PENGALAMAN PENGGUNAAN PRE-EXPOSURE PROPHYLAXIS (PREP) BERDASARKAN TEORI TRANSTEORITIKAL MODEL (TTM) PADA LSL DI KOTA TANGERANG
DOI:
https://doi.org/10.15408/jrph.v7i1.44985Abstract
Pre-Exposure Prophylaxis (PrEP) is an effective method for preventing Human Immunodeficiency Virus (HIV) among Men Sex Men (MSM), but its uptake in Tangerang City remains low. This study explores the experiences of MSM using PrEP based on the Transtheoretical Model (TTM) in Tangerang City. Conducted from January to June 2024, this descriptive qualitative research involved three key informants and two supporting informants from healthcare and community services, selected purposively. Content analysis was employed to examine the TTM stages: precontemplation, contemplation, preparation, action, and maintenance. In the precontemplation stage, MSM continue risky sexual behaviors despite recognizing HIV risks. During contemplation, they demonstrate good knowledge about HIV and PrEP and express a strong intention to start PrEP. The preparation stage underscores the importance of community and healthcare support in initiating PrEP. In the action stage, many MSM face side effects like nausea and dizziness. In the maintenance stage, despite awareness and support, side effects, boredom, and the belief of reduced risk lead MSM to discontinue PrEP. All informants experienced the five TTM stages, but two of three discontinued PrEP at the maintenance stage. Intensive initial support is crucial to manage side effects and ensure adherence to PrEP.
Keywords: HIV, MSM, PrEP
References
PUSDATIN KEMENKES RI. Infodatin HIV. Jakarta: Kementerian Kesehatan RI Pusat Data dan Infoemasi; 2020. 1–66 p.
World Health Organization. www.who.int. 2023 [cited 2023 Jul 3]. Data on the size of the HIV epidemic. Available from: https://www.who.int/data/gho/data/themes/hiv-aids/data-on-the-size-of-the-hiv-aids-epidemic
Ditjen P2P. Laporan Tahunan HIV AIDS 2022 Kemenkes [Internet]. Jakarta: Direktorat Jenderal Pencegahan dan Pengendalian Penyakit Kementerian Kesehatan RI; 2023. 1–91 p. Available from: http://p2p.kemkes.go.id/wp-content/uploads/2023/06/FINAL_6072023_Layout_HIVAIDS-1.pdf
Kemenkes RI. Petunjuk Teknis Tatalaksana Program Profilaksis Pra-Pajanan (Prep) Oral Untuk Orang Berisiko Tinggi Terinfeksi Hiv di Indonesia. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023.
World Health Organization. Guideline on When To Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV. 2015;(September):1–76.
Weir BW, Wirtz AL, Chemnasiri T, Baral SD, Decker M, Dun C, et al. High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study. Lancet Reg Heal - Southeast Asia. 2023;15(May):1–13.
Peng L, Cao W, Gu J, Hao C, Li J, Wei D, et al. Willingness to use and adhere to HIV pre-exposure prophylaxis (Prep) among men who have sex with men (msm) in china. Int J Environ Res Public Health. 2019;16(14).
Mueses-Marín HF, Alvarado-Llano B, Torres-Isasiga J, Camargo-Plazas P, Bolívar-Rocha MC, Galindo-Orrego X, et al. Scales to Assess Knowledge, Motivation, and Self-Efficacy for HIV PrEP in Colombian MSM: PrEP-COL Study. AIDS Res Treat. 2021;2021.
Songtaweesin WN, LeGrand S, Bandara S, Piccone C, Wongharn P, Moonwong J, et al. Adaptation of a theory-based social networking and gamified app-based intervention to improve pre-exposure prophylaxis adherence among young men who have sex with men in bangkok, thailand: Qualitative study. J Med Internet Res. 2021;23(11).
UNAIDS. IN DANGER: UNAIDS Global AIDS Update 2022. Geneva: Joint United Nations Programme on HIV/ AIDS; 2022. 1–376 p.
Spiritia. Daftar Layanan PrEP di Indonesia [Internet]. 2024 [cited 2024 Jan 2]. Available from: https://spiritia.or.id/layananprep
PrEP Indonesia. prepid.org. 2024 [cited 2024 Jan 11]. Laporan PrEP Kota Tangerang. Available from: https://app.prepid.org/dashboard
Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini A, Daei A. Transtheoretical model of health behavioral change: A systematic review. Iran J Nurs Midwifery Res. 2019;24(2):83–90.
Jambak N, Febrina W, Wahyuni A. FAKTOR-FAKTOR YANG MEMPENGARUHI PERUBAHAN PERILAKUPASIEN HIV/AIDS. Hum Care J. 2018;1(2).
Anurmalasari R. Hubungan Antara Pemahaman Tentang HIV / AIDS dengan Kecemasan Tertular HIV / AIDS Pada WPS ( Wanita Penjaja Seks ) Langsung di Cilacap. 2010;1–19. Available from: https://api.semanticscholar.org/CorpusID:141324175
Siddharthan, Selvaraj, Naing, Nyi, Ramakrishnappa, Sowmya, et al. Transtheoretical Model of Behavioural Change. 2021;13:344–7.
Boonroungrut C, Fei H. The Theory of Planned Behavior and Transtheoretical Model of Change: a systematic review on combining two behavioral change theories in research. J Public Heal Dev. 2014;16(1):151–9.
Vigliotti V, Taggart T, Walker M, Kusmastuti S, Ransome Y. Religion, faith, and spirituality influences on HIV prevention activities: A scoping review. PLoS One [Internet]. 2020;15(6):1–20. Available from: http://dx.doi.org/10.1371/journal.pone.0234720
Orser L, O’Byrne P, Holmes D. Perceptions, motivations, and beliefs about HIV risk and pre-exposure prophylaxis (PrEP) among participants in a nurse-led PrEP service (PrEP-RN). BMC Infect Dis [Internet]. 2022;22(1):1–11. Available from: https://doi.org/10.1186/s12879-022-07146-3
Hulstein SHM, Matser AP, van der Loeff MFSP, Hoornenborg EP, Prins MP, de Vries HJCP. Eligibility for HIV Preexposure Prophylaxis, Intention to Use Preexposure Prophylaxis, and Informal Use of Preexposure Prophylaxis Among Men Who Have Sex With Men in Amsterdam, the Netherlands. Sex Transm Dis [Internet]. 2021;2:86–93. Available from: https://journals.lww.com/stdjournal/fulltext/2021/02000/eligibility_for_hiv_preexposure_prophylaxis,.3.aspx
Bil JP., Davidovich U, van der Veldt WM., Prins, Mariaa B, de Vries, Henry J.C.b, c D, Sonder, Gerard J.B.e F, et al. What do Dutch MSM think of preexposure prophylaxis to prevent HIV-infection? A cross-sectional study. AIDS Epidemiol Soc. 2015;29(8):955–64.
Gamarel KE, Golub SA. Intimacy Motivations and Pre-exposure Prophylaxis (PrEP) Adoption Intentions Among HIV-Negative Men Who Have Sex with Men (MSM) in Romantic Relationships. Ann Behav Med. 2015;49(2):177–86.
Lee JJ, Barry M, Kerani R, Sanchez THD, Katz DA. The Pre-exposure Prophylaxis (PrEP) Care Continuum Among English-Speaking Latino Sexual Minority Men in the United States (2014–2020). JAIDS J Acquir Immune Defic Syndr. 2023;3(93):199–207.
Hojilla JC, Vlahov D, Crouch PC, Dawson-Rose C, Freeborn K, Carrico A. HIV Pre-exposure Prophylaxis (PrEP) Uptake and Retention Among Men Who Have Sex with Men in a Community-Based Sexual Health Clinic. AIDS Behav. 2017;22:1096–9.
Patel RR, Mena L, Nunn A, McBride T, Harrison LC, Oldenburg CE, et al. Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention. PLoS One. 2017;12(5):1–7.
Jenness SM, Weiss KM, Goodreau SM, Gift T, Chesson H, Hoover KW, et al. Incidence of gonorrhea and chlamydia following human immunodeficiency virus preexposure prophylaxis among men who have sex with men: A modeling study. Clin Infect Dis. 2017;65(5):712–8.
Serota DP, Rosenberg ES, Lockard AM, Rolle CPM, Luisi N, Cutro S, et al. Beyond the Biomedical: Preexposure Prophylaxis Failures in a Cohort of Young Black Men Who Have Sex with Men in Atlanta, Georgia. Clin Infect Dis. 2018;67(6):965–70.
Richards et al. The Role of Healthcare Providers in the Roll-Out of PrEP. Physiol Behav. 2018;176(5):139–48.
Rusie LK, Orengo C, Burrell D, Ramachandran A, Houlberg M, Keglovitz K, et al. Preexposure prophylaxis initiation and retention in care over 5 Years, 2012-2017: Are quarterly visits too much? Clin Infect Dis. 2018;67(2):283–7.
Ranjit YS, Dubov A, Polonsky M, Fraenkel L, Ogunbajo A, Mayer K, et al. Pre-exposure Prophylaxis Among Men Who have Sex with Men: Dual Motivational Model of Intention to Use Pre-exposure Prophylaxis. AIDS Behav [Internet]. 2019;23(2):534–43. Available from: https://doi.org/10.1007/s10461-018-2214-2
Matthews LT, Baeten JM, Celum C, Bangsberg DR. Periconception pre-exposure prophylaxis to prevent HIV transmission: benefits, risks, and challenges to implementation. AIDS. 2010;24(13):1975–82.
