Voluntary HIV testing, disclosure, and stigma among injection drug users in Bali, Indonesia

Recently, large increases have been noted in injection drug use and HIV prevalence in Indonesia. Because voluntary HIV counseling and testing can play an important role in HIV prevention, it is important to understand factors related to its use. The objective of this study was to identify factors related to the use of voluntary HIV testing among drug users. In-depth interviews were conducted with a sample of 40 drug users in the Denpasar area of Bali, Indonesia. Drug users may be interested in testing if they have enough information about AIDS to know that they are at risk and that they need this information to protect themselves and others from infection. Barriers toward testing included the fear of a positive result, fear of reactions from family and community members and stigmatization. Other obstacles include a feeling of hopelessness, problems with testing, unavailability and side effects of AIDS drugs and other factors. Many persons would not disclose their status to community members and sexual partners. There were serious concerns about others being ashamed of them and the impact of HIV on relationships with spouses and sexual partners and on employment.