Theme: Models of Care Year: 2019
Background:
The Indonesian Drug Users Network (PKNI) is a community-based organization that works closely
with marginalized populations, including people who use injection drugs (PWID), and many from
their community live with or are at risk of HIV and HCV. Additionally, many in their community also
face an elevated risk of incarceration due to the criminalization of drug use in Indonesia. It is in this
context that a community-led effort to increase HCV knowledge and testing within the prison setting
was conducted.
Description of model of care/intervention:
In July 2018, PKNI signed a memorandum of understanding with the Correctional Department of
Ministry of Law and Justice to provide a protocol and guideline for HCV screening and treatment in
the prison setting by medical personnel. Additional stakeholders involved in the initiative included
the Ministry of Health, the Indonesian Hepatologist Association, and Clinton Health Access Initiative.
Study clubs were conducted to improve the literacy of incarcerated individuals on HCV prevention
and treatment. As part of each club, anonymous HCV testing was offered; those who tested positive
were offered same-day treatment. Every session was facilitated by one doctor and one PKNI staff.
Effectiveness:
As a result of the MoU, 447 persons were tested, 77 (17.2%) of whom tested positive. PKNI conducted
3 HCV study clubs attended by 90 prisoners in narcotics prison. In Pengayoman Hospital, 14 of the 30
people (46.7%) tested by the trained internist were later confirmed with HCV viremia. These
individuals were given the option to immediately start DAA treatment. Trainings of doctors were
conducted in six prisons.
Conclusion and next steps:
This community-led initiative helped increase HCV knowledge in the prison setting, identified HCV
positive individuals and allowed provision of same-day treatment. This collaborative effort between
may serve as a blueprint for further scale up in Jakarta, a city with approximately 17,000 prisoners.
Disclosure of Interest Statement:
PKNI’s intervention was made possible through financial support from Unitaid