Motivational Interviewing as an Intervention to Improve Antiretroviral Treatment Initiation among People who Inject Drugs (PWID): A Pilot Study in Jakarta and Bandung, Indonesia

Evi Sukmaningrum; Astri Parawita Ayu; Lydia Verina Wongso; Miasari Handayani; Sarahsita Hendrianti; Nurhayati Hamim Kawi; Nur Aini Kusmayanti; Nurjannah Sulaiman; Irwanto Irwanto; Matthew Law; Rudi Wisaksana

doi:10.2174/2589977515666230531154629

Motivational Interviewing as an Intervention to Improve Antiretroviral Treatment Initiation among People who Inject Drugs (PWID): A Pilot Study in Jakarta and Bandung, Indonesia

Curr Drug Res Rev. 2023 May 31. doi: 10.2174/2589977515666230531154629. Online ahead of print.

Authors

Affiliations

¹ University Centre of Excellence AIDS Research Centre Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, Jakarta Indonesia.
² Faculty of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
³ School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
⁴ Research Center for Care and Control of Infectious Diseases, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
⁵ Faculty of Public Health, University of Indonesia, Depok, Indonesia.
⁶ Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
⁷ Subdirectorate HIV&AIDS, Ministry of Health Republic Indonesia.
⁸ Kirby Institute, University of New South Wales, Sydney, Australia.

PMID: 37259929
DOI: 10.2174/2589977515666230531154629

Abstract

Introduction: Progress towards the 95-95-95 target among People Who Inject Drugs (PWID) with Human Immunodeficiency Virus (HIV) infection was considerably low. A behavioral approach, such as motivational interviewing (MI), has been recognized as an effective strategy for improving HIV treatment outcomes among PWID.

Objective: This study aimed at assessing the impact of MI counselling to improve ARV initiation among HIV-positive PWID.

Methods: A cohort design pilot study was performed, and participants were recruited using a convenience sampling technique. Participants were PWID with HIV who accessed healthcare facilities in two Indonesian cities. Selected participants were assigned to an intervention group and a control group. The intervention group followed MI counselling, while the control group received ART following the standard of care. The participants were assigned to each group based on their preferences. The data was collected between January 2018 and January 2019.

Results: In total, 115 PWID with HIV participated in this study in the intervention (n=30) and control (n=85) groups. All but one intervention group's participants started ART, while 68/85 in the control group did so. Receiving MI counselling significantly contributed to ART initiation. In addition, the participants were followed-up until 12 months after ARV initiation. During this period, we found that similar proportions of participants in both groups discontinued the treatment, and only a small number achieved HIV viral suppression.

Conclusion: The positive effect of MI counselling on ART initiation provides insight into the possibility of its wider implementation. Further studies are needed to gain a deeper understanding of MI counselling and its effect on other outcomes of the HIV treatment cascade.

Keywords: HIV; Motivational Interviewing; health care; injecting drug use; time-to-treatment; treatment adherence.