Multiple Sexual Partners, Condom Use, and Their Associations with Hiv Infection among Man Who Have Sex with Man in Medan

Background: Human Immunodeficiency Virus (HIV) continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2017, 940 000 people died from HIV-related causes globally. There were approximately 36.9 million people living with HIV at the end of 2017 with 1.8 million people becoming newly infected in 2017 globally. Key populations are groups who are at increased risk of HIV irrespective of epidemic type or local context. They include: men who have sex with men, people who inject drugs, people in prisons and other closed settings, sex workers and their clients, and transgender people. This study aimed to examine multiple sexual partners, condom use, and their associations with HIV infection among man who have sex with man (MSM) in Medan, North Sumatera. Subjects and Method: This was a case control study conducted at puskesmas (community health centre) Teladan in Medan, North Sumatera, in May 2018. A sample of 96 MSM was selected for this study. The dependent variable HIV infection. The independent variables were multiple sexual partners and condom use. The HIV status was taken from the medical record. The other data were collected by questionnaire. The data were analyzed by a multiple logistic regression. Results: Multiple sexual partners (OR= 2.93; 95% CI= 1.25 to 6.86; p= 0.022) and no condom use (OR= 2.83; 95% CI= 1.23 to 6.52; p= 0.024) were associated with an increased risk of HIV. Conclusion: Multiple sexual partners and no condom use are associated with an increased risk of HIV. Keywords: HIV, multiple sexual partners, condom use, men who have sex with me

Hubungan Komunikasi Interpersonal Petugas Kesehatan terhadap Kepatuhan Pasien Menjalani Pengobatan TB Paru di Puskesmas Sunggal Medan Tahun 2014

Interpersonal communication is communication between two people face to face, which allows any other person reaction catch participants directly, either in verbal or nonverbal. Interpersonal communication is only consistedof two people, such us the patient and nurse, the husband and wife, teacher and student and etc. So that communicator can see the reaction given by komunikan. But the real practice interpersonal communication is often overlooked because of time belonging to the health worker. Treatment Compliance is a complete regularly and complete treatment without interrupted for at least 6 months up to 8 months. With good interpersonal communication built up between the health worker and the patients are expected to improve patient medication adherence.This research is descriptive analytic study with the purpose of analyzing the relations interpersonal communication health worker on the compliance of patients lived treatment of Pulmonary Tuberkulosis. The population in this study were all patients with Pulmonary Tuberculosis in Sunggal the Health Center and the number of samples is entire populations that as many as 42 people.Data was obtained with the interview using questionnaire were analyzed using Chi-square test at = 0.05. The results showed the frequency of adherent patients as many as 28 people (66,7%)and non-adherentmany as 14 people (33.3%). The results of statistical tests shows interpersonal communication variable aspects of openness, empathy, supportiveness and equality effect to compliance of patients lived treatment of pulmonary Tuberculosis in Medan Sunggal the Health Center. Pulmonary Tuberculosis.To the health worker advised that holds especially Pulmonary Tuberculosis program in order to always provide motivation to patients to regularly take medication at the health center

Bpjs Barrier to Strategic Purchasing of Primary Care Service at Public and Private Health Facilities in Subulussalam, Aceh

Background: Strategic purchasing plays an important role in the cost structure and competitiveness of small and large businesses. Managing Board of Social Insurance (BPJS) has implemented strategic purchasing of health services in the National Health Insurance (JKN) scheme. Strategic purchasing is important to provide quality products and services at low costs. Strategic purchasing of health service has five critical criteria: (1) what is to purchase; (2) to whom it is for; (3) whom it is from; (4) what is the price; (5) how to purchase it. This study aimed to assess BPJS barrier to strategic purchasing of primary care service at public and private health facilities in Subulussalam, Aceh. Subjects and Method: This was a qualitative study conducted in Subulussalam, Aceh, from February to July 2015. A total of 12 key informants for this study, including BPJS administrators, hospital managers. The theme was strategic purchasing of health service. The data were collected by in-depth interview, direct observation, and document review. The data was analyzed by thematic analysis. Results: BPJS administered the same standards of strategic purchasing health service from the public and private health providers. However, there were some unresolved problems: (1) BPJS faced difficulty to select primary care providers independently; (2) Illegal use of other member’s JKN card to get health service; (3) Redundant claims from the primary care providers; (4) Claim of inpatient days exceeding the maximum allowable limit; (5) Delay in non-capitations reimbursement payment to primary care provider; (6) Inequitable distribution of health manpower across health facilities. Conclusion: BPJS has implemented strategic purchasing of primary care services with the same standards applied to public and private primary care providers. However, there remain some problems of purchasing health services that call for immediate corrective actions, including routine monitoring, explanation of delay, advocacy, equitable distribution of health manpower. Keywords: strategic purchasing, primary care service, health facility, BPJS

Persepsi Jajaran Pimpinan Tentang Kawasan tanpa Rokok ( Ktr ) di Dinas Kesehatan Kabupaten Langkat Tahun 2014

No Smoking Area is a place or area that prohibited for production, sales, advertising, promotion and use of cigarettes activities. Determination of No Smoking Area is an effort to protect the public against the risk of health problems due to the threat of contaminated environment. This is background of researcher to conduct the research with using a qualitative studies to identify and understand the perception of the leadership ranks at the District Health Office Langkat about No Smoking Area year 2014 because the leadership is the people who are influential in establish a policy to be determined.This study uses a qualitative approach that utilizes a data collection technique with in-depth interviews to six-person as informant.The results showed all informants are agreeing on the No Smoking Area in District Health Office Langkat because it has a positive impact especially in health sector. Informants also had a strong commitment to realize it. The policy draft regarding to No Smoking Area expressed by several informants in written rules and sanctions, it starts with the appeal and the to awareness by using the health promotion steps. Therefore, researcher suggest that the Leadership ranks to sets the No Smoking Area immediately and dissemination of guidelines for implementation of the No Smoking Area.Keyword = perception, leadrship ranks, smoke and no smoking area

Factors Associated with Utilization of Hiv Counseling Service at Budi Kemuliaan Hospital, Batam, Riau

Background: Testing for Human Immunodeficiency Virus (HIV) is the gateway to treatment, care, and prevention. To scale up treatment and prevention, rapid increases in both the volume of testing and the ability to counsel those who are tested are needed. The use of testing globally, however, is very low. Most people living with HIV get testing and counseling only when they already have advanced clinical disease. This study aimed to examine the association between perceived risk of illness and the utilization of HIV counseling service at Budi Kemuliaan Hospital, Batam, Riau. Subjects and Method: This was a cross-sectional study conducted at Budi Kemuliaan Hospital, Batam, Riau. A sample of 76 patients with HIV was selected for this study. The dependent variable was utilization of HIV counseling service. The independent variables were perceived risk of illness and environment. Data on the use of HIV counseling service were taken from the medical record. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Utilization of HIV counseling was associated with high perceived risk of illness (OR= 6.63; p= 0.001), after adjusting for the effect of environmental factor. Conclusion: Utilization of HIV counseling is associated with high perceived risk of illness, after adjusting for the effect of environmental factor. Keywords: human immunodeficiency virus, counseling, utilization, perceived risk, illness, environment

Associations of Contact History, Smoking Status, Nutrition Status, and Arv Treatment, with Tb-Hiv Co-Infection among People with Hiv/Aids

Background: Tuberculosis (TB) and HIV co-infection causes a heavy burden on health care systems and poses particular diagnostic and therapeutic challenges. Studies into predictors of TB-HIV co-infection is lacking in Indonesia. This study aimed to examine the associations of contact history, smoking status, nutrition status, and ARV treatment, with TB-HIV co-infection among people with HIV/AIDS. Subjects and Method: This was a cross sectional study conducted in Balige, North Sumatera. A sample of 82 people living with HIV/AIDS were selected for this study, comprising 41 cases with and 41 controls without TB-HIV co-infection. The dependent variable was TB-HIV co-infection. The independent variables were contact history, smoking status, nutrition status, and ARV treatment. The data on HIV/AIDS co-infection were taken from the medical record at HKBP Committee HIV/AIDS service in Balige. Other variables were measured by questionnaire. Data were analyzed by multiple logistic regression. Results: 82.9% of sample had no contact history, 56.1% had poor nutrition status, 78% were smokers, and 58.5% had irregular ARV treatment. TB-HIV coinfection increased with poor nutrition status (OR= 3.48; p= 0.014), smoking status (OR= 3.39; p= 0.021), and irregular ARV treatment (OR= 10.16; p<0.001). Conclusion: TB-HIV co-infection increases with poor nutrition status, smoking status, and irregular ARV treatment. Keywords: TB-HIV co-infection, nutrition status, smoking status, ARV treatment

Pengaruh Metode Promosi Kesehatan terhadap Pengetahuan dan Sikap Penderita Tb dalam Pencegahan Tb di Puskesmas Aek Parombunan Kota Sibolga

Penyakit Tuberkulosis (TB) masih menjadi permasalah kesehatan di dunia hingga saat ini, World Health Organization melaporkan bahwa 10 juta kasus baru TB dengan jumlah kasus relatife stabil. Kasus TB ini, sebagian besar berada di negara berkembang, diantaranya di Indonesia. Upaya pengendalian TB secara Nasional telah dilakukan dengan program DOTS (Directly Observed Treatment Shourt Course), program ini adalah pengawasan langsung pengobatan dengan jangka pendek. Tujuan penelitian ini untuk menganalisis pengaruh promosi kesehatan terhadap pengetahuan dan sikap penderita TB dalam pencegahan TB di Puskesmas Kota Sibolga. Jenis penelitian yang digunakan adalah eksperimen semu dengan rancangan pretest-posttest control group design. Jumlah sampel dalam penelitian sebanyak 15 orang. Sebelum melakukan analisis data dilakukan uji Saphiro-wilk dan diperoleh data berdistribusi normal, kemudian dilanjutkan analisis data uji paired t-test dan diperoleh nilai rerata pengetahuan dari 13,40 menjadi 22,73 dengan nilai p = 0,000 dan niai rerata sikap dari 9,67 menjadi 12,47 dengan nilai p = 0,000 yang artinya bahwa ada pengaruh kombinasi ceramah dan audiovisual/film terhadap pengetahuan dan sikap penderita TB. Berdasarkan hasil uji tersebut dapat disimpulkan bahwa pemberian promosi kesehatan dengan metode kombinasi ceramah dengan media audiovisual berpengaruh terhadap Perubahan pengetahuan dan sikap penderita TB dalam pencegahan TB. Oleh karena itu diperlukan pengembangan media promosi kesehatan secara terus menerus terkait pencegahan penyakit TB