Biomedical Science Doctorate Studies Stage-of-Change-Based Education to Improve ARV Therapy Adherence in Children Living with HIV

• Posted by: Admin
• Selasa, 30 Juni 2026
• Has been read 368 time(s)

Biomedical Science Doctorate Studies Stage-of-Change-Based Education to Improve ARV Therapy Adherence in Children Living with HIV

Held in the Meeting Room on the Third Floor of the Postgraduate Building, Udayana University, Jl. PB Sudirman, Denpasar, Bali, the Biomedical Science Doctoral Study Program, Faculty of Medicine, Udayana University, held an open doctoral promotion defense with candidate Ketut Espana Giri, S.ST., M.Kes., for the dissertation "Implementation of Stage-of-Change Theory to Improve Caregivers' Knowledge, Attitudes, and Behaviors Regarding Antiretroviral Therapy Adherence in Children Living with Human Immunodeficiency Virus." (June 29, 2026)

ARV therapy adherence in HIV-infected individuals remains a major challenge due to the child's dependence on caregivers. Conventional educational approaches have not been able to produce long-term behavioral changes. This study aims to test the effectiveness of stage-of-change theory in increasing knowledge, changing caregivers' attitudes, and behaviors regarding ARV therapy adherence in HIV-infected individuals, and exploring caregivers' experiences and behavioral change processes.

This study employed a mixed-methods sequential explanatory design. The first (quantitative) phase employed a true experimental design, with a sample size of 33 respondents who met the inclusion criteria. The control (n=18) and intervention (n=15) groups were randomly selected and administered a pretest and posttest. The intervention consisted of four weeks of education and counseling based on the stage of change theory for caregivers of people living with HIV/AIDS (CLHIV). The second (qualitative) phase involved in-depth interviews with nine informants. Quantitative data were analyzed using logistic regression, while qualitative data were analyzed thematically.

The first phase demonstrated that the intervention significantly improved knowledge and changed attitudes and behaviors of caregivers in assisting people living with HIV/AIDS (CLHIV) on ARV therapy. However, improvements in these three aspects were not directly related to ARV therapy adherence. Multivariate analysis identified that caregiver burden was the most significant factor contributing to non-adherence, with a more than elevenfold increased risk. Qualitative findings supported these results by demonstrating that caregiver behavioral changes occurred gradually according to the stages of change, but sustainability during the maintenance phase was significantly influenced by high physical, emotional, and socioeconomic burdens.

Interventions based on the stage of change theory have successfully increased internal capacity, including knowledge, attitudes, and behavior of caregivers. However, to reach the maintenance stage, it must be accompanied by caregiver burden management. A comprehensive approach is needed to improve ARV therapy adherence in people living with HIV/AIDS (CLHIV).

This examination was led by the Vice Dean for Academic Affairs and Planning and Acting Vice Dean for Student Affairs and Information, Faculty of Medicine, Udayana University, Prof. Dr. I Made Ady Wirawan, MPH., Ph.D., with the following examiners:

1. Prof. Dr. Pande Putu Januraga, M.Kes., Dr.PH. (Promoter)

2. Prof. Dr. I Made Ady Wirawan, S.Ked., MPH., Ph.D. (Co-Promoter I)

3. Dr. Ni Ketut Sutiari, SKM., M.Si (Co-Promoter II)

4. Prof. Dr. dr. I Made Jawi, M.Kes

5. Prof. Dr. Ir. Ida Bagus Putra Manuaba, M.Phil

6. Prof. Dr. Dr. I Wayan Weta, MS., Sp.GK

7. Prof. Dr. Dr. I Wayan Putu Sutirta Yasa, M.Si

8.Dr. Luh Seri Ani, SKM., M.Kes

9.Dr. Dr. I Wayan Gede Artawan Eka Putra, M. Epid

10. Dinar Saurmauli Lubis, SKM., MPH., Ph.D

By academic invitation:

1.Dr. Kadek Tresna Adhi, SKM., M.Kes

2.Dr. Dr. Ketut Suarjana, S.Ked., MPH

3.Dr. Ni Nyoman Budiani, S.SiT., M.Kes

4.Dr. Ni Putu Widarini, SKM., MPH

5.Dr. Dr. Ni Made Sri Nopiyani, MPH

In this exam, Dr. Ketut Espana Giri, S.ST., M.Kes., was declared the 497th Doctoral Graduate of the Biomedical Science Doctoral Study Program, Faculty of Medicine, Udayana University with Cum Laude honors.

Gallery