All study participants that received intervention and meet inclusion criteria intervention that will be offered OFT

All HIV Patients in the clinic that not received any intervention

All study participants that received intervention and meet inclusion criteria intervention that will be offered SAI

All patients coming to brothel or Community Based Organization services will be offered to get tested and received ART

All patients that recently found HIV Positive "HIV Naive" offered to get SMS Reminder

PWID in Jakarta and Bandung that recently found HIV Positive or lost to follow up ARV offered MI intervention

HIV/AIDS

The intervention will introduce provider supervised and unsupervised self-testing as an option for early HIV diagnosis among MSM community in Denpasar Bali Indonesia.

Oral Fluid Based Self Testing

In this intervention, there will be a change in the clinical practice of ART initiation. In the current practice, clients are asked to perform full pre-ART laboratory examination (complete blood count, liver and renal function tests) before decision of ART initiation. In this intervention, the study participants who are already confirmed as HIV positive and meet specific clinical criteria (see below) will initiate ART (antiretroviral therapy) immediately (after clients' approval) without having to perform full pre-ART laboratory examination. Here, laboratory criteria for initiating ART will be simplified and specific laboratory examination, I.e. creatinine test will be delayed in two weeks after ART initiation.

Simplified ART Initiation

The CBOs involved in this intervention are Kebaya and Vesta. Kebaya is an CBO working for Transgender (TG) community. It serves as community gathering place for TG and others, as HIV testing site on regular bases, and also as shelter for homeless HIV patients. The proposed intervention Is that HATI Project will provide HIV testing and treatment in the community, CBO and brothel in collaboration with nearby Puskesmas.

CBO AND BROTHEL-BASED ART SERVICE

HATI SMS reminder: short message services as reminders to inform ART patients when to take medication, visit the clinics (1 week before the next visit) and remind if they miss clinic appointment.

SMS REMINDER

The approach used in this intervention is an individual counselling with a MI approach, as it is considered a brief form of therapy have been known to be effective in improving HIV treatment adherence.
The sessions will be held from 3 to up to 10 MI counselling over 6-month period of intervention. The goal of this intervention is to help PWID gain an understanding of their medication-taking behaviors and the actions necessary to successfully maintain a high level of adherence

MOTIVATIONAL INTERVIEWING

Yayasan Kerti Praja

Dr. Sardjito Hospital, Yogyakarta Indonesia

Atma Jaya HIV-AIDS Research Centre

Hasan Sadikin Hospital, Bandung, Indonesia

HIV Awal (Early) Testing & Treatment Indonesia Project Intervention Phase

HIV Awal (Early) Testing & Treatment Indonesia Project Implementing 'Test and Treat' Strategies for HIV Treatment and Prevention in Key Populations in Indonesia: a Prospective Implementation Research Study (Intervention Phase)

Proportion of people from each key population who are virologically suppressed 12 months after HIV diagnosis. Analyses will be conducted separately for each key affected population

To quantify and compare other components of the HIV treatment cascade/continuum of care, including
Uptake of HIV testing and retesting
Clinical and immunological stage at time of HIV diagnosis
Uptake of ART and time to initiation of treatment
ART adherence and retention in care

To assess the safety and acceptability of early ART initiation, including :
ART toxicity
Short term incidence of AIDS and mortality in those who do and do not initiate ART
Proportion failing on first-line ART by virological criteria
Emergence of resistance mutations in those failing first-line ART
For those who decline immediate ART, reasons for refusal and barriers to initiation of ART

To assess behavioural aspects of a T&T strategy, including :
Impact of ART initiation on risk behaviour
Impact of enhanced community-based intervention package on risk behaviour

Total number of virologically suppressed individuals from each key affected population

sabine/vərəm

HIV Awal (Early) Testing & Treatment Indonesia Project Intervention Phase

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