The study was conducted in the two cities of Bandung and Yogyakarta and the island of Bali, each of which have high prevalence and clinical services with experience of working with key populations. The populations selected for the study
were men who have sex with men (MSM), female sex workers (FSW), transgender
women (known as waria in Indonesia), and people who inject drugs (PWID). Because the study failed to find many PWID, a fourth
arm enrolling only PWID was added in the capital, Jakarta, and they could
already be diagnosed as long as they had not previously taken ART.
The study was based in hospital centres, which then invited local clinics to participate. As a result, 77% of
participants were diagnosed and 67% had their baseline ART assessment visit at
primary care centres. Slightly over half of these were government-run local health
clinics, known in Indonesia as Puskesmas, and the rest at NGO-run private
clinics. Not all the Puskesmas and NGO clinics prescribed ART, and in these
cases people were referred to clinics that did.
The study enrolled 831 participants. These formed a high proportion of people diagnosed at the study sites over the trial period.
of the Indonesian reporting system, it is impossible to say what proportion of newly diagnosed people this represents in the localities and whether that differs from
population to population, but the researchers estimate that in Bali, they recruited 70% of members of key populations who had been diagnosed across the island in the study period. The Indonesian Health Ministry estimates that only 44% of people with HIV in the country have been diagnosed.
Of the 831 enrolled, 77% were MSM, 14% were FSW, 6% were
PWID and 3% were waria. There were some differences between the groups: for instance,
MSM tended to be slightly younger than the median age of 27 years and waria
and PWID were older (34 years). FSW and waria were more likely to lack
secondary education, with only 26% and 44% having attended high school, compared
with 86% of MSM.
One cause for concern was that a high proportion of those
diagnosed had advanced HIV disease and had presumably been infected for several years. At
diagnosis, 73% of participants had a CD4 count below 350 cells/mm3 and 15% had an HIV-related condition.