a two-month period was observed for one of two people with reactive HIV test result. Conclusions Pilot activities in the three countries demonstrate that integration of community-based testing data into surveillance systems is feasible and can help improve national surveillance data by providing key information.

Acceptability of Voluntary Counselling and Testing (VCT) Among Tuberculosis (TB) Patients in Ghana

Patients should first be counselled and tested for HIV to benefit from available care and treatment options. The aim of this paper was to find out the level of acceptance of HIV testing among patients who visit the Chest Diseases Clinic of the Korle-Bu Teaching Hospital, Ghana. Information about all adult tuberculosis patients who attended the clinic between January and December 2019 in which patients’ socio-demographic information and tuberculosis treatment history were taken from the TB register, patients who showed initial willingness were referred to a VCT counsellor for HIV counselling before testing was done. Rapid test methods were used, and the results were disclosed. The logistic regression method was used to assess the factors associated with HIV co-infection, willingness, and acceptability. 250 tuberculosis (TB) patients who were among the total of 485 gave their consent and willingly participated in this study. Their median age was 30 years (range, 13–50+), and 56.8% of them were females. 29 patients had tested previously, including 29 HIV positive. 66.0% (165) were willing to be tested.

Tipe Kepribadian dan Status Kesehatan Mental pada Kelompok Risiko Tinggi HIV/AIDS di Wilayah Kerja Puskesmas Ngemplak I

ABSTRAK Pendahuluan: Lelaki Suka Lelaki (LSL) dan transgender merupakan sebagian dari kelompok yang beresiko tinggi mendapatkan HIV/AIDS. Meningkatnya morbiditas dan mortalitas kasus HIV/AIDS di Indonesia harus diimbangi dengan upaya pencegahan dan pengenalan dini faktor yang berkontribusi. Pengenalan kepribadian dan status kesehatan mental kelompok resiko tinggi sedini mungkin dapat mencegah timbulnya perjalanan penyakit atau gangguan yang lebih serius seperti depresi dan bunuh diri. Penelitian ini bertujuan untuk mengetahui tipe kepribadian dan status kesehatan mental pada kelompok risiko tinggi HIV/AIDS di wilayah kerja Puskesmas Ngemplak I.Metode: Penelitian ini merupakan penelitian deskriptif dengan kuesioner Woodworth-Eysenck Inventory sebagai alat pengambilan data. Penelitian dilakukan pada bulan November 2020 dengan teknik purposive sampling pada Lembaga Swadaya Masyarakat (LSM) komunitas resiko tinggi HIV/AIDS yang bekerjasama dengan Puskesmas Ngemplak I dalam program Voluntary Counselling and Testing (VCT).Hasil: Data yang didapatkan dari 20 responden menunjukkan bahwa 18 responden merupakan LSL dan 2 responden merupakan transgender dari lelaki menjadi perempuan. Data dari tes woodworth didapatkan 25% dari responden cenderung obsessive compulsive, 50% memiliki kecenderungan schizoid, 35% cenderung paranoid, 55% cenderung depresi, 35% cenderung impulsif, 55% cenderung memiliki ketidakstabilan emosi, dan 25% cenderung antisosial. Data dari tes eysenck menunjukkan bahwa 40% dari responden memiliki kecenderungan neurotik atau gangguan kecemasan dan 65% cenderung memiliki kepribadian introvert.Kesimpulan: Mayoritas tipe kepribadian dari komunitas LSL dan transgender adalah kepribadian introvert dan linier dengan kecenderungan depresi. Pengenalan tipe kepribadian dan status kesehatan mental sedini mungkin dapat bermanfaat untuk mencegah adanya perilaku yang beresiko tinggi terhadap suatu penyakit bahkan dapat mencegah terjadinya depresi berat hingga percobaan bunuh diri.

Trends and predictors of HIV positivity and time since last test at voluntary counselling and testing encounters among adults in Kilifi, Kenya, 2006-2017

Background: Little is known about HIV retesting uptake among key populations (KP) and general populations (GP) in Kenya. We assessed trends and predictors of first-time testing (FTT), late retesting (previous test more than one year ago for GP or three months for KP), and test positivity at three voluntary counselling and testing (VCT) centres in coastal Kenya. Methods: Routine VCT data covering 2006-2017 was collected from three VCT centres in Kilifi County. We analysed HIV testing history and test results from encounters among adults 18-39 years, categorized as GP men, GP women, men who have sex with men (MSM), and female sex workers (FSW). Results: Based on 24,728 test encounters (32% FTT), we observed declines in HIV positivity (proportion of encounters where the result was positive) among GP men, GP women, first-time testers and MSM but not among FSW. The proportion of encounters for FTT and late retesting decreased for both GP and KP but remained much higher in KP than GP. HIV positivity was higher at FTT and late retesting encounters; at FSW and MSM encounters; and at encounters with clients reporting lower educational attainment and sexually transmitted infection (STI) symptoms. HIV positivity was lower in GP men, never married clients and those less than 35 years of age. FTT was associated with town, risk group, age 18-24 years, never-married status, low educational attainment, and STI symptoms. Late retesting was less common among encounters with GP individuals who were never married, had Muslim or no religious affiliation, had lower educational attainment, or reported STI symptoms. Conclusions: HIV positive test results were most common at encounters with first-time testers and late re-testers. While the proportion of encounters at which late retesting was reported decreased steadily over the period reviewed, efforts are needed to increase retesting among the most at-risk populations.

High prevalence and incidence of human immunodeficiency virus 1 among men who have sex with men at the voluntary counselling and testing center in Northeast Brazil

The human immunodeficiency virus (HIV) Brazil epidemic had shown an increase in heterosexual transmission and decrease in vertical transmission. However, its incidence has increased among men who have sex with men. Serological screening of patients at a voluntary counselling and testing center in Cabo de Santo Agostinho city, Pernambuco province, Northeast Brazil, was performed to determine the HIV-1 prevalence and incidence. The HIV-1 incidence in the frozen serum aliquots obtained from 2006-2009 was determined using BED-capture enzyme immunoassay. This study evaluated 23,862 individuals, who were serologically tested for HIV-1. HIV-1 infection was diagnosed in 318 individuals (1.33%). MSM showed a higher prevalence of infection (6.8%; 95% confidence interval [CI]: 4.9-9.5) as compared to heterosexual men (2.8%; 95% CI: 2.35-3.36) and women (0.9%; 95% CI: 0.76-1.0) (p < 0.0001). MSM also showed a higher rate of incidence with 3.93 per 100 people/year. Early diagnosis and preventive measures can reduce the pandemic spread.

Community-led HIV self-testing for men who have sex with men in Lebanon: lessons learned and impact of COVID-19

Background In Lebanon, HIV is concentrated in both native and refugee communities of men who have sex with men (MSM). For over 10 years, the National AIDS Program (NAP) has offered HIV voluntary counselling and testing through a partnership with nongovernmental organizations (NGOs). In 2018, implementation of HIV self-tests (HIVST) was introduced, and this self-care intervention has been further scaled up during the coronavirus disease 2019 (COVID-19) pandemic. This paper (1) describes the effectiveness of implementing HIVST in Lebanon, and (2) discusses how the success of HIVST implementation has been reflected during the COVID-19 pandemic. Methods The NAP conducted a series of workshops (July–November 2018) to introduce HIVST services for healthcare workers working at different NGOs. The workshops highlighted that HIVST would be distributed for free, that it would be confidential and voluntary, and that participants were encouraged to notify the NGOs of their results, which would be kept strictly confidential. NGOs collected data anonymously and confidentially from beneficiaries (age, consistency of condom use and HIV testing history), who were asked to call back with the results of their HIVST. At the NAP, data were combined, aggregated and analysed. Results In 2019, the NGOs distributed 1103/1380 (79.9%) HIVST kits to their beneficiaries. The NGOs collected feedback on 111 kit results, of which two were HIV-positive. Feedback about HIVST results from beneficiaries was low (111/1103) due to noncompliance of beneficiaries and the lack of human and financial resources in the NGOs. From January through May 2020, a total of 625/780 HIVST kits (80.1%) were distributed. This period was divided into pre-COVID-19 and during COVID-19. The follow-up with the beneficiaries during COVID-19 was much improved because of the absence of on-site activities, shifting more efforts towards HIVST (449/625). There have been no reports of social harm related to HIVST. Conclusion HIVST implementation in Lebanon serves as an example of introducing a self-care intervention as part of a community-led effort. In order to maintain HIVST services at the same improved level, reorganization of care is needed within each NGO following the adaptation process due to COVID-19, along with continuous monitoring and evaluation of HIVST reported data.