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"HIV merupakan penyakit yang sering terjadi bersamaan dengan penyakit lain. Keberadaan penyakit penyerta memerlukan terapi bersama dengan obat ARV. Hal ini memungkinkan terjadinya interaksi antar obat yang berpotensi menyebabkan penurunan atau peningkatan kadar obat dalam darah, yang bisa menimbulkan kegagalan terapi atau efek samping berupa toksisitas. Penelitian ini bertujuan melihat potensi interaksi yang penting secara klinis dari terapi ARV dengan obat komorbidnya. Penelitian ini adalah penelitian non eksperimental, pengambilan data dilakukan secara potong lintang pada pasien HIV dengan komorbid yang dirawat di rumah sakit Cipto Mangunkusumo dalam periode Januari 2016 sampai dengan Juli 2017. Data diambil dari electronic health record dan pusat rekam medis RSCM. Dari 224 pasien HIV yang masuk kedalam kriteria inklusi, terdapat 121 pasien yang memenuhi persyaratan dan diambil menjadi subjek penelitian. Potensi interaksi yang penting secara klinis didefinisikan sama dengan potensi interaksi mayor memerlukan modifikasi dosis, jangan diberikan bersamaan, kontraindikasi atau hindari . Hasil penelitian menunjukkan dari 121 pasien, potensi interaksi mayor terjadi pada 18 pasien 14,99 dengan potensi interaksi yang menurunkan kadar ARV pada 14 pasien 11,57 . Kejadian potensi interaksi mayor yang paling banyak terjadi yaitu antara nevirapin dan rifampisin 3,53 . Komorbid terbanyak adalah Tuberkulosis Paru 12,92 . Diperlukan penelitian prospektif pengukuran kadar obat dan efek terapi akibat interaksi obat ARV dengan obat komorbidnya.

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HIV is a disease commonly presents with other comorbidities which need concomitant treatments with ARV. Drug-drug interaction is an unavoidable consequence which may potentially lead to an increase or a decrease of affected drug and ultimately resulted in therapeutic failure or otherwise, toxicity.This study was aimed to look at the potential of clinically significant drug-drug interactions between ARV and other treatments. This was a non experimental cross sectional study conducted on HIV patients with comorbids treated at the Cipto Mangunkusumo hospital from January 2016 to Juli 2017. Data were taken from the electronic health record and Cipto Mangunkusumo hospital medical record. From 224 HIV patients who meet the criteria of inclusion, there are 121 patients that rsquo;s fulfilled the conditions and was taken to be the subjects of research. The potential of clinically significant drug-drug interactions are definitioned as potential for major interaction requiring dose modification, do not coadminister, contraindicated or avoid . The results showed that potential for mayor interactions occurred in 18 out of 121 patients 14.99 . Potential decrease of blood ARV level was found in 14 patients 11.57 . The occurance of potential for major interaction mostly happened between nevirapin and rifampisin 3,35 . The most comorbid is pneumonia tuberculosis 12.92 . Prospective study is required to measure drugs level and the effect of therapy consequence ARV drugs interaction with comorbid drugs"

"This is the first report of HIV drug resistance in RSUPN Dr. Cipto Mangunkusumo. We tested We reviewed eleven new cases of HIV patients who had virologic failure after 6 months first-line antiretroviral therapy. With the sequencing method, analysis of gene mutations encoded HIV drug resistance. Genotypic resistance results and HIV-1 subtype were interpreted by Stanford DR database. Of ten plasma samples that were successfully amplified and sequenced, all samples were resistant to at least one antiretroviral drug. Genotypic resistance towards the antiretroviral drugs being used was observed in lamivudine (90%), tenofovir (83%), nevirapine (100%) dan efavirenz (100%). It is interesting that no zidovudine resistance were found, including in four patients receiving zidovudine in their HAART. The common NRTI mutations were M184VI and K65R, while NNRTI mutations were Y181CFGVY, K103N, A98AG, E138GQ and G190AGS. No mayor PI mutations were found. Based on these findings, we supports the need for appropriate virology monitoring and HIV drug resistance survey in clinical practice and access to drug options in case of virology failure."

"Permasalahan Narkoba dan Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) menjadi epidemi ganda yang menuntut ditangani oleh pemerintah, yaitu Badan Narkotika Nasional (BNN) dan Komisi Penanggulangan AIDS (KPA). Munculnya paradigma yang berbeda antara Pemerintah dan Yayasan Pelita Ilmu Kampung Bali (YPI Kambal) menyebabkan masalah Narkoba dan HIV/AIDS itu tidak tertangani dengan baik. Penelitian ini mengajukan Rumusan Permasalahan : (1) Apa perbedaan paradigma implementasi pencegahan Narkoba dan HIV/AIDS yang dilakukan pemerintah dan YPI Kambal?; (2) Mengapa YPI Kambal tetap dapat eksis walaupun berbeda paradigma implementasi pencegahan Narkoba dan HIV/AIDS dengan kebijakan pemerintah?; dan (3) Apa langkah-langkah yang dilakukan Pemerintah dalam mengkoordinasikan implementasi kebijakan pencegahan Narkoba dan HIV/AIDS dengan YPI Kambal? Penelitian ini menggunakan prosedur deskriptif analitis atau eksplanatoris yang dilakukan selama hampir empat bulan. Teori yang membimbing penulis adalah teori Paradigma, teori Implementasi, konsep Lembaga Swadaya Masyarakat, Pencegahan Narkoba dan HIV/AIDS, Narkoba, Heroin/Putaw, HIV/AIDS.Dari hasil penelitian ini diketahui : (1) Pemerintah menggunakan pendekatan hukum dan kesehatan, dengan Model Mekanisme Paksa, didukung dana APBN dan APBD dan bersikap hati-hati menerapkan program Pertukaran Jarum Suntik Steril (PJSS). Sedang YPI Kambal menggunakan Pendekatan Sosial Kemasyarakatan, dengan model Mekanisme Pasar, dana swadaya dan donasi negara donor dan tidak masalah menerapkan PJSS. (2) Faktor-faktor yang menyebabkan YPI Kambal tetap dapat eksis, yaitu : (a) membuka diri, (b) dalam berorganisasi membuka diri dengan manajemen terbuka kepada anggotanya. (c) Perkembangan anggota yang meningkat; (d) Perkembangan wilayah binaan yang semakin meluas. (e) Adanya lembaga atau instansi yang mengadopsi konsep YPI Kambal. (3) Langkah-langkah yang dilakukan Pemerintah dalam mengkoordinasikan implementasi kebijakan pencegahan Narkoba dan HIV/AIDS dengan YPI kambal, antara lain : (a) Dengan melakukan Kunjungan ke Kampung Bali; (b) Mengundang Partisipasi YPI Kambal dalam Kegiatan Pemerintah; (c) Memberikan bantuan berupa obat-obatan, ambulan dan petugas Medis; (d) Melakukan Implementasi Pencegahan Narkoba dan HIV/AIDS secara bersama.

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Problems of Drug abuse and of Human Immunodeficiency Virus/Immunodeficiency Syndrome acquired (HIV/AIDS) become double epidemic which claim to be handled by government are National Narcotic Board (BNN) and Commission of Struggle AIDS (KPA) different Appearance Paradigm between Government and Institution of Yayasan Pelita Ilmu Kampung Bali (YPI Kambal) causing the problem of Drugs and HIV/AIDS do not handle better. This research raise formula problems : (1) What difference of preventive implementation paradigm the problem of Drugs and HIV/ AIDS between government and YPI Kambal?; (2) Why YPI Kambal remain to earn exist although differ preventive implementation paradigm of Drugs and HIV/ AIDS with policy of government?; and (3) What done stages and steps is Government in coordinated preventive policy implementation of Drugs and HIV/AIDS with YPI Kambal? This research use analytical descriptive procedure or conducted explanatory during almost four months. Theory guiding writer [is] Paradigm theory, Implementation theory, theory Model Implementation, preventive of Drugs and HIV/ AIDS.From this research result is known : (1) Government use the approach punish and health, with the Mechanism Model Force, supported by fund of State budget and District budget and behave to beware of to apply the Needle Exchange Program (NEP). Medium of YPI Kambal use the Community Base, with the model of Market Mechanism, self-supporting fund and donation of donor state and problem not apply the NEP. ( 2) Factors causing YPI Kambal remain to earn the eksis, that is : (a) expose oneself, (b) in have organization to expose oneself with the management opened to its member; (c) member Growth mounting; (d) regional Growth of area program which progressively extend; (e) the Existence of institute or institution adopting concept of YPI Kambal. (3) Stages; Steps conducted by Government in coordinated the implementation of policy of prevention of Drugs and HIV/AIDS by YPI Kambal, for example : ( a) Visiting to Kampung Bali; ( b) Invite The Participation of YPI Kambal in Governmental Activity; (c) Give the aid in the form of medicine, Medical worker and; ( d) Conduct The Preventive Implementation of Drugs and HIV/AIDS together."

"Praktek klinik lanjut selama praktek residensi keperawatan pada sistem imunologi dimaksudkan untuk mampu memberikan asuhan keperawatan, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai inovator di ruang perawatan. Residen melakukan asuhan keperawatan dengan kasus kelolaan utama menggunakan pendekatan teori adaptasi Roy dan 30 kasus resume menggunakan pendekatan teori Bandura. Dari hasil kasus kelolaan utama, diagnosa keperawatan utama yang muncul adalah defisit nutrisi sehingga intervensi utama keperawatan fokus pada manajemen nutrisi. Dari kasus resume masalah keperawatan yang paling banyak ditemukan yaitu ketidakpatuhan pengobatan. Intervensi keperawatan dukungan kepatuhan program pengobatan ditujukkan untuk meningkatkan kepatuhan pengobatan. Selain itu, intervensi yang dilakukan adalah melakukan proyek inovasi keperawatan berupa penerapan konseling pengobatan ART terstruktur dalam meningkatkan kepercayaan diri perawat serta kepatuhan pengobatan pasien. Evidence Based Nursing yang telag dilakukan residen adalah melakukan uji validitas dan reliabilitas PHQ-9 untuk skrining depresi yang menunjukkan bahwa PHQ-9 valid dan reliabel dalam mendeteksi depresi pada pasien dengan HIV.

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Advanced clinical practice during nursing residency practice in the immunology system is intended to be able to provide nursing care, implement Evidence Based Nursing (EBN) and as an innovator. Resident conducts nursing care with main cases using Roy's adaptation theory approach and 30 cases resumes using Bandura theory approach. From the results of the main case, the main nursing diagnosis was nutritional deficit so nursing interventions focused on nutritional management. From the case of resume, the most common nursing problem found was non-adherence. Nursing interventions is adherence support are aimed to improve treatment adherence. In addition, the nursing intervention was innovation project structured ART treatment counseling to increase nurse confidence and patient treatment compliance. Evidence Based Nursing that has been done by residents is to test the validity and reliability of PHQ-9 for depression screening which shows that PHQ-9 is valid and reliable in detecting depression in patients with HIV."

"Terdapat 200 anak dengan penyakit ginjal tahap akhir (PGTA) di Indonesia. Hampir 99% menjalani hemodialisis. Pasien dengan catheter double lumen (CDL) sering mengalami infeksi pada akses hemodialisis yang digunakan. Penelitian ini bertujuan melihat karakteristik pasien yang menjalani hemodialisis menggunakan CDL baik tunnelled (TCDL) maupun non-tunnelled (NTCDL), insidensi infeksi, faktor risiko yang memengaruhi terjadinya infeksi, dan angka kesintasan CDL. Penelitian ini adalah kohort retrospektif menggunakan data rekam medik pasien anak yang dipasang akses vaskular hemodialis oleh Divisi Bedah Vaskular RSUPN Dr. Cipto Mangunkusumo (RSCM) mulai Januari 2016 hingga Juli 2022. Sebanyak 154 pasien PGTA anak menjalani hemodialisis di RSCM. Didominasi oleh laki-laki, dengan median usia 14,0 tahun (range: 2,0–18,0). Terdapat 277 prosedur pemasangan akses vaskular, terdiri dari 164 NTCDL dan 113 TCDL. Komplikasi infeksi keseluruhan mencapai 220 kasus (79,4%), infeksi exit site 179 kasus (64,6%), dan catheter-related blood infection 41 kasus (14,8%). Faktor yang berhubungan dengan infeksi adalah leukositosis/leukopenia, hipoalbuminemia, dan lama pemakaian (p<0,05). Median survival NTCDL: 45,0 hari (IK95%: 39,2 – 50,8) vs. TCDL: 213,0 hari (IK95%: 149,6 – 276,4); Log-rank p <0,001. Tidak terdapat perbedaan karakteristik demografi, antara kelompok NTCDL dengan TCDL. Terdapat perbedaan angka median kesintasan (median survival) CDL sejak insersi hingga terjadi infeksi antara NTCDL dengan TCDL.

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There were 200 children with end-stage renal disease (ESRD) in Indonesia. Nearly 99% undergo hemodialysis. Pediatric ESRD with catheters double lumen (CDL) often experienced hemodialysis access infections. This study aimed to find the characteristics of patients between tunnelled CDL (TCDL) and non-tunnelled (NTCDL), the incidence, risk factors, and survival of infection. This study was a retrospective cohort using medical record who had hemodialysis vascular access placement by the Division of Vascular and Endovascular Surgery RSUPN Dr. Cipto Mangunkusumo Hospital (CMH) from January 2016 to July 2022. A total of 154 pediatric ESRD underwent hemodialysis at CMH, dominated by males, with median age 14.0 years (range: 2.0–18.0).  There were 277 procedures for placing vascular access, 164 NTCDL and 113 TCDL. Overall infection occured in 220 cases (79.4%), exit site infection in 179 cases (64.6%), and catheter-related blood infection in 41 cases (14.8%). Factors associated with infection were leukocytosis/leukopenia, hypoalbuminemia, and duration of catheter use (p<0.05). NTCDL median survival: 45.0 days (95%CI: 39.2 – 50.8) vs. TCDL: 213.0 days (95%CI: 149.6 – 276.4); Log-rank p<0.001. There were no demographic characteristic differences between the NTCDL and TCDL groups. There was a median catheter survival difference between NTCDL and TCDL from insertion to infection episode."

"Tuberkulosis TB merupakan salah satu penyakit pembunuh yang kerap menjadi masalah besar di dunia dan diperburuk oleh masalah efek samping obat yang berdampak pada terhentinya pengobatan pasien TB. Penelitian ini dilaksanakan untuk mengkaji hubungan antara efek samping OAT dengan keberlanjutan pengobatan TB. Studi ini dilakukan dengan desain penelitian analitik menggunakan studi cross-sectional dengan melibatkan 172 data rekam medis penderita TB paru dewasa yang diobati dan mendapatkan efek samping di RSCM selama tahun 2014. Pada penelitian ini didapatkan 73,8 pasien mendapatkan efek samping minor dan 26,2 mengalami efek samping minor. Jenis efek samping minor yang muncul didominasi oleh gangguan gastrointestinal 34 dan jenis efek samping mayor didominasi hepatitis yang diinduksi oleh obat 60 . Penelitian ini menunjukkan terdapatnya hubungan yang bermakna antara variabel jenis efek samping dengan keberlanjutan terapi OR, 9,33; 95 CI, 4,20-20,72.

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Tuberculosis TB is one of top infectious diseases killer and remains as a major health problem worldwide. Moreover, the TB treatment adverse effects are able to escalate the treatment default. This study aimed to evaluate the correlation between anti TB drug adverse reactions and treatment default. A cross sectional study was performed with a total of 172 medical record data of adult pulmonary TB patients who were treated with first line anti TB drugs in Dr. Cipto Mangunkusumo National General Hospital during 2014 and experienced adverse reaction.

127 patients 73.8 were experiencing minor adverse reaction and 45 patients 26.2 were experiencing mayor adverse reaction. The adverse reaction was dominated by gastrointestinal disorders 34 and drug induced hepatitis 60. There was a significant correlation between adverse reactions of anti TB drug and the treatment default cases OR, 9.33 95 CI, 4.20 20.72 p."

"Kurangnya kepatuhan terhadap pengobatan menjadi faktor risiko munculnya jenis HIV yang resisten terhadap obat, yang dapat ditularkan kepada orang lain. Kepatuhan terhadap pengobatan yang buruk tidak hanya membahayakan kesehatan individu tetapi juga meningkatkan penularan. Penelitian ini bertujuan untuk mengamati faktor-faktor yang berhubungan dengan terjadinya ketidakpatuhan minum obat ARV pada ODHIV yang mendapatkan terapi ARV di Rumah Sakit Umum Daerah Kabupaten Tangerang. Jenis penelitian ini menggunakan penelitian observasional dengan rancangan cross sectional. Penelitian dilakukan di poli HIV Rumah Sakit Umum Daerah Kabupaten Tangerang dan waktu penelitian dilakukan pada bulan November 2023 menggunakan data sekunder. Populasi penelitian berjumlah 1.337 ODHIV yang aktif menjalani pengobatan antiretroviral di Rumah Sakit Umum Daerah Kabupaten Tangerang dengan menggunakan total sampling sesuai dengan kriteria inklusi dan ekslusi sehingga sampel penelitian berjumlah 1.286 ODHIV. Hasil analisis univariat menunjukan bahwa usia ≥ 35 tahun (56,45), laki-laki (61,20%), pendidikan rendah (87,10%), belum kawin atau cerai (51,92%), domisili dalam kabupaten Tangerang (55,88%), mendapatkan konseling kepatuhan (63,73%), memiliki jaminan kesehatan (51,92%), ≥5km akses layanan kesehatan (54,07%), IO non TB (40,90%), stadium lanjut (63,69%), viral load ≥40 mL (46,73%), tidak ada efek samping obat (53,34%), lamanya pengobatan >5 tahun (72,01%), masuk kedalam populasi kunci (88,01%) dan tidak mendapat dukungan (61,12%). Hasil analisis kai kuadrat secara statistik ada hubungan antara umur, jenis kelamin, status pendidikan, status perkawinan, domisili, pelayanan konseling kepatuhan, stadium klinis WHO, viral load, lamanya pengobatan ARV, kelompok populasi kunci dan dukungan teman sebaya (P-Value<0,05) dengan ketidakpatuhan minum obat ARV. Hasil analisis cox regression dengan faktor yang secara statistik berhubungan terhadap ketidakpatuhan minum obat antiretroviral pada ODHIV adalah umur (P-Value=0,01) nilai PR 1,20 dengan 95% CI (1,05-1,38), status perkawinan (P-Value=0,02) nilai PR 1,18 dengan 95% CI (1,03-1,36), domisili (P-Value=0,01) nilai PR 1,19 dengan 95% CI (1,04-1,36), viral load (P-Value=0,001) nilai PR 1,27 dengan 95% CI (1,10-1,43), lamanya pengobatan ARV (P-Value=0,005) nilai PR 1,25 dengan 95% CI (1,07-1,47), kelompok populasi kunci (P-Value=0,02) nilai PR 1,27 dengan 95% CI (1,04-1,56), dukungan teman sebaya (P-Value=0,04) nilai PR 1,15 dengan 95% CI (1,00-1,32). Faktor umur, status perkawinan, domisili, viral load, lamanya pengobatan, kelompok populasi kunci dan dukungan teman sebaya  memiliki pengaruh terhadap ketidakpatuhan minum obat antiretroviral (ARV) pada ODHIV di Rumah Sakit Umum Daerah Kabupaten Tangerang.

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Lack of treatment adherence becomes a risk factor for the emergence of drug-resistant strains of HIV, which can be transmitted to others. Poor adherence to treatment harms the individual’s health and increases the risk of transmission. This study aims to observe the factors associated with the occurrence of non-adherence to taking ARV drugs in PLHIV who receive ARV therapy at the Regional General Hospital of Tangerang Regency. This type of study uses observational research with a cross-sectional design. The study was conducted at the HIV Specialist of the Regional Govern Hospital of Tangerang Regency and the time of the study was carried out in November 2023 using secondary data. The study population amounted to 1,337 PLHIV who were actively undergoing antiretroviral treatment at the Regional General Hospital of Tangerang Regency using total sampling by inclusion and exclusion criteria so that the study sample amounted to 1,286 PLHIV. The results of the univariate analysis showed that the age of ≥ 35 years (56.45), male (61.20%), low education (87.10%), unmarried or divorced (51.92%), domiciled in Tangerang district (55.88%), received compliance counselling (63.73%), had health insurance (51.92%), ≥5km of health service access area (54.07%), non-TB IO (40.90%), advanced stage (63.69%), viral load ≥40 mL (46.73%), no drug side effects (53.34%), duration of treatment ≥5 years (72.01%), entered into key populations (88.01%) and received no support (61.12%). The results of the kai squared analysis statistically showed there was an association between age, sex, educational status, marital status, domicile, adherence to counselling services, WHO clinical stage, viral load, duration of ARV treatment, key population groups and peer support (P-Value<0.05) with non-adherence to taking ARV drugs. The results of Cox Regression analysis with factors statistically related to non-adherence to taking antiretroviral drugs in ODHIV were age (P-Value = 0.01), PR value 1.20 with 95% CI (1.05-1.38), marital status (P-Value = 0.02), PR value 1.18 with 95% CI (1.03-1.36), domicile (P-Value = 0.01), PR value 1.19 with 95% CI (1.04-1.36), viral load (P-Value = 0.001), PR value 1.27 with 95% CI (1.10-1.43),  duration of ARV treatment (P-Value = 0.005), PR value 1.25 with 95% CI (1.07-1.47), key population group (P-Value = 0.02), PR value 1.27 with 95% CI (1.04-1.56), peer support (P-Value = 0.04), PR value 1.15 with 95% CI (1.00-1.32). Factors such as age, marital status, domicile, viral load, duration of treatment, key population groups and peer support have an influence on non-adherence to taking antiretroviral drugs (ARV) in PLHIV at the Regional General Hospital of Tangerang Regency."

"ABSTRAK Kasus HIV/AIDS dan tuberkulosis banyak diderita masyarakat perkotaan.Penyakit pada masyarakat perkotaan berkaitan dengan karakteristik lingkungandan gaya hidup masyarakat perkotaan. Kasus HIV biasanya disertai denganberbagai infeksi oportunistik. Infeksi opportunistik yang paling banyak ditemukanadalah tuberkulosis, diikuti dengan kandidiasis oral, dan diare. Masalahkeperawatan utama pada pasien dengan tuberkulosis adalah ketidakefektifanbersihan jalan napas berhubungan dengan retensi sputum. Penulisan karya ilmiahakhir ini bertujuan untuk menganalisis intervensi mandiri keperawatan berupakombinasi antara anjuran minum air putih hangat, postural drainase, dan batukefektif untuk mengatasi masalah bersihan jalan napas tidak efektif. Intervensidilakukan pada pasien HIV/AIDS dengan tuberculosis di ruang rawat penyakitdalam RSCM. Hasil dan evaluasi dari intervensi yang dilakukan yaituberkurangnya penumpukan sputum pada jalan napas pasien, sehingga pasien tidakmerasakan sesak seperti sebelumnya dan bisa bernapas lebih lega. Perawatdiharapkan dapat melakukan intervensi mandiri keperawatan berupa kombinasiantara anjuran minum air putih hangat, postural drainase, dan batuk efektiftersebut untuk membantu memperbaiki status pernapasan pasien.ABSTRACT Cases of HIV / AIDS and tuberculosis affects many urban communities. Diseases

in urban communities are related to environment and lifestyle characteristics of

urban communities. HIV cases are usually accompanied by a variety of

opportunistic infections. The most common opportunistic infections is

tuberculosis, followed by oral candidiasis and diarrhea. The main nursing

problems in patients with tuberculosis is the ineffectiveness of airway clearance

related to the retention of sputum. This final scientific thesis aims to analyze the

independent nursing intervention in the form of a combination of the

recommendation to drink warm water, postural drainage, and cough effectively to

address the problem of ineffective airway clearance. The intervention was

conducted in HIV/AIDS patient with tuberculosis in medical ward RSCM. The

result of interventions was reduced sputum buildup in the airway of the patient, so

the patient did not feel crowded as before and could breathe more easily. Nurses

are expected to conduct independent nursing interventions in the form of a

combination of the recommendation to drink warm water, postural drainage and

effective coughing to help improve patient's respiratory status. ;Cases of HIV / AIDS and tuberculosis affects many urban communities. Diseases

in urban communities are related to environment and lifestyle characteristics of

urban communities. HIV cases are usually accompanied by a variety of

opportunistic infections. The most common opportunistic infections is

tuberculosis, followed by oral candidiasis and diarrhea. The main nursing

problems in patients with tuberculosis is the ineffectiveness of airway clearance

related to the retention of sputum. This final scientific thesis aims to analyze the

independent nursing intervention in the form of a combination of the

recommendation to drink warm water, postural drainage, and cough effectively to

address the problem of ineffective airway clearance. The intervention was

conducted in HIV/AIDS patient with tuberculosis in medical ward RSCM. The

result of interventions was reduced sputum buildup in the airway of the patient, so

the patient did not feel crowded as before and could breathe more easily. Nurses

are expected to conduct independent nursing interventions in the form of a

combination of the recommendation to drink warm water, postural drainage and

effective coughing to help improve patient's respiratory status. ;Cases of HIV / AIDS and tuberculosis affects many urban communities. Diseases

in urban communities are related to environment and lifestyle characteristics of

urban communities. HIV cases are usually accompanied by a variety of

opportunistic infections. The most common opportunistic infections is

tuberculosis, followed by oral candidiasis and diarrhea. The main nursing

problems in patients with tuberculosis is the ineffectiveness of airway clearance

related to the retention of sputum. This final scientific thesis aims to analyze the

independent nursing intervention in the form of a combination of the

recommendation to drink warm water, postural drainage, and cough effectively to

address the problem of ineffective airway clearance. The intervention was

conducted in HIV/AIDS patient with tuberculosis in medical ward RSCM. The

result of interventions was reduced sputum buildup in the airway of the patient, so

the patient did not feel crowded as before and could breathe more easily. Nurses

are expected to conduct independent nursing interventions in the form of a

combination of the recommendation to drink warm water, postural drainage and

effective coughing to help improve patient's respiratory status. "