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Tesis ini bertujuan untuk mengembangkan alat ukur yang dapat digunakan untuk mengukur kualitas hidup terkait kesehatan pada orang dengan HIV/AIDS. Metode yang digunakan adalah konfirmatif eksploratif terhadap empat Gold Standard yaitu WHOQOL-HIV BREF, MOS HIV, EQ-5D-5L dan Ina-HRQoL. Dilakukan suatu studi literature dan uji validitas dan reliabilitas untuk memilih atribut yang sesuai untuk digunakan sebagai alat ukur. Ke-empat goldstandar diujikan pada masing-masing 30 responden. Dari 81 item pertanyaan diperoleh 70 item yang valid, dilakukan reduksi item dengan mengeliminasi item yang tidak sesuai dengan dimensi yang ditetapkan yaitu dimensi FISIK, MANDIRI, SOSIAL, MENTAL dan SPIRITUAL, sehingga diperoleh 40 item yang sesuai. Setelah itu dilakukan pengelompokan pada item yang sama atau menanyakan hal yang sama sehingga diperoleh 17 atribut. Ditambah satu atribut Bekerja yang dipandang penting maka keseluruhan atribut menjadi 18 yaitu Vitalitas, Rasa Sakit, Tidur, Mobilitas, Akyifitas Pribadi, Bepergian, Bekerja, Hubungan Personal, Dukungan Teman, Seksual,Aktifitas Sosial, Konsentrasi, Citra Diri, Menikmati Hidup, Perasaan Negatif, Hidup Berarti, Khawatir Masa Depan, Takut Kematian. Kedelapanbelas atribut kemudian dikembangkan menjadi kuesioner dan diujikan pada 30 responden dengan nilai alpha Cronbach 0,905, sehingga alat ukur ini dinilai valid dan reliable. Alat ukur yang baru dinamakan D-HIV HRQOL kemudian di aplikasikan pada 119 responden pada Yayasan Layak dengan nilai alpha Cronbach sebesar 0,895. Dari 119 responden ternyata 73,11% laki-laki dan 26,89% perempuan; kelompok umur terbanyak adalah 30-39tahun yaitu sebanyak 65,55% dan kedua terbanyak pada umur 20-29 tahun yaitu 23,53%. Tingkat pendidikan responden cukup baik yaitu 68,91% tingkat menengah atas, dan pekerjaan terbanyak adalah swasta 52,94%. Dari riwayat penggunaan narkotika diperoleh 52,10% pernah, dan 17,65% masih aktif, demikian juga riwayat penggunaan alkohol 42,86% pernah dan 3,36% masih aktif. Faktor penularan terbanyak adalah melalui pemakaian narkotika suntikan sebanyak 63,87% dan seksual sebanyak 35,29%. Untuk nilai CD4 hanya 103 responden yang melengkapi data 44,66% pada 200-500 cells/ml dan 38,83% pada kurang dari 200 cells/ml. Hanya 19 responden yang sudah pernah diperiksa viral load, 10 undetected dan 9 detected. Menurut stadium 52,10% pada stadium II, dan 29,41 pada stadium II. Sebanyak 26,89% belum menerima pengobatan ARV dan 22,69% sudah menjalani ARV selama lebih dari 2 tahun. Nilai utility rata-rata pada 50,61 (0,7) dengan nilai minimum pada 22 (0.30) dan maksimum pada 69 (0.96), time preference rata-rata adalah 17,06. Sehingga nilai QALY?s adalah 11,94.
The objective of this thesis is to develop an instrument that could be used in examining health related quality of life on people living with HIV/AIDS. The method used in this case is confirmative explorative to the four gold standards which is WHOQOL-HIV BREF, MOS HIV, EQ-5D-5L and Ina-HRQoL. Literature, validity, and reliability tests are conducted to choose the appropriate attributes to be used in the measuring instrument. These four gold standards were each tested on 30 respondents. Out of 81 items, 70 were found valid. An item reduction was carried by eliminating items that does not fit the dimensions, which is Physical, Social, Independence, Mental, and Spiritual dimensions, so that 40 suitable items was obtained. After that, classification on the same items, or items that was asking the same questions was done so that 17 attributes is obtained. And the ?Working? attribute was added because it was deemed important for the instrument. The result was 18 attributes which is Vitality, Pain, Sleep, Mobility, Personal Activity, Traveling, Working, Personal Relationship, Friend Support, Sexual, Social Activity, Concentration, Self-Image, Enjoying Life, Negative Feeling, Meaningful Life, Worries about the Future, and Fear of Death. These 18 attributes was then developed into a questionnaire and tested on 30 respondents with the Cronbach alpha values of 0.905, so that this instrument was deemed valid and reliable. The new instrument named D-HIV HRQOL was then applied to 119 respondents at ?Yayasan Layak? with the Cronbach alpha value of 0.895. Out of 119 respondents 73.11% were male and 26.59% were female; the largest age group was 30-39 years old as much as 65.55%, the second largest was 20-29 years old as much as 23.53%. The education level of the respondents was high enough, as much as 68.91% was middle class up. As much as 52.94% of the respondents were working in private sectors. As much as 52.10% of the respondents was using drugs in the past, with 17.65% is still actively using drugs, as much as 42.86% of the respondents was drinking alcohol in the past, with 3.36% is still actively drinking it. The largest factor of transmission was injection drugs as much as 63.87% and trough sexual as much as 35.29%. only 103 respondents fills in the CD4 value, of which 44.66% is at 200-250 cells/ml and 38.83% is at less than 200 cells/ml. Only 19 respondents were tested on viral load, 10 of which is proven undetected, and 9 detected. Stadium wise, as much as 52.10% of the respondents were at the second stadium, and 29.41% were at the third stadium. As much as 26.89% have yet to receive ARV treatment and 22.69% has received ARV treatment for the past 2 years. The average utility value is at 50.61 (0.7) with the lowest value being 22 (0.30) and the highest is 69 (0.96). The average time preference is 17.06, so the resulting QALY value is 11.94.
Kata Kunci : PMS; HIV/AIDS; Perilaku Seksual Remaja
This research aim to know the description of the knowledge and attitudes of teenagersabout PMS and HIV/AIDS with risk behavior of PMS and HIV/AIDS. Research conducted inSMA Negeri 1 Wundulako, Kolaka, Southeast Sulawesi in 2013. Design research was a cross-sectional with a quantitative approach in high school teenagers (189). The results showedmost of the teens have no behavior was risk, 16,22 years, male, Moslem, knowledge is quitegood (<mean), negative attitude (<mean), exposure to media information, and personalcontacts that are less active. Results of statistical tests proved there was a meaningfulrelationship between age, sex (OR = 2.18), knowledge (OR = 2.16), attitude (OR = 2,19),sources of information media (OR = 2.5) and personal contacts (OR = 2,19) with riskbehavior of PMS and HIV/AIDS.Key words : PMS; HIV/AIDS; Risk of Sexual behavior
Indonesia telah mengadopsi kebijakan akses obat ARV bagi semua penderita HIV/AIDS (universal access) sejak tahun 2006 dengan target waktu pencapaian pada akhir tahun 2009. Oleh karena itu, penelitian ini dilujukan untuk mengetahui kesiapan pemerintah yang bertanggung jawab di bidang kesehatan dalam melaksanakan kebijakan tersebut di Provinsi DKI Jakarta pada tahun 2009, dengan pendekatan model sistem. Penelitian ini menggunakan pendekatan kualitatif untuk menggali informasi secara mendalam. Peningkatan validitas data dilakukan dengan menggunakan data primer maupun data sekunder sena triangulasi data. Hasil penelitian menunjukkan bahwa pemerintah yang bertanggung jawab di bidang kesehatan belum dapat melaksanakan kebiiakan obal ARV bagi semua penderita HIV/AIDS (universal access) di Provinsi DKI Jakarta sesuai target waktu. Penelitian menyarankan implementasi kebijakan tersebut perlu memperhatikan komunikasi kebijakan yang intensif kepada Iintas sektor terkail, optimalitas penggunaaan sumber daya, ketersediaan insentif yang berdampak Iangsung bai pelaksana kebUakan, dan koordinasi yang kuat antara pemerintah pusat dan pemerintah daerah serta tempat layanan obat ARV.
Since 2006, Indonesia has adopted universal access policy for antiretroviral drug which is targeted to be achieved by the end ot' 2009. Therefore, the thesis is focused on examining the readiness of government authority in health sector in implementing the policy in DKI Jakarta Province 2009 by using model system. The design of the research is a qualitative approach. It is intended to explore deeper information on the policy implementation process. To ensure data validity, the research was done by using primary data obtained from in depth interview and secondary data from document assessment. Furthermore, data triangulation was also conducted. The result of the research showed that govemment authority in health sector is not able to achieve universal access for antiretroviral drug by the target time yet. It is suggested that the iinplementation of universal access for antiretroviral drug should consider several factors, i.c. intensive policy communication among related stakeholders, optimality in utilizing the resources, the availability of appropriate incentive for policy implementer, and strong coordination between central and district government and with the health facilities that offer antiretroviral therapy as well.
