Evaluasi Program Penanggulangan HIV/AIDS Pada Layanan Voluntary Counseling And Testing (VCT) dan Antiretroviral Therapy (ART) Tahun 2024-2025 di RSUD Bali Mandara Provinsi Bali

Background: Newly diagnosed HIV cases in Bali Province remain predominantly concentrated among the productive-age population and are associated with high population mobility. As a referral hospital, RSUD Bali Mandara provides Voluntary Counseling and Testing (VCT) and Antiretroviral Therapy (ART) services, with an increasing number of visits. However, treatment adherence and retention remain areas of concern. Objective: This study aimed to evaluate the implementation of the HIV/AIDS prevention and control program in VCT and ART services at RSUD Bali Mandara during 2024–2025. Methods: This program evaluation study employed a mixed-methods approach using the Program Logic Model to assess the input, process, and output components. Data were collected through semi-structured in-depth interviews with four purposively selected informants and a review of program documents. Results: For the input component, five themes were identified: a strong multidisciplinary team; guidelines and SOPs as a shared reference; working around facility limitations and a national ARV stock-out; funding that relies on government support; and technology that eases service delivery while adding double-entry work because SIHA and SMILE are not integrated. For the process component, five themes were identified: counseling as a space of acceptance leading to treatment readiness; rapid test results alongside underused Molecular Rapid Test (MRT) capacity; keeping patients in treatment from initiation to daily adherence; connected referrals that maintain continuity of therapy; and periodic data validation to identify service gaps. For the output component, pre- and post-test counseling coverage reached 100%, and the number of active ART patients increased. However, the proportion of patients with undetectable viral load decreased from 57% to 30%, and three cases of lost to follow-up (LTFU) were identified in 2025. Conclusion: The implementation of VCT and ART services at RSUD Bali Mandara was generally satisfactory. However, strengthening examination facilities, monitoring treatment adherence and retention, optimizing the viral load testing network, and integrating information systems are needed to improve program effectiveness