IMPLEMENTASI PROGRAM PRE-EXPOSURE PROPHYLAXIS (PrEP) UNTUK PENCEGAHAN DAN PENANGGULANGAN HIV/AIDS DI PUSKESMAS GEDONGTENGEN KOTA YOGYAKARTA
Purnama Dewi Siregar, Dr. Dra. Retna Siwi Padmawati, M.A ; dr. Amirah Ellyza Wahdi, MSPH
2025 | Tesis | S2 Ilmu Kesehatan Masyarakat
Latar Belakang: Profilaksis pra-pajanan (PrEP)
merupakan program pencegahan HIV bagi populasi berisiko. Puskesmas
Gedongtengen, sebagai percontohan pertama pemberi layanan PrEP di Kota
Yogyakarta, menunjukkan tingkat keberlanjutan pasien yang rendah, dengan hanya
16,3% pasien yang melanjutkan penggunaan hingga bulan ketiga dan 5,9% hingga
bulan ke-12. Penelitian ini berfokus untuk mengeksplorasi implementasi program
PrEP untuk pencegahan dan penanggulangan HIV/AIDS di Puskesmas Gedongtengen
Kota Yogyakarta dengan menggunakan kerja kerja RE-AIM. Metode: Penelitian
ini adalah studi kualitatif dengan pendekatan studi kasus. Informan dipilih secara
purposive sesuai kriteria inklusi. Data dikumpulkan melalui wawancara mendalam,
observasi, dan telaah dokumen, kemudian dianalisis menggunakan framework
analysis dengan bantuan NVivo 12.
Hasil: Jangkauan:
Program PrEP di Puskesmas Gedongtengen didukung oleh kolaborasi dengan
LSM dan penggunaan media sosial untuk menyasar populasi berisiko tinggi, namun
penjangkauan terhadap populasi kunci dan kelompok berisiko belum optimal. Efektivitas: Program
PrEP di Puskesmas Gedongtengen belum sepenuhnya efektif. Efektivitas program
hanya terlihat pada tahap awal melalui pencegahan HIV, peningkatan layanan, dan
jumlah pasien baru, namun program tidak efektif pada tahap lanjutan seperti rendahnya
kepatuhan, penghentian penggunaan, dan keberlanjutan layanan. Hambatan utama
meliputi persepsi keliru pasien, rendahnya penggunaan kondom, efek samping, dan
keterbatasan stok obat. Adopsi: Meskipun program PrEP
di Puskesmas Gedongtengen memiliki potensi untuk diadopsi dengan baik, biaya
retribusi awal sebelum mengakses layanan menjadi hambatan utama. Implementasi:
Pelaksanaan program PrEP di Puskesmas Gedongtengen diperkuat dengan
pengembangan kapasitas SDM melalui pelatihan Training of Trainers. Pemeliharaan:
Keberlanjutan
program PrEP bergantung pada tindak lanjut yang dilakukan oleh pemangku
kepentingan di berbagai tingkat.
Kesimpulan:
Program PrEP di Puskesmas Gedongtengen berkontribusi pada upaya
pencegahan HIV/AIDS di Kota Yogyakarta. Namun, implementasinya belum sepenuhnya
komprehensif dan menghadapi tantangan pada aspek adopsi, jangkauan, dan
pemeliharaan. Diperlukan penguatan strategi kolaboratif, peningkatan literasi
pasien, dan dukungan kebijakan untuk menjamin keberlanjutan program.
Kata Kunci: PrEP, implementasi program, kerangka
kerja RE-AIM, puskesmas
Background: Pre-Exposure Prophylaxis (PrEP) is an HIV prevention program targeted at high-risk populations. Indonesia is currently in the stage of implementing and scaling up PrEP usage. Gedongtengen Community Health Center (Puskesmas Gedongtengen) is one of the health facilities providing PrEP services and serves as the first community health center piloting the PrEP program in Yogyakarta. Preliminary studies indicate a decline in PrEP service visits at Gedongtengen Community Health Center over quarterly (3-month) and annual (12-month) periods. Therefore, it is necessary to understand the sustainable and comprehensive implementation of PrEP services using the RE-AIM framework. This study aims to explore the implementation of the Pre-Exposure Prophylaxis (PrEP) program for HIV/AIDS prevention and control at Gedongtengen Community Health Center, Yogyakarta. Methods: This study is qualitative research with a case study approach. Informants were selected purposively based on predefined inclusion criteria. Data were collected through in depth interviews, observation, and document review, then analyzed using a framework analysis with the assistance of NVivo 12.
Results: Reach: The PrEP program at Gedongtengen Primary Health Center collaborated with NGOs and utilized social media to reach high-risk populations; however, outreach to key groups remained suboptimal. Effectiveness: The PrEP program at Gedongtengen Primary Health Center has not been fully effective. Its effectiveness was only evident in the initial phase through HIV prevention, improved service delivery, and an increase in new patients. However, the program was less effective in the later stages, as reflected by low adherence, discontinuation of use, and limited service sustainability. Key barriers included patients’ misconceptions, low condom use, side effects, and limited drug availability. Adoption: Although the PrEP program at Gedongtengen Health Center has the potential to be well adopted, the initial service fee before accessing the program becomes a major barrier. Implementation: The program’s implementation was strengthened by building human resource capacity through Training of Trainers. Maintenance: The sustainability of the PrEP program depended on the follow-up actions and support provided by stakeholders at multiple levels.
Conclusion: The PrEP program at Gedongtengen Primary Health Center supports HIV/AIDS prevention in Yogyakarta City but remains incomplete, facing challenges in adoption, reach, and sustainability. Stronger collaboration, improved patient literacy, and stable policy and funding support are needed to ensure its continuity.
Keywords: PrEP, program implementation, RE-AIM framework, primary health center
Kata Kunci : Kata Kunci: PrEP, implementasi program, kerangka kerja RE-AIM, puskesmas/Keywords: PrEP, program implementation, RE-AIM framework, primary health center
