Title:

After-Office-Hours Service to Reach Out MSM in Sub-district Primary Health Center

Author:
1. Siti Nawiyah, HIV Programme Coordinator PKC Pasar Rebo
2. ….

Background:
In DKI Jakarta province, almost half of HIV reported cases came from MSM. This situation
matches Indonesia epidemic modeling that indicates new HIV infection among MSM will
continue to raise and become number one driver. There were estimated 60,696 MSM in DKI
Jakarta and despite of extensive outreach work and mobile testing, the total number of MSM
getting tested, enrolled in and still on ART remained low. Ongoing strong stigma against LGBT
from general society made them reluctant to access public health service that put them on risk
of revealing sexual orientation.

Description:
One sub-district primary health center or “Puskesmas Kecamatan (PKC)” Pasar Rebo in East
Jakarta district had been very popular among MSM community in DKI Jakarta for their client-
friendly services. Since 2015, PKC Pasar Rebo had opened STI & CST clinic after office hours on
Friday and on Saturday 1-2 times per month. On September 2016, with international support
through local NGO, PKC Pasar Rebo extended their service hour to every Friday and one day on
weekend aiming to reach more MSM, particularly those who cannot visit Puskesmas during
office hours.

Lesson learned:
Long service hour of PKC Pasar Rebo increased average number of visits to STI & CST clinic to
almost 200% where …(dari jumlah rerata pasien yang berkunjung berapa % pasien LSL) were
MSM. Among … (jumlah pasien LSL yang masih on ART bulan terakhir) MSM patients, …%
(berapa % pasien LSL berdomisili di K/K DKI selain Jaktim) came from districts other than East
Jakarta and …% (berapa % pasien LSL berdomisili di luar Prov. DKI) resided outside DKI Jakarta
Province. One patient even lived abroad and regularly visited PKC Pasar Rebo to refill ARV
prescription. PKC Pasar Rebo did not conduct much promotion about their MSM-friendly clinic
having only 1 social media with 101 followers. Their MSM patients mostly heard about this clinic
from their peers and came accompanied by a fellow who had already visited the clinic. Whether
extended service hour factored into why MSM chose this clinic over other PKCs was still unclear
because the number of patients during those hours is the same with the one during office hours.
Until November 2017, there were a total of … (jumlah LSL pernah ARV – LBPHA 3.1.) MSM who
ever started ART and … (jumlah LSL masih ARV – LBPHA 4.5.) of them were still on ART.

Conclusion/next steps:
Almost all MSM patients of PKC Pasar Rebo mentioned several reasons they chose and
remained there were, among others, 1) simple patient’s circuit; 2) short waiting time; and 3)
non-judgmental staff. For 2018, PKC Pasar Rebo plans to continue this after-office-hours service
with or without external support.