Understanding reasons for lack of acceptance of HIV programs among indigenous Papuans: a qualitative study in Indonesia
Elfride Irawati Sianturi
A * , Elmiawati Latifah B , Sitti N. Soltief C D , Robert B. Sihombing D , Eva S. Simaremare A , Christiantie Effendy E , Ari Probandari F , Sri Suryawati G and Katja Taxis H
A Faculty of Mathematics and Natural Sciences Universitas Cenderawasih, Jayapura, Papua, Indonesia.
B Department of Pharmacy, Faculty of Health Science, Universitas Muhammadiyah Magelang, Magelang, Indonesia.
C Voluntary and Counselling, and Testing Clinic (VCT), Jayapura Public Hospital, Indonesia.
D Perhimpunan Konselor VCT-HIV (PKVHI), Jayapura, Indonesia.
E Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
F Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia.
G Department of Pharmacology and Therapeutics, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
H Pharmaco-Therapy, Epidemiology and Economics (PTEE) Department of Pharmacy, University of Groningen, Groningen, the Netherlands.
Sexual Health 19(4) 367-375 https://doi.org/10.1071/SH21206
Submitted: 15 October 2021 Accepted: 4 May 2022 Published: 23 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Melanesians are indigenous Papuans racially and culturally different from most Indonesians. The Melanesia region is characterised by high poverty and inequalities, even though it has the highest revenue. Furthermore, Papua has the highest HIV prevalence rate, 24-fold higher than that of other regions. Therefore, this study aimed to examine the resistance of indigenous people residing in eastern Indonesia towards HIV programs.
Methods: This is a qualitative study analysed using grounded theory. Data were collected from July to September 2018 through semi-structured face-to-face interviews involving 23 Papuans. The interviews were conducted in Bahasa Indonesia, audio-recorded, summarised and transcribed for analysis.
Results: The results showed that being a good Papuan emerges from four interconnected categories, including culture and religion, dealing with modernisation, integrated HIV program and stigma reduction. As a substantive theory underpinning the indigenous people’s experiences with HIV programs, ‘Keep being a good Papuan’ was a way of overcoming problems and dealing with modernism to eliminate HIV. This largely focuses on the local culture, implying any adjustment should keep their tradition and welcome modernism.
Conclusions: The future of the HIV programs should be agreed upon, funded, implemented, measured and achieved by stakeholders. This could be achieved by elaborating a supportive culture and community-based interventions. Furthermore, the implementation should be prioritised to integrate and improve the programs’ quality to take into account community needs and the available resources.
Keywords: behaviour changes, HIV/AIDS, indigenous people, Indonesia, integrated, modernisation, Papuan, stigma.
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