Developing and implementing an MSM-led, community-based HIV service model in South Sulawesi: an implementation research process evaluation.

INTRODUCTION

HIV is concentrated among men who have sex with men (MSM) in Indonesia, yet integrated community-led HIV services remain limited outside major cities.

AIM: As part of a three-phase implementation research project adapting Thailand's Key Population-Led Health Services approach, we present the Phase 2 pilot implementation of an MSM-led, community-based service (CBS) model in South Sulawesi, focusing on predefined process indicators and early adoption signals. Phase 3 implementation outcomes are not reported.

METHODS

We conducted a process evaluation in Makassar City and Bulukumba Regency. Strategies included 3-day competency-based training for community health workers, a 1-week supervised internship at public primary health centers ( puskesmas ), engagement with health authorities to obtain designation letters and commitments for rapid test supplies, and the establishment of two static CBS sites. We summarized quantitative indicators descriptively and analyzed open-ended feedback and implementation records using conventional content analysis.

RESULTS

Fourteen MSM community health workers completed training and met minimum competency thresholds (attendance, knowledge, skills). All completed internships at eight puskesmas . District/city health offices issued designation letters for internship/referral sites and committed HIV/syphilis rapid diagnostic tests. Two static CBS sites were launched. Satisfaction was high; 92.9% reported the training was too short and requested longer practicum time, indicating a feasibility-acceptability trade-off.

CONCLUSIONS

The pilot achieved key start-up milestones and demonstrated early adoption of an MSM-led CBS model linked to puskesmas in a non-metropolitan province. The findings will guide refinement of training, supervision, and logistics, and inform Phase 3 measurement, including fidelity.

SPANISH ABSTRACT: http://links.lww.com/IJEBH/A628.