Background: Tuberculosis (TB) and human immunodeficiency virus (HIV) are global health challenges that exacerbate each other’s progression, leading to high mortality rates, particularly in Asia and Africa. This study aimed to evaluate the implementation of the TB-HIV co-infection program and barriers to its implementation in Semarang City, Indonesia, to improve regional responses and patient outcomes.
Methods: This qualitative study used focus group discussions (FGDs) with 20 purposively selected participants from key stakeholder groups in Semarang City. Data were collected over two days, transcribed verbatim, and thematically analyzed using NVivo 15 software, following Braun and Clarke’s thematic analysis framework. Triangulation and member-checking enhanced validity.
Results: This study identified three major themes and fifteen sub-themes through thematic analysis of FGD data obtained from stakeholders at different organizational levels. The first theme, TB-HIV prevention programs, includes co-infection screening, household contact tracing, mobile health services, and the provision of TB preventive therapy (TPT). The second, treatment programs, covers adaptation of guidelines, integrated service delivery, mentorship support, and case reporting. The third addresses challenges and barriers, including poor integration, dependence on donor funding, limited outreach to high-risk groups, logistical constraints, low public awareness, and stigma.
Conclusion: While the TB-HIV co-infection program in Semarang City shows promise, particularly in screening and TPT, its effectiveness is limited by systemic fragmentation, stigma, and reliance on donor-funded initiatives. To improve implementation, stronger cross-sector collaboration, stable domestic financing, and context-adapted public education strategies are necessary. These findings underscore the need for reforms prioritizing fully integrated TB-HIV services, empowering community-based interventions, and strengthening supply chains to ensure continuity of care.