Challenges and social support provisions in the treatment of HIV infected children in Indonesia
Abstract
Latar belakang: Pengobatan pada anak yang terinfeksi HIV merupakan beban bagi para orang tua/pengasuh karena berbagai permasalahan menyangkut kesehatan mereka.
Metode: Penelitian untuk mengeksplorasi pengalaman dan dukungan sosial pada pengobatan anak terinfeksi HIV dilakukan di 5 provinsi di Indonesia dengan prevalensi HIV tertinggi. Total sampel anak sebanyak 239 orang dari sejumlah 267 orang yang direncanakan. Data dikumpulkan dengan wawancara semi terstruktur dengan orang tua/pengasuhnya. Analisis dilakukan terhadap 16 anak berusia 2-14 tahun yang telah mendapatkan terapi obat antiretroviral.
Hasil: Dari sejumlah 160 anak, sebanyak 62,5% anak mengkonsumsi 1-2 item obat dan 36,9% mengkonsumsi 3 5 item. Efek samping yang paling sering terjadi adalah kulit kemerahan, mual dan muntah. Kesulitan yang paling sering dihadapi adalah rasa bosan dan anak mempertanyakan minum obat. Orangtua/pengasuh berusaha melanjutkan pengobatan dengan mengingatkan jadwal minum obat, membujuk, memberikan penjelasan bahkan memaksa atau mengancam mereka untuk minum obat. Kesulitan tersebut makin bertambah seiring meningkatnya usia anak. Dukungan yang paling sering berasal dari orang tua dan keluarga besar seperti nenek atau paman, khususnya untuk anak yang sudah yatim.
Kesimpulan: Pemahaman hambatan pengobatan pada anak terinfeksi HIV dapat membantu untuk menyediakan intervensi yang tepat untuk meningkatkan kepatuhan yang akan mendorong kesuksesan terapi mereka.
Kata kunci: anak terinfeksi HIV, antiretroviral, dukungan social, pengobatan, kesulitan
Abstract
Background: The treatment of HIV infected children is a burden to their caregiver due to many existing problems related with their health.
Methods: A research to explore the experience and social support on the treatment of HIV infected children was conducted in 5 provinces in Indonesia with highest prevalence of HIV. Total children sample was 239 out of previous 267 planned. Data was collected through semi structured interview with caregivers of the children. Analysis was conducted to 160 children aged 2-14 years old who were on antiretroviral therapy.
Results: Among those 160 children, 62.5% took 1-2 items of medicines and 36.9% took 3-5 items. The most frequent adverse events were skin rash followed by nausea and vomiting. Boredom and questioning were the most frequent difficulties. The caregivers attempted to continue the treatment by reminding the children on schedule to take medicines, wheedling, explaining, forcing or even threatening them. The difficulties appeared more as the children grew older. The most frequent supports mainly came from parents, and extended family such as grandmother or uncle especially for orphaned children.
Conclusion: Understanding obstacles in HIV infected children will help to do proper interventions to improve adherence that will lead to successful therapy.
Keywords: HIV infected children, antiretroviral, social support, treatment, difficulties
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