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Abstract

Men who have sex with men (MSM) are a key population contributing to the largest proportion of new HIV infections among the adult population in Indonesia, accounting for 44% of new infections in 2024. However, antiretroviral therapy (ART), as a key intervention in HIV control, remains suboptimal among this group, with previous studies showing that only around 57% of MSM living with HIV in Indonesia were receiving ART. In urban settings such as Greater Jakarta, these gaps may be more pronounced due to complex social and structural barriers to care. This study used a cross-sectional design based on data from the 2023 Integrated Biological and Behavioral Survey (IBBS). The sample included MSM respondents from seven cities/districts in Greater Jakarta with biologically confirmed HIV-positive results. Data were analyzed using univariate, bivariate, and multivariable approaches, with crude and adjusted prevalence ratios estimated using Cox regression with a constant time approach. Among the 505 respondents, 63.96% were not on ART. In the multivariable analysis, the factors significantly associated with not being on ART among MSM were poor knowledge about ART benefits (aPR = 1.36, 95% CI: 1.06 – 1.73, p-value = 0.015) and no discussion with community workers (aPR = 1.33, 95% CI: 1.05 – 1.69, p-value = 0.016). Improving treatment literacy and strengthening community-based engagement are essential to ensure that MSM have adequate knowledge about ART and can access HIV treatment services. These findings highlight the need for targeted interventions to improve ART uptake and reduce treatment gaps among MSM in high-burden urban settings.

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Bahasa Abstract

Lelaki yang berhubungan seks dengan lelaki (LSL) merupakan populasi kunci yang berkontribusi terhadap jumlah terbesar infeksi HIV baru pada populasi dewasa di Indonesia, yaitu sebesar 44% pada tahun 2024. Namun, pengobatan antiretroviral (ARV), sebagai intervensi utama dalam pengendalian HIV, masih belum optimal pada kelompok ini, dengan penelitian sebelumnya menunjukkan bahwa hanya sekitar 57% LSL dengan HIV yang menjalani pengobatan ARV di Indonesia. Di wilayah perkotaan seperti Jakarta Raya, kesenjangan ini dapat menjadi lebih nyata akibat hambatan sosial dan struktural yang kompleks dalam akses layanan. Penelitian ini menggunakan desain potong lintang berdasarkan data dari Survei Terpadu Biologis dan Perilaku (STBP) tahun 2023. Sampel mencakup responden LSL dari tujuh kota/kabupaten di wilayah Jakarta Raya dengan hasil HIV positif yang dikonfirmasi secara biologis. Data dianalisis secara univariat, bivariat, dan multivariat, dengan crude dan adjusted prevalence ratio diestimasi menggunakan regresi Cox dengan pendekatan waktu konstan. Dari 505 responden, 63,96% tidak menjalani terapi ARV. Pada analisis multivariat, faktor berhubungan signifikan dengan tidak menjalani ARV pada LSL adalah pengetahuan tentang manfaat ARV yang kurang (aPR = 1,36; 95% CI: 1,06 – 1,73; p-value = 0,015) dan tidak berdiskusi dengan petugas komunitas (aPR = 1,33; 95% CI: 1,05 – 1,69; p-value = 0,016). Peningkatan literasi tentang pengobatan dan penguatan keterlibatan berbasis komunitas sangat penting untuk memastikan bahwa LSL memiliki pengetahuan yang memadai tentang ARV dan dapat mengakses layanan pengobatan HIV. Temuan ini menekankan perlunya intervensi yang terarah untuk meningkatkan cakupan ARV dan mengurangi kesenjangan pengobatan pada LSL di wilayah perkotaan dengan beban HIV yang tinggi.

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