PMID: 19920304Jul 1, 2009Paper

Behavioral aspects of HIV prevention and care in Indonesia: A plea for a multi-disciplinary, theory- and evidence-based approach

Acta Medica Indonesiana
Elmira N SumintardjaHarm J Hospers

Abstract

Projections estimate 1,000,000 HIV infected by 2015 in Indonesia. Key behaviors to HIV prevention and care are determined by a complex set of individual/ environmental factors. This paper presents empirical data, local evidence and theoretical concepts to determine the role of social sciences in HIV prevention/care. Injecting Drug Use (IDU) is a social and very risky activity: 95% injected in the presence of peers and 49% reported needles sharing. 82% of IDUs do not use condoms consistently. Poor adherence to ARV treatment is related to a complex set of, mostly behavioral, factors beyond effective influence by standard professional skills of medical staff. Meta-analysis indicated that about 1/3 of the variance in behaviour can be explained by the combined effect of intention and perceived behavioral control, the two cornerstones of the Theory of Planned Behavior (TPB). It is advisable to adapt TPB in the light of the Indonesian context. Current theories of behavior and behavior change give professionals of all disciplines, working in HIV prevention and care, effective tools to change behavior and to improve HIV prevention and access and quality of HIV care.

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