HIV/AIDS Services at Padang City Community Health Centers: A Qualitative Study of Voluntary Counseling and Testing (VCT)
Abstract
Indonesia is estimated to have approximately 570,000 people living with HIV (PLHIV). However, only 31% have accessed antiretroviral therapy (ART), and 14% have achieved viral suppression. Padang City is the city with the highest number of new HIV/AIDS cases in West Sumatra over the past four years. The number of cases was 225, 227, 286, and 333 in 2020, 2021, 2022, and 2023, respectively. Although HIV testing coverage has increased, evaluating the implementation of VCT services remains important to identify barriers affecting service quality and program performance. This study aims to analyze the VCT HIV/AIDS services in several health centers in Padang City, using the input, process, and output (IPO) systems framework. A qualitative descriptive study was conducted in four Community Health Centers selected purposively based on HIV case burden, comprising two with the highest and two with the lowest numbers of cases. Participants were selected purposively based on their involvement in VCT service delivery. Data were collected through in-depth interviews, observation, documentation review, and focus group discussions, with source and method triangulation used to ensure data credibility. The results showed that VCT inputs were generally adequate. Human resources were sufficient and trained, and facilities were in good condition. However, funding was sufficient for Community Health Centers with lower case numbers but insufficient for those with higher case numbers. In terms of process, planning, implementation, and evaluation generally followed the guidelines. In terms of output, Andalas Health Center did not reach the target for examinations, while health centers with the lowest cases reached the target. In conclusion, the implementation of VCT at health centers in Padang city was generally adequate. However, funding limitations, unclear task distribution, and the failure to achieve the HIV testing target at one of the highest case health centers indicate that several aspects of service implementation still need improvement.
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