Facilitators to Accessibility of HIV/AIDS-Related Health Services among Transgender Women Living with HIV in Yogyakarta, Indonesia
Facilitators to Accessibility of HIV/AIDS-Related Health Services among Transgender Women Living with HIV in Yogyakarta, Indonesia
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DOI：
10.1155/2019/6045726
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发表时间：
2019-01-01
影响因子：
1.7
通讯作者：
Mwanri, Lillian
中科院分区：
文献类型：
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作者：
Fauk, Nelsensius Klau;Merry, Maria Silvia;Mwanri, Lillian
这项研究旨在探讨促进因素或有利因素，提高艾滋病毒阳性变性妇女（在印度尼西亚日惹也称为瓦里亚）获得艾滋病毒/艾滋病相关保健服务的机会（定义为能够使用的机会）。2017年12月至2018年2月进行了一项采用一对一深入访谈的定性研究。参与者是HIV阳性的瓦里亚招募使用有目的的和雪球抽样技术。采用定性研究的框架分析法对数据进行分析。研究结果显示，参与者对艾滋病毒/艾滋病的知识和艾滋病毒/艾滋病相关的卫生服务的可用性是服务可及性的促进因素。来自瓦里亚同胞的情感支持以各种方式表现出来，如亲切和关怀的关注、细心的倾听和鼓励的话语，是一种重要的社会支持，在支持瓦里亚获得服务方面发挥了作用。由瓦里亚同胞个人或联合分享与艾滋病毒/艾滋病有关的保健服务信息，并提供工具性支助，包括互相帮助从医院或社区保健中心领取抗逆转录病毒药物，在紧急情况下联系救护车，互相陪同前往保健服务设施，帮助那些没有医疗保险的人获得免费医疗服务也是社会支持，研究参与者。提供建设性反馈和肯定等评价支持是瓦里亚获得服务的另一个有利因素。调查结果表明，需要广泛传播信息，教育瓦里亚人口及其重要的其他人了解艾滋病毒/艾滋病和相关的保健服务，以提高他们对艾滋病毒/艾滋病的认识和接受艾滋病毒/艾滋病阳性者。在该国其他环境中开展教育和广泛传播这一信息，也将增加瓦里亚及其家庭和社区获得艾滋病毒/艾滋病服务的机会，解决目前存在的卫生不平等问题。调查结果还强调了在瓦里亚社区内建立瓦里亚同伴支持小组的重要性，以及瓦里亚参与艾滋病毒/艾滋病活动和方案的重要性，这可能会提高他们对艾滋病毒/艾滋病的认识，并获得与艾滋病毒/艾滋病有关的卫生服务。
The study aimed to explore facilitators or enabling factors that enhance accessibility (defined as the opportunity to be able to use) to HIV/AIDS-related health services among HIV positive transgender women, also known as Waria in Yogyakarta, Indonesia. A qualitative study employing one-on-one in-depth interviews was conducted from December 2017 to February 2018. Participants were HIV positive Waria recruited using purposive and snowball sampling techniques. Data were analysed using the framework analysis for qualitative research. The findings showed that participants' knowledge of HIV/AIDS and the availability of HIV/AIDS-related health services were enablers to the services accessibility. Emotional support from fellow Waria displayed in various ways, such as kind and caring attention, attentive listening, and encouraging words, was an important social support that played a role in supporting Waria's accessibility to the services. HIV/AIDS-related health service information shared personally or jointly by fellow Waria and instrumental support including helping each other to collect antiretroviral (ARV) from hospitals or community health centres, contacting ambulance in emergency situations, accompanying each other to health service facilities, and helping those without the health insurance to receive free health services were also the social support enabling accessibility to the services among the study participants. Appraisal support such as providing constructive feedback and affirmation was another enabling factor to Waria's accessibility to the services. The findings indicate the needs to broadly disseminate information and educate Waria populations and their significant others about HIV/AIDS and related health services to raise their awareness of HIV/AIDS and acceptance of HIV/AIDS positive individuals. Educating and broadly disseminating this information in other settings in the country will also increase accessibility to the HIV/AIDS services among Waria, their families, and communities addressing the currently existing inequities in health. The findings also reinforce the importance of the establishment of Waria peer-support groups within Waria communities and the involvement of Waria in HIV/AIDS activities and programs, which may increase their awareness of HIV/AIDS, and accessibility to HIV/AIDS-related health services.