Surveillance Implementation Of HIV/AIDS In Jember Regency

Received: July, 9, 2020 Revised: November, 12, 2020 Available online: February, 2021 The number of people living with HIV/AIDS in Indonesia is increasing every year. HIV/AIDS surveillance is the most effective way to control the spreading of HIV/AIDS cases. This study aims to describe the implementation of HIV/AIDS surveillance in Jember. This paper was a descriptive study that included all public health centers (PHCs) conducting HIV/AIDS surveillance. The sample was the Jember District Departement of Health Office and four PHCs using purposive sampling. Variables in this study were input, process, and output. The data was obtained from an interview using a questionnaire. The results indicated that the four PHCs did not have an epidemiologist. Data collection mostly derived from Voluntary Counseling and Testing (VCT) and mobile VCT. Processing HIV/AIDS surveillance data utilized the HIV/AIDS and STDs Information System (SIHA) application and validated by the District Department of Health Office once a month. However, only two PHCs conducted analysis and data interpretation. Dissemination was only done by the District Departement of Health Office and 2 out of 4 PHCs. Hence, the components and process of surveillance needed to be optimized.


INTRODUCTION
Human Immunodeficiency Virus-Acquired Immuno Deficiency Syndrome (HIV/AIDS) is a chronic infectious disease that is still a significant global public health problem today. Worldwide HIV prevalence reached 36.9 million at the end of 2017, while the incidence rate was 1.8 million people. The mortality rate due to HIV globally was 940,000 in 2017 (WHO, 2018a). The number of new HIV cases in The percentage of HIV/AIDS patients in males was more significant than in females in 2016. The rate of HIV male patients was 63.3%, and female was 36.7%. While the percentage of people with AIDS (Acquired Immune Deficiency Syndrom) a male was 67.9% and 31.5% for female (Health Ministry of Indonesia, 2017). East Java Province was the highest number of new HIV cases in Indonesia,with 15,931 patients during 2015 and 2017 (Health Ministry of Indonesia, 2018 One of the government's efforts to combat the spread and reduce HIV/AIDS cases is implementing an integrated surveillance system. Surveillance is the most effective way to control infectious diseases in the community through surveys (Candra B., 2009). It is a system that runs continuously and has four main activities, namely data collection, data processing, data analysis and interpretation, and data dissemination. The primary purpose of surveillance is to detect changes in trends or distribution to initiate investigations or take control measures (Amirudin R., 2017).
The Implementation of Health Surveillance must be carried out in every health facility and health agency, starting from the district/city to the central level (Indonesia, 2003 The variable in this study refers to the systems approach, including input, process, and output. Primary data was obtained through direct interviews with respondents using a questionnaire. Meanwhile, secondary data collection utilized the Jember District Department of Health Office documentation and the four PHCs.
The data collected then processed and analyzed descriptively by comparing the study results with the theory and or program guidelines.

RESULTS
Financing a. APBD (The Regional Revenue and Expenditure Grouping data a. Age factor b. Characteristics, region, risk factors, HIV/AIDS status, and death from AIDS Village Midwife c.
Village Nurse d.
Clinic e. Stakeholders

DISCUSSION
Surveillance has four main activities: data collection, data processing, data analysis, and interpretation, also dissemination. In the Implementation of HIV/AIDS surveillance in Jember District, most of the data collection came from VCT and mobile VCT. HIV/AIDS surveillance data processing used the SIHA Previous research described that epidemiologists in carrying out HIV/AIDS surveillance were only at the district level, but at the PHC level were health workers such as nurses and midwives (Chandra H, 2018).
Lack of epidemiologists can be circumvented by including health workers appointed as the surveillance There should be a new mechanism to meet the increasing demands for financing the HIV/AIDS program so that funding sources can be sufficient to implement HIV/AIDS surveillance (WHO, 2017).
PHC officers play an essential and crucial role in recording data accurately and completely. Because it is the first door or the first data collector, the data will then be analyzed and reported by the District Department of Health Office to a high level to the Ministry of Health. Thus, surveillance officers who do not regularly collect data significantly affect the quality of the data produced. Therefore, data collection barriers should be used as a material to evaluate HIV/AIDS surveillance. By WHO guidelines, the data collection process must pay attention to the quality of data collected by implementing practices that ensure the quality of data standards during data collection and monitoring the data entry process (WHO, 2018b Indonesia, 2003). Each PHC had not done this yet.