Bottleneck Analysis Cakupan Terapi Antiretroviral pada Orang dengan HIV (ODHIV) di Puskesmas Teladan Tahun 2024

Abstract

HIV can be likened to an "iceberg phenomenon" because many aspects of this problem are not immediately visible. Teladan Public Health Center ranks second highest in new HIV positive cases in 2023 of all public health centers in Medan City. This research aims to analyze bottleneck of antiretroviral therapy coverage in people living with HIV (PLHIV) at Teladan Public Health Center. The research method used is evaluative research by analysis bottleneck uses the Tanahashi model, which includes eight indicators: drug availability, facilities and infrastructure, human resources, accessibility, acceptability, first contact, ongoing contact, and service quality. The research results show that the indicators for drug availability: drugs are met but some drugs are approaching expiration; indicators of availability of facilities and infrastructure: counseling room lacks privacy; indicators of human resource availability: lack of counselors; accessibility indicator: none bottleneck; acceptability indicators: high levels of stigma and discrimination against PLHIV; first contact indicator: 73.02% of PLHIV know the status of the target 95%; continuous contact indicators: 61.06% of PLHIV on ART from the target of 95% and LFU of 18%; quality indicator: 90% suppressed viral load, has not reached the target of 95% due to inhibiting factors on the side supply and demand. The conclusion of this research is that there are bottleneck on each indicator, except accessibility. Various bottlenecks in ARV therapy coverage need to be overcome through increasing monitoring of drug stocks, improving infrastructure, meeting human resource needs, anti-stigma education, optimizing counseling, continuous psychological support to ensure improved service quality and optimal coverage of ARV therapy at Teladan Public Health Center