Nurdin Rahman
Faculty of Public Health, Universitas Tadulako, Palu, Sulawesi Tengah, Indonesia

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Navigating Stigma and Survival: A Phenomenological Study of HIV Risk Among MSM in Palu, Indonesia Nur Afni; Nurdin Rahman; Muhammad Ryman Napirah; Andi Mascunra Ami
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 8 No. 10 (2025)
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v8i10.8105

Abstract

Introduction: In this study, we aimed to explore the multidimensional social determinants influencing HIV vulnerability among men who have sex with men (MSM) within the context of stigma and exclusion in Indonesia. With high HIV prevalence among MSM and persistent social discrimination, our objective was to examine how social, economic, and structural factors contribute to health risks and hinder access to HIV prevention and care services. Methods: This qualitative study involved a phenomenological approach conducted across the urban setting of Palu, Indonesia, over a three-month period. A total of 15 participants were enrolled, and data were collected through in-depth interviews with purposively selected key informants. Results: The primary outcome of the study was the identification of structural and psychosocial barriers that shape HIV vulnerability, including fear of discrimination, familial rejection, and economic precarity. Additionally, digital platform use and inconsistent condom usage emerged as significant behavioral factors. Statistical analyses were not applicable due to the qualitative nature of the study. However, thematic analysis revealed intersecting themes aligned with the social-ecological model and syndemic theory. Conclusion: In conclusion, our study contributes to the understanding of HIV vulnerability among MSM by highlighting the impact of intersecting stigma, poverty, and systemic exclusion. This research provides insights into the need for community-led and culturally responsive interventions. Future studies should address the integration of economic empowerment strategies and digital outreach mechanisms, ultimately advancing knowledge in the field of international public health.
Between Stigma and Survival: The Role of Digital Backstage and Selective Disclosure in MSM Health Navigation in Palu, Indonesia Fitri Sulistiyani; Nurdin Rahman; I Made Tangkas; Ahmad Sinala
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 8 No. 11 (2025)
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v8i11.8303

Abstract

Introduction: In this study, we aimed to explore how Men Who Have Sex with Men (MSM) in post-disaster Palu, Indonesia, manage their sexual identities under religious conservatism, patriarchal norms, and heightened moral surveillance following the 2018 earthquake. Within this religiously conservative and disaster-affected context, our objective was to understand how MSM employ impression-management strategies to navigate visibility, stigma, and safety, and to analyze their implications for mental health, healthcare-seeking behavior, and overall well-being. This study addresses gaps in the literature by situating MSM experiences within Indonesia’s sociocultural and religious frameworks, thereby contributing to regional and cross-cultural analyses of LGBTQ+ identity negotiation in Southeast Asia. Methods: This qualitative phenomenological study employed in-depth interviews, photo-elicitation, and digital ethnographic observation over six months in Palu. A total of twenty-five MSM participants aged 18–40 were purposively recruited to ensure diversity of experience and social background. Sampling continued until thematic saturation was reached, meaning no new themes emerged during ongoing analysis. Data collection included semi-structured interviews and analysis of interactions on online platforms (e.g., Telegram, BlueD, and Instagram). Visual materials contributed to the coding framework by illustrating non-verbal expressions of impression management, later integrated into thematic synthesis. Ethical approval was obtained from the Institutional Review Board (IRB) of the Faculty of Public Health, Universitas Muhammadiyah Palu, following the British Psychological Society (BPS) and American Anthropological Association (AAA) ethical codes. Participants provided verbal and written informed consent, and all identifying details were anonymized. Results: The primary outcome of the study was an understanding of how MSM in Palu adaptively navigate identity, stigma, and safety through impression management. Key findings revealed that MSM maintain dual personas—performing heteronormativity in public (front-stage) while expressing their authentic identities within digital backstage spaces. Selective disclosure of sexual orientation was governed by contextual trust, relational safety, and fear of institutional stigma. Digital platforms functioned as crucial psychosocial and health-navigation spaces, enabling solidarity and access to information. However, overreliance on digital interactions sometimes intensified isolation and reproduced inequalities linked to digital literacy and class. While these adaptive strategies ensure survival under moral surveillance, they inadvertently reinforce structural stigma by normalizing concealment and restricting public visibility. Conclusion: In conclusion, this study contributes to understanding how Men Who Have Sex with Men (MSM) in Palu construct survival and well-being through impression management under conditions of religious-patriarchal stigma and disaster-induced moral tightening. It illustrates that dual personas, selective disclosure, and digital backstage practices function both as protection and as mechanisms that perpetuate invisibility. These findings inform the design of culturally sensitive, confidentiality-centered health interventions, emphasizing peer navigation, digital outreach, and faith-inclusive stigma reduction. Future studies should investigate the long-term mental health impacts of sustained concealment and digital dependency, advancing inclusive policies and provider training across Indonesia’s public health systems and the broader Southeast Asian region.