title: The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons.
abstract: Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03-1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00-1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.
authors.affiliation: Department of Health Systems Science, University of Illinois at Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL, 60612, USA. gabriel.culbert@gmail.com.|Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia. gabriel.culbert@gmail.com.|Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. gabriel.culbert@gmail.com.|Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia. gabriel.culbert@gmail.com.
authors.forename: Gabriel J
authors.initials: GJ
authors.lastname: Culbert
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.|Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Bazazi
authors.affiliation: Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
authors.forename: Agung
authors.initials: A
authors.lastname: Waluyo
authors.affiliation: Directorate General of Corrections, Indonesian Ministry of Law and Human Rights, Jakarta, Indonesia.
authors.forename: Astia
authors.initials: A
authors.lastname: Murni
authors.affiliation: Bina Nusantara University, Jakarta, Indonesia.
authors.forename: Azalia P
authors.initials: AP
authors.lastname: Muchransyah
authors.affiliation: Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
authors.forename: Mariska
authors.initials: M
authors.lastname: Iriyanti
authors.affiliation: Directorate General of Corrections, Indonesian Ministry of Law and Human Rights, Jakarta, Indonesia.
authors.lastname: Finnahari
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Maxim
authors.initials: M
authors.lastname: Polonsky
authors.affiliation: Department of Health Policy & Administration, University of Illinois at Chicago School of Public Health, Chicago, IL, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Levy
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.|Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007214:Indonesia; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D011329:Prisoners / Q000523:psychology*; D011330:Prisons; D011897:Random Allocation; D057545:Social Stigma; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Antiretroviral therapy; HIV; Indonesia; Medication attitudes; Prisons; Stigma