HIV Case Management – Strategic Intervention for Marginalized Populations of PLHIV


HIV Case Management –
Strategic Intervention for Marginalized Populations of PLHIV

Varel, Yayasan LAYAK, Jakarta, Indonesia, yayasan_layak@yahoo.com

Background

MSM who are also HIV infected experience double stigma due to their HIV status and sexual orientation. Often the fear of disclosure of both HIV status and sexual orientation creates a barrier for the MSM PLHIV to access care, support, and treatment (CST) in their community.
MSM who are HIV infected are not only difficult to identify but also difficult to link with existing CST services due to fear of disclosure.

Activity

Disclosure counseling is a part of the case manager’s intervention; especially if the inability to disclose significantly affects the client’s health or the health of others. Other health counseling topics with PLHIV might include information about existing resources for treatment and support in the community; education on how to access these services, and risk reduction counseling for reducing the transmission of HIV to sexual partners.
As in many members of marginalized communities, MSM exhibit low self confidence and isolation from peer support. The case manager was able to link the MSM PLHIV to supportive peer communities and activities which fostered increased self confidence.

Result
Through the HIV case management intervention, the MSM client was able to self disclose to health care workers which immediately enabled him to have access to ARV and other related health services. As a result, his health improved radically. Furthermore, safer sexual practices were reported by the client to the case manager. Successful linkages were made with peer support groups which also reinforced safer sexual practices and adherence to ARV therapy.

Conclusion
HIV case management with members of marginalized communities such MSM can increase the likelihood of gaining access to existing community based services which improve overall health and quality of life of the PLHIV

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