KESIAPAN RUMAH SAKIT RUJUKAN HIV-AIDS DI PROVINSI JAWA BARAT DALAM IMPLEMENTASI LAYANAN PENCEGAHAN PENULARAN HIV DARI IBU KE ANAK (PPIA)

ABSTRACT Transmission of HIV-AIDS from mothers to their children are of increasingly concern and it remains an iceberg phenomenon. West Java is one of five provinces in Indonesia with highest cases of HIV-AIDS as well as maternal and infant mortality rates. Prevention of mother to child HIV transmission (PMTCT) program has been implemented in Indonesia since 2004. Ministry of Health has appointed several hospitals as centers of referral of PMTCT in the same area, however, its implementation has not been known yet. The aim of this research is to find out the preparedness of PMTCT services in four referral hospitals in West Java Province, namely HS Hospital, KBd Hospital, KBk Hospital, and MM Hospital. The preparedness of PMTCT services can be assessed from preparedness of medical staff and supporting staff in providing such services, the preparedness of facilities and infrastructures, and constraints of service as well. The study carried out in 2014 with qualitative approach. The result shows that there are some differences of preparedness amongst four hospitals in PMTCT service implementation, mostly because of unpreparedness in terms of facilities and infrastuctures (reagents, medicines, medical equipment, rooms, laboratories), lack of training, stigma from medical staff, and there is no guarantee for occupational safety and health of medical staff in providing PMTCT services. The conclusion of the results is that HS Hospital is the most well-prepared in PMTCT service implementation, whereas KBd Hospital needs medicine equipment and laboratories for HIV-AIDS examination. Similarly, KBk Hospital needs awareness campaign and training to reduce negative stigma from medical staff. Lastly, MM Hospital needs awareness campaign, training, completeness of personal protective equipment, leadership commitment and other supports for birth delivery services for HIV positive mothers. Keywords: HIV-AIDS, PMTCT, Hospital, West Java ABSTRAK Penularan HIV-AIDS pada ibu rumah tangga sudah semakin mengkhawatirkan dan ibarat fenomena gunung es. Provinsi Jawa Barat sebagai salah satu dari lima provinsi tertinggi di Indonesia dengan jumlah kasus HIV-AIDS dan merupakan provinsi dengan angka kematian ibu dan bayi tertinggi. Program Pencegahan Penularan HIV dari Ibu ke Anak (PPIA) merupakan program yang sudah dilakukan di Indonesia sejak tahun 2004. Kemenkes sudah menunjuk beberapa rumah sakit untuk dapat menjadi pusat rujukan PPIA di wilayahnya, namun belum diketahui bagaimana implementasinya selama ini. Tujuan penelitian untuk mengetahui bagaimana kesiapan layanan PPIA di RS Rujukan HIV-AIDS di Provinsi Jawa Barat, yakni : RS HS, RSUD KBd, RSUD KBk, dan RS MM. Kesiapan layanan PPIA dilihat dari bagaimana kesiapan tenaga medis dan tenaga pendukung dalam memberikan layanan PPIA, kesiapan sarana dan prasarana, serta kendala layanan. Penelitian dilakukan pada tahun 2014 dengan pendekatan kualitatif. Hasil penelitian menunjukkan bahwa kesiapan ke-empat RS berbeda-beda dalam implementasi layanan PPIA, namun sebagian besar karena ketidaksiapan dalam hal sarana prasarana (reagen, obat-obatan, alat kesehatan, ruangan, pemeriksaan laboratorium), kurangnya pelatihan, masih adanya stigma dari tenaga kesehatan, serta belum adanya jaminan keamanan dan keselamatan bagi tenaga kesehatan pemberi layanan PPIA. Kesimpulannya adalah RS HS merupakan yang paling siap dalam implementasi layanan PPIA, RSUD KBd masih harus melengkapi obat-obatan dan pemeriksaan laboratorium terkait HIV-AIDS, RSUD KBk masih memerlukan sosialisasi dan pelatihan agar tidak ada stigma dari tenaga kesehatan, RS MM masih memerlukan sosialisasi, pelatihan, kelengkapan alat pelindung diri, komitmen pimpinan dan sebagainya agar dapat segera memberikan layanan persalinan bagi ibu positif HIV. Kata kunci: HIV-AIDS, PPIA, RS, Jawa Barat