Socio-ecological barriers and facilitators to same-day HIV testing and treatment experiences of seroconverting men who have sex with men in Indonesia

Same-day HIV testing and treatment (SDTT) has been formally established in Indonesia as a strategic initiative to enhance the linkage of individuals diagnosed with HIV to antiretroviral (ARV) treatment services. This study endeavors to address barriers and facilitators of MSM on the same-day HIV testing by systematically investigating the experiences of MSM who undergo the SDTT. This study explores the experiences of MSM in Bali as they undergo SDTT. Through in-depth interviews and focus group discussions with two distinct groups - 15 MSM and 11 field workers, outreach staff, and nurses, the study found that barriers and facilitators experienced by participants were related to socio-ecological factors. Individual knowledge, motivation, and awareness are central to starting treatment. Support from peers, social networks, and medical staff also plays a key role. Trust in healthcare providers and accessible clinics make starting and staying in treatment easier, while government support for viral load testing helps as well. However, ongoing challenges remain, especially in overcoming stigma and ensuring effective communication. Improving SDTT uptake among MSM will require continued support from counselors, stronger communication about treatment benefits, and strategies to address both personal and systemic barriers.