Mpox re-emerged as an outbreak in October 2023, with 59 confirmed cases in Indonesia, including 42 in Jakarta, between October 13 and November 26. Men who have sex with men (MSM), particularly those living with HIV, were identified as high-risk due to sexual contact transmission. In response, the Indonesian Ministry of Health and the Jakarta Health Agency collaborated with community organization for MSM living with HIV to mitigate the outbreak. This collaboration successfully curbed the transmission rate in Jakarta in December 2, 2023. Research on Mpox in Indonesia has focused mainly on clinical aspects, with limited exploration of public health responses. This paper tried to explore the community-based response to Mpox.
METHODS
We conducted a qualitative interview-based investigation to explore Mpox outbreak responses in Indonesia. Using respondent-driven sampling, we interviewed 21 participants, including vaccine recipients, NGOs, government officials, and community organizations. Interviews were conducted online and in-person between June and September 2024. Data were analyzed using an inductive thematic analysis approach.
RESULTS
Community involvement in handling the Mpox outbreak started in identifying Mpox cases. The Indonesian Health Ministry and Jakarta Health Agency collaborated with community organizations to determine the most effective methods of communication and to identify necessary actions. First, health workers and outreach workers were able to identify individuals at-risk through the existing HIV service system. They utilized routine visits for antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) to share Mpox information and testing. Second, drawing from COVID-19 pandemic, Mpox contact tracing efforts employed rapid response mechanisms. Combined with the HIV service system, outreach workers facilitated safe disclosure and offer partner notification. These made the overall healthcare experience more familiar. Lastly, the close relationship between outreach workers and health workers reduced the anxiety for accessing Mpox services, made them willing to disclose their health status and previous risky sexual behavior.
CONCLUSIONS
Community organization for MSM living with HIV leads to an effective response. Outreach workers and community organizations identified and reached at-risk individuals for Mpox infection, utilizing the existing HIV system, contact tracing, and the established relationship with health workers at primary healthcare.
Authors
Fikri Haidar1, Rinaldi Ridwan1, Nidia Muryani1, Ignatius Praptoraharjo1, Adi Nugroho2, Benjamin Hegarty3
1 University Centre of Excellence – AIDS Research Center Health Policy and Social Innovation, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia, 2 Lambung Mangkurat University, Banjarbaru, Indonesia, 3 The Kirby Institute, Sydney, Australia
