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Developing The Community Outreach Effectiveness Model (COEM) for HIV Prevention Among Key Populations in Indonesia: Evidence from The IBBS

Media Kesehatan Masyarakat Indonesia · Vol. 21 No. 4 (2025) · pp. 359–369

DOI
10.65844/mkmi.v21i4.45782
ISSN
2356-4067, 0216-2482
Published
2025-12-31
Publisher
Faculty of Public Health, Hasanuddin University, Makassar
Language
en
License
creativecommons.org/licenses/by-nc-sa/4.0/

Abstract

Indonesia continues to experience a concentrated HIV epidemic, with key populations female sex workers, men who have sex with men, transgender women, and people who inject drugs bearing a disproportionate burden, while uptake of HIV prevention services and sustained behavior change remain inadequate. Community outreach has been widely implemented to address these gaps; however, its effectiveness has not been comprehensively documented at the national level. This study aimed to assess the impact of community outreach interventions on HIV prevention uptake and behavioral outcomes among key populations in Indonesia using the Community Outreach Effectiveness Model (COEM). A quantitative retrospective study was conducted using secondary data from the Integrated Bio-Behavioral Survey (IBBS) collected across multiple districts in Indonesia. HIV prevention outcomes were compared between districts with and without community outreach interventions. The study population comprised key populations included in the IBBS, with sample sizes determined by the survey design. Data were collected through structured behavioral questionnaires and biological testing. Multivariable logistic regression analysis was applied to examine associations between exposure to outreach components and HIV testing uptake as well as consistent condom use, and the COEM was developed to operationalize outreach pathways linking inputs to outcomes. The results demonstrated that exposure to community outreach was strongly associated with higher HIV testing uptake across all key populations, with referral by outreach workers showing the greatest effect. Outreach exposure was also significantly associated with improved condom use, particularly through peer-delivered information, free condom distribution, and social media engagement. Combined exposure to multiple outreach components resulted in incremental improvements in both HIV testing uptake and consistent condom use. In conclusion, community outreach functions as a protective factor that strengthens HIV prevention behaviours among key populations in Indonesia, underscoring the need to institutionalize and scale up comprehensive, multi-component outreach strategies within national HIV policies and programs.

Keywords

Collaboration network of the authors

10 authors · 18 co-authorship links · 6 across different organisations

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  • Joint United Nations Programme on HIV/AIDS
  • Kementerian Kesehatan Republik Indonesia
  • University of Indonesia
  • Affiliation unknown
  • Different organisations
  • Same organisation
  • Affiliation unknown
  • Thicker line = more joint articles · bigger circle = more articles
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Co-authorOrganisationJoint articles
Fatien HamamahJoint United Nations Programme on HIV/AIDS1
Dheni FidiyahfiJoint United Nations Programme on HIV/AIDS1
Leonita AgustineJoint United Nations Programme on HIV/AIDS1
Bambang SutrisnaUniversity of Indonesia1
Abas B. DjauhariKementerian Kesehatan Republik Indonesia1
Ratna DjuwitaUniversity of Indonesia1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://journal.unhas.ac.id/index.php/mkmi/oai, first harvested 5 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en">Developing The Community Outreach Effectiveness Model (COEM) for HIV Prevention Among Key Populations in Indonesia: Evidence from The IBBS</dc:title>
	<dc:creator xml:lang="en">Wahyuniar, Lely</dc:creator>
	<dc:creator xml:lang="en">Sutrisna, Aang</dc:creator>
	<dc:creator xml:lang="en">Wicaksana, Dimas Budi</dc:creator>
	<dc:creator xml:lang="en">Habsi, Rizky</dc:creator>
	<dc:subject xml:lang="en">Community Outreach</dc:subject>
	<dc:subject xml:lang="en">HIV Prevention</dc:subject>
	<dc:subject xml:lang="en">Key Population</dc:subject>
	<dc:subject xml:lang="en">COEM</dc:subject>
	<dc:subject xml:lang="en">HIV Testing</dc:subject>
	<dc:description xml:lang="en">Indonesia continues to experience a concentrated HIV epidemic, with key populations female sex workers, men who have sex with men, transgender women, and people who inject drugs bearing a disproportionate burden, while uptake of HIV prevention services and sustained behavior change remain inadequate. Community outreach has been widely implemented to address these gaps; however, its effectiveness has not been comprehensively documented at the national level. This study aimed to assess the impact of community outreach interventions on HIV prevention uptake and behavioral outcomes among key populations in Indonesia using the Community Outreach Effectiveness Model (COEM). A quantitative retrospective study was conducted using secondary data from the Integrated Bio-Behavioral Survey (IBBS) collected across multiple districts in Indonesia. HIV prevention outcomes were compared between districts with and without community outreach interventions. The study population comprised key populations included in the IBBS, with sample sizes determined by the survey design. Data were collected through structured behavioral questionnaires and biological testing. Multivariable logistic regression analysis was applied to examine associations between exposure to outreach components and HIV testing uptake as well as consistent condom use, and the COEM was developed to operationalize outreach pathways linking inputs to outcomes. The results demonstrated that exposure to community outreach was strongly associated with higher HIV testing uptake across all key populations, with referral by outreach workers showing the greatest effect. Outreach exposure was also significantly associated with improved condom use, particularly through peer-delivered information, free condom distribution, and social media engagement. Combined exposure to multiple outreach components resulted in incremental improvements in both HIV testing uptake and consistent condom use. In conclusion, community outreach functions as a protective factor that strengthens HIV prevention behaviours among key populations in Indonesia, underscoring the need to institutionalize and scale up comprehensive, multi-component outreach strategies within national HIV policies and programs.</dc:description>
	<dc:publisher xml:lang="en">Faculty of Public Health, Hasanuddin University, Makassar</dc:publisher>
	<dc:date>2025-12-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en">Peer-reviewed Article</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://journal.unhas.ac.id/index.php/mkmi/article/view/45782</dc:identifier>
	<dc:identifier>10.65844/mkmi.v21i4.45782</dc:identifier>
	<dc:source xml:lang="en">Media Kesehatan Masyarakat Indonesia; Vol. 21 No. 4: DECEMBER 2025; 359-369</dc:source>
	<dc:source>2356-4067</dc:source>
	<dc:source>0216-2482</dc:source>
	<dc:source>10.30597/mkmi.v21i4</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://journal.unhas.ac.id/index.php/mkmi/article/view/45782/14081</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2025 by author</dc:rights>
	<dc:rights xml:lang="en">https://creativecommons.org/licenses/by-nc-sa/4.0/</dc:rights>
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