HIV / AIDS CONTROL POLICY FOR ENDING THE AIDS EPIDEMI BY 2030 IN BANJARMASIN : AN IN-DEPTH ANALYSIS OF THEORITICAL FRAMEWORKS.

Nana Noviana 1 , Sri Suwitri 2 , Bambang Supriyono 3 and Sutopo Patria Jati 4 . 1. Regional Research and Developement Agency, South Kalimantan Province, Indonesia. 2. Professor at the Doctoral Public Adminstration, Diponegoro University, Semarang, Indonesia. 3. Professor at the Brawijaya University, Surabaya, Indonesia. 4. Lecturer at the Public Health Faculty, Diponegoro University, Semarang, Indonesia. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 12 July 2019 Final Accepted: 14 August 2019 Published: September 2019

In an effort to solve a social problems, especially the HIV/AIDS problems, is needed a policy that can answer the needs of the community for efforts to prevent HIV/AIDS. The increase in HIV / AIDS cases in the Banjarmasin city to attracted the goverment attention to take immediate action in the prevention of HIV / AIDS by issuing regional regulation Number. 11 of 2012 concerning prevention of HIV / AIDS in the city of Banjarmasin. The purpose of this study was to update the theoretical literature based on articles that support the formulation of research related to the policy implementation of prevention HIV / AIDS. We conducted a literature review of several articles relevant to this research to update the existing theoretical framework. The articles taken are filtered based on titles and abstracts to identify and be a reference to the theoretical framework related to the policy implementation of prevention HIV/AIDS . An in-depth analysis of this theoretical framework is carried out to formulate key concepts that refer to the research formula. The literature review of this article identifies a key framework that supports research on the policy implementation of prevention HIV / AIDS . This key framework is in accordance with the formulation of the problem in the research, namely: policy implementation of prevention HIV/AIDS, actors who play a role in the implementation of prevention HIV/AIDS, as well as supporting factors and inhibitors of the policy implementation of prevention HIV/AIDS. The key concept is interconnected and is the basis for developing a research framework in the implementation of HIV / AIDS prevention policies in an effort to end epidemic the AIDS 2030 in Banjarmasin City.

…………………………………………………………………………………………………….... Introduction:-
The problem of HIV / AIDS is a problem of the world, which needs to get attention from all levels, both from the government/stakeholders and the community because cases of HIV/AIDS can cause pain which results in a decrease ISSN: 2320-5407 Int. J. Adv. Res. 7 (9), 1102-1115 1103 in work effectiveness even to the point of death. In an effort to solve social problems, especially the problem of policy implementing of prevention HIV/AIDS requires the role of policy implementers to form a policy or opinion. Therefore, to realize a good and appropriate policy of prevention HIV/AIDS, the policy must meet the needs of the community.
HIV/AIDS case finding in Banjarmasin City in 2005, where 4 people were found with HIV. And the spread of HIV cases is increasing from year to year, we see this from the report of the Banjarmasin City Health Office in 2017. The following is the data on the number of HIV / AIDS cases in Banjarmasin: Increasing HIV cases in the city of Banjarmasin from year to year are increasingly apprehensive. Based on the data above, the spread of HIV cases from 2011 to 2017 increased by an average of 11 cases every year.
The increase in HIV / AIDS cases get attention from the Banjarmasin city government, as the government's response in an effort to accommodate the needs of the community to prevent HIV / AIDS, was publish the Banjarmasin City Regulation on the prevention of HIV/AIDS number. 11 of 2012 contains 8 point (1) concerning prevention of HIV / AIDS. So that multisectoral cooperation is needed in the effort to deal with the spread of HIV/AIDS. The Banjarmasin City Regional Regulation concerning the prevention of HIV/AIDS Number. 11 of 2012 contains 8 efforts to prevent HIV/AIDS carried out in the city of Banjarmasin. But besides that, UNAIDS has also made prevention efforts globally, while the prevention efforts are expected to be able to prevent in the area, especially in Banjarmasin City. Efforts to prevent HIV transmission are delivered by UNAIDS in On the Fast-Track to End AIDS , to end the AIDS epidemic with ambitious targets.
The government programs that have been carried out in the city of Banjarmasin in the effort to prevent HIV/AIDS are carried out by several agencies that have basic tasks and functions in the prevention of HIV/AIDS such as the AIDS Commission, the Health Service and Social Services. However, in implementing the HIV/AIDS prevention program, each agency does not coordinate with each other so that the prevention effort will be done on its own.
In this theoretical review, we can see some theoretical thoughts from several articles that can support the policy implementation of prevention HIV/AIDS. Based on key concepts that can be developed for the policy implementation of prevention HIV/AIDS to update the theoretical literature based on articles that support the formulation of research related to the policy implementation of prevention HIV/AIDS.

Methods:-
From several articles obtained and relevant to this research, then filtered and reviewed from the contents of the article to fit the focus of this research. The articles taken are filtered based on titles and abstracts to identify and be a reference to the theoretical framework related to the policy implementation of prevention HIV/AIDS. Articles are excluded when they are not in accordance with research on the policy implementation of prevention HIV/AIDS, as well as articles referring to actors implementing the policy implementation of prevention HIV/AIDS and factors that support and inhibitor the policy implementation of prevention HIV/AIDS. Articles taken either articles from international or national journals. Then these concepts are processed into key concepts that refer to the research formula.

Result:-
The following are some of the previous studies used as references in this study:

Discussion:-
Policy Implementation of HIV/AIDS Control Previous research has identified many policy of prevention HIV / AIDS. " Implementing AIDS Policy in Post-Apartheid South Africa" Helen Schneider dan Joanne Stein; 2001, this paper outlines the development of AIDS policy in a political context, then examines the difficulty of implementing a comprehensive response to AIDS at every level of the country undergoing restructuring. In addition, it is also explained that the involvement of politicians / actors is still lacking, thus creating conflict and inhibiting the response in the long term.
The paper also focused the importance of grouping outside government in promoting effective policy actions, and the type of leadership needed to mobilize various actors around with a shared vision.
The conclusion in Schneider and Stein's (2001) study that the cause of implementation failure in South Africa was due to the emergence of a false level of political understanding, lack of political commitment so that the emergence of a centralized and authoritarian leadership in facilitating AIDS cases.
In the effort to develop AIDS policy it is suggested to develop a model of policy implementation approaches that are rooted in the advantages and limitations of regional situations (Schneider & Stein, 2001).

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The following are the models by Rauner and brandeau which aim to convey the composition, achievements and challenges of the AIDS policy model, Rauner and Brandeau (2001) mention several key aspects of the policy framework that can influence the future HIV/AIDS policy modeling process, namely :

Geographical Area
Some aspects of HIV prevention, care and treatment require different approaches in different geographical regions. For example, in order to develop appropriate communication for HIV prevention programs, it is important to consider government policies, socioeconomic status, culture, gender relations, and spirituality. As another example, sequentially to design effective HIV prevention programs, it is important to understand how HIV spreads in different geographical areas.

Setting and Target Group
The AIDS policy model is used in a number of 'settings'. This setting can affect the relevant intervention model and the required policy model. The AIDS policy model can be used by government agencies and policy makers. They can be applied by health care providers such as public hospitals, walking care institutions, emergency units, longterm health care institutions, shelters for HIV/AIDS sufferers, sexually transmitted infections clinics, and drug treatment offices and outreach / outrech organizations. They can also be used by institutions that do not provide health care, such as companies that want to determine the right workplace policy of HIV/AIDS.

Rauner and Brandeau (2001) divided the intervention model into two dimensions: Behavioral Interventions
This program is an intervention on behavior and aims to fight risky behavior and individual risk. This program includes general counseling, testing programs, partner notification programs, programs to reduce the risk of pregnant women in infants, sexual contact and drug abuse.

Non-Behavioral Interventions
The Non-Behavioral Interventions program includes health care system guarantee programs, tightening the immigration and quarantine system, and general programs such as recording HIV/AIDS sufferers, maintaining and treating patients, availability of vaccines and medicines.
Both of these Behavioral Interventions and Non-Behavioral Intervention programs have similar aspects in the intervention, namely behavioral change, especially for health workers in carrying out health care system guarantees.

Affordability of Interventions (ability to intervene)
A very important issue in developing countries is the affordability of HIV intervention, this is due to the limited types of prevention and treatment programs that can be implemented realistically.

Effectiveness of Interventions
The effectiveness of an intervention requires knowledge and assumptions in the development of a robust AIDS policy model. In an effort to develop a policy model to get accurate decisions, the effectiveness of appropriate and appropriate measures of intervention is needed. For example, a model that assumes that fighting risk behavior is linearly related to funds spent on counseling and testing programs that might reduce cost effectiveness.

Time Horizon and Type of Policy Model
The AIDS policy model aims to provide an exact assessment of the financing and benefits of the program as well as assist in determining appropriate policy decisions. Suitable models for evaluating HIV interventions depend on several factors such as evaluation intervention programs, time related to the effects of interventions, population groups affected by interventions and epidemic dynamics in population groups, the degree of uncertainty about the impact of interventions. Like other policy models, the AIDS policy model must be related to the balance of simplicity and ease that do not correspond to reality.

Type of Economic Analysis
Policy makers and program managers need to understand the costs and benefits of various interventions when they plan and evaluate HIV prevention and treatment programs. Economic analysis can help to estimate various costs and benefits.
The development of AIDS is increasing and unknowingly when it will end, while there are limited resources in figthing the spread of HIV and the treatment of sufferers. Rauner and Brandeau (2001) conclude how policymakers should work hard to understand how to find a model of approach, analysis and how to present findings related to the AIDS policy model to resolve future problems.

Actors/ stakeholders who play a role in the policy implementation of HIV/AIDS Control
Josephine J. Dawuni (2008) dalam "The Gendered Face of HIV/AIDS : The move towards Policy Implementation in Ghana". This study aims to examine the institutional and structural framework related to HIV/AIDS in Ghana as well as gender implications in development. This study provides recommendations related to HIV/AIDS prevention, namely: a) maximize pharmaceutical companies; b) intensification of policies and frameworks; c) civil society advocacy; d) integration of men and women; e) target social factors. Dawuni suggested that to empower women more is an effective effort in fighting HIV/AIDS, so changing government policies and socio-cultural systems opens up the limitations of women in making choices. Furthermore, Dawuni gave recommendations related to HIV/AIDS prevention, one of which was civil society advocacy ("Dawuni.pdf," n.d.). P.J. Rey (2008) in the article "The Brazilian Treatment Model: A New Course for Global AIDS Policy", states that Brazil in recent years has been fighting the AIDS epidemic and has adopted a radical approach. The approach adopted was actually deviating from the approach and technology developed by most international donor agencies that are committed to the prevention and treatment of HIV/AIDS. Therefore, Brazil's policy on AIDS treatment is very unique, namely that only a comprehensive approach in figthing AIDS that can reduce the stigma of HIV/AIDS, can provide an effective stimulus to someone to test if they feel symptoms of illness. This approach also provides education to change the behavior of the target group and most importantly reduce transmission and death. This approach find success, in the World Bank report that the death rate of AIDS sufferers decreased from 15,200 in 1995 to 8,400 in 2001. The approach taken to prevent HIV/AIDS is to reduce transmission and death by providing education on the behavior of actors receiving certain policies / groups ("jurnal P.J rey. Global aids.pdf," n.d.).
M.L.S. Mataboge , S. Beukes , A.G.W. Nolte in his journal entitled The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane. The aims of this study to exsplore and describes the experience of reproducing health services for clients and health care providers in relation to the provision of reproductive health services including prevention of HIV and AIDS in primary health services in Tshwane. Conclusions from research need Integration of input from people during policy development is an important step to ensure that informal settlements are provided with reproductive health services that are easily accessible to settlement residents to build social networks. Reproductive health services provided today are not able to overcome adolescent reproductive health problems and thus professional support is needed. Then to explore and describe providers of reproductive health services including prevention of HIV and AIDS needed a professional support in policy development ( Result of research to explain that policy of prevention HIV/AIDS in Malang Regency has been carried out according to the objectives of the policy making stated in the Regional Regulation. Stakeholder involvement in each policy process shows good cooperation between the government and NGOs (NGOs), and the community. The results of this study also show the factors that make support and constraints in the implementation of this policy.

Article key concepts
Source : processed by researchers (2019) 1112

Nafsiah Mboi dan Smith (2006)
in "Indonesia Fighting a Rising Tide : The Response to AIDS in East Asia", in his research found several obstacles related to the fight against HIV/AIDS in Indonesia. First, the breadth and diversity of Indonesian territory. Second, the developing sex industry and the lack of willingness to use condoms. Third, barriers to responding to injecting drugs. Fourth, the inconsistency between knowledge and behavior. Fifth, poverty. Sixth, Limited capacity of health systems. Seventh, stigma and discrimination. Eighth, gender inequality. Ninth, group refusal in prevention, condom use. The conclusion of this study states that many things related to war the HIV/AIDS depend on the leadership of all levels, the level of involvement of the local community in combating HIV/AIDS and the effectiveness of the services provided to those in need.

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In this study and previous research, HIV/AIDS prevention policy needs a policy implementation model based on the advantages and limitations of an area (Schneider & Stein, 2001) and with the key aspects of the policy model that can influence the HIV/AIDS policy modeling process (Rauner & Brandeau, 2001).

The Key concept the Synthesis Discussed in the Theoretical Framework for the Study of the AIDS Epidemic Termination in 2030
Research that discusses the implementation of HIV/AIDS prevention policies in an analysis by Helen Schneider and Joanne Stein; 2001, which suggested developing a model of policy implementation approach rooted in the advantages and limitations of regional situations. Then a similar study also discussed the policy implementation of prevention HIV/AIDS , Marion S Rauner and Margaret L Brandeau (2001) provided an overview of the development of AIDS policy models and mentioned several key aspects in the policy framework that could influence the process of making an HIV/AIDS policy model.
Then, research that discusses actors who play a role in the policy Implementation of Prevention HIV/AIDS, as analyzed by Josephine J. Dawuni (2008). Which provides recommendations related to HIV/AIDS prevention, one of which is to advocate for civil society. In addition, P.Jey (2008) mentions the approach taken to prevent HIV/AIDS to reduce transmission and death by providing education on the behavior of certain recipients of certain policies / groups. M.L.S. Mataboge, S. Beukes, A.G.W. Nolte also discussed actors who play a role in the policy implementation of prevention HIV/AIDS, which mention that exploring and describing reproductive health service providers including HIV and AIDS prevention requires professional support in policy development. Gape Kabayakgosi and Keneilwe P. Mpule (2008) also mentioned that by involving many policy actors it would facilitate the transformation of HIV/AIDS policies.
Another study discusses the supporting and inhibiting factors for the policy implementation of prevention HIV/AIDS is Suwitri (2009) which states that some aspects are less optimal in implementing HIV and AIDS prevention policies and factors that influence the implementation of HIV and AIDS prevention policies. In addition, Diyan also mentioned the factors that made support and constraints in policy implementation. Nafsiah's latest fund stated that many things related to the HIV/AIDS war depend on the leadership of all levels, the level of involvement of the local community in combating HIV/AIDS and the effectiveness of the services provided to those in need.

Conclusion:-
Based on the key concept of synthesis from the interrelated theoretical framework to develop, study and evaluate the policy implementation of prevention HIV/AIDS. Each article has its own role in relation to the elements of research, both the relationship with actors involved in implementing the implementation of HIV/AIDS prevention policies and the factors that support or hinder the implementation of HIV/AIDS prevention policies.