Voluntary HIV testing, disclosure, and stigma among injection drug users in Bali, Indonesia

• Published in: AIDS education and prevention 2004-12, Vol.16 (6), p.487-498
• Main Authors: FORD, Kathleen, WIRAWAN, Dewa Nyoman, GUSTI MADE SUMANTERA, ANAK AGUNG SAGUNG SAWITRI, STAHRE, Mandy
• Format: Article
• Language: English
• Subjects: Acquired Immune Deficiency Syndrome; Adult; AIDS; Bali; Beliefs; Biological and medical sciences; Constraints; Counselor Characteristics; Disclosure; Drug Injection; Drug Therapy; Drug use; Fear; Female; Females; Gender Differences; Gender Discrimination; Health Care Services; Health education; Health Knowledge, Attitudes, Practice; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Indonesia - epidemiology; Infectious diseases; Injection; Injections; Male; Medical sciences; Narcotics; Patient Acceptance of Health Care - psychology; Pregnancy; Prevention; Self Disclosure; Sexual behavior; Sexually transmitted diseases; Side effects; STD; Stereotyping; Stigma; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - psychology; Surveys and Questionnaires; Test Results; Testing Problems; Tests; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 0899-9546; 1943-2755
• DOI: 10.1521/aeap.16.6.487.53789

Recently, large increases have been noted in injection drug use and HIV prevalence in Indonesia. Because voluntary HIV counseling and testing can play an important role in HIV prevention, it is important to understand factors related to its use. The objective of this study was to identify factors related to the use of voluntary HIV testing among drug users. In-depth interviews were conducted with a sample of 40 drug users in the Denpasar area of Bali, Indonesia. Drug users may be interested in testing if they have enough information about AIDS to know that they are at risk and that they need this information to protect themselves and others from infection. Barriers toward testing included the fear of a positive result, fear of reactions from family and community members and stigmatization. Other obstacles include a feeling of hopelessness, problems with testing, unavailability and side effects of AIDS drugs and other factors. Many persons would not disclose their status to community members and sexual partners. There were serious concerns about others being ashamed of them and the impact of HIV on relationships with spouses and sexual partners and on employment.