Abstract

Indonesia’s 2014 health reforms advocated for universal health coverage for all Indonesians. The reforms made provision for integrated human immunodeficiency virus (HIV) programmes, with testing available at community health centres and hospitals for pregnant women and women of childbearing age. The question remains, though, as to whether testing has been effective. This article focuses on barriers women face accessing HIV testing and presents findings from the experiences of 18 HIV-positive women. To triangulate findings, interviews were conducted with 26 health workers, 9 non-governmental organisation workers and 12 HIV stakeholders. The article examines barriers to pregnant women’s access to HIV tests, showing that barriers relate to women not having reproductive health rights. It highlights reproductive rights noted in the Respectful Maternity Care Charter, and violations to them relevant to HIV testing in pregnancy. Five reported rights violations include: women being unable to access information; being unable to make informed decisions; having no right to confidentiality and privacy; experiencing ongoing discrimination; and having no right to timely HIV testing. The failure of Indonesia to protect these rights contributes to women being denied HIV testing. Findings show the need for increased HIV testing services for pregnant women and assert that health personnel and programme policy-makers need to be held accountable for the protection and fulfilment of women’s rights in respect of HIV testing. The findings show that policy makers must make changes to ensure health services improve, health professionals must be better trained, and women’s socio-cultural and political contexts must be considered.

摘要

印度尼西亚 2014 年的卫生改革倡导为所有印度尼西亚人提供全民健康覆盖。改革为综合人体免疫缺陷病毒 (HIV) 计划做出了规定，在社区卫生中心和医院为孕妇和育龄妇女提供检测。不过，问题仍然存在，即测试是否有效。本文重点关注女性在接受 HIV 检测时面临的障碍，并介绍了 18 位 HIV 阳性女性的经验结果。为了对调查结果进行三角测量，对 26 名卫生工作者、9 名非政府组织工作人员和 12 名艾滋病毒利益相关者进行了访谈。这篇文章检查了孕妇获得 HIV 检测的障碍，表明这些障碍与没有生殖健康权利的妇女有关。它强调了《相互尊重的孕产保健宪章》中提到的生殖权利，以及与孕期艾滋病毒检测相关的侵犯人权行为。五项被举报的侵犯权利行为包括： 妇女无法获取信息；无法做出明智的决定；没有保密和隐私权；遭受持续的歧视；并且无权进行及时的 HIV 检测。印度尼西亚未能保护这些权利导致妇女被拒绝进行艾滋病毒检测。调查结果表明需要增加对孕妇的 HIV 检测服务，并声称卫生人员和计划决策者需要对保护和实现妇女在 HIV 检测方面的权利负责。调查结果表明，政策制定者必须做出改变，以确保改善卫生服务，