Study on HIV-AIDS Prevention in Kendari City

As the capital of Southeast Sulawesi Province, Kendari City experiences high population mobility and has recorded a continued increase in HIV/AIDS cases over the past six years, despite the enactment of Regional Regulation No. 7 of 2017 and Regional Regulation No. 19 of 2014 concerning infectious disease control and HIV/AIDS management. This policy paper aims to formulate strategies to accelerate the initiation of antiretroviral therapy (ART) among people living with HIV (PLHIV), locally referred to as Orang dengan HIV (ODHIV), in Kendari City through problem identification, root cause analysis, and policy option assessment. The prioritization of problems using the Urgency, Seriousness, and Growth (USG) method revealed that the primary challenge was the suboptimal identification of PLHIV and their subsequent linkage to treatment under the Test and Treat approach. Root cause analysis using Failure Mode and Effects Analysis (FMEA) identified two priority issues: the absence of systematic anti-stigma regulations and community education programs, and disparities in the competencies of counselors providing HIV care, support, and treatment (Perawatan, Dukungan, dan Pengobatan [PDP]). Four policy alternatives were evaluated using Multi-Criteria Decision Analysis (MCDA) based on five criteria: effectiveness, budget efficiency, administrative feasibility, stakeholder support, and speed of impact. The assessment findings supported an integrated policy approach encompassing stronger anti-stigma regulations and community education, equitable capacity building for PDP counselors, integrated service delivery through a one-stop service model, and enhanced interoperability of the HIV/AIDS Information System (Sistem Informasi HIV/AIDS [SIHA]).