Indonesia facing increasing number of HIV/AIDS cases

Indonesia is facing an increasing number of HIV/AIDS cases, particularly among commercial sex workers and injection drug users, and the country's Papua region is facing a generalized epidemic, according to a report released recently by the World Health Organization, UNAIDS, and other international agencies and local nongovernmental organizations, Reuters reports.

The report, which did not provide estimates on HIV/AIDS cases in Indonesia, said that the country also faces a lack of resources to deal with the issue, according to Bjorn Melgaard of WHO. Melgaard added that Indonesia also has several constraints in dealing with HIV/AIDS, including weak preventive initiatives among high-risk groups, blood safety issues and inadequate clinical care. "Indonesia has one of the fastest growing HIV epidemics in Asia," the report says, adding, "Although the HIV prevalence among adults is still generally low, it has reached high levels among specific populations," including IDUs and sex workers. The report also cited a recent survey that found the country's Papua region has an HIV prevalence of 2% -- 20 times the national average. According to the report, there is "recent evidence of a generalized epidemic" in Papua, and the region will not be able to adequately address the situation because of its weak health care infrastructure and lack of resources (Reuters, 2/19). According to Melgaard, HIV/AIDS in Indonesia is progressing along two paths -- a concentrated epidemic among high-risk populations and the generalized epidemic seen in Papua. "Due to the unique nature of the epidemic and the limited financial, human and technical resources locally available, fundamentally different needs should be addressed in Papua," he added. I. Nyoman Kandun, director general of communicable diseases at the country's health ministry, said that the government has considered taking a more proactive approach to reach specific populations in Papua, according to the Jakarta Post (Jakarta Post, 2/19). Although Indonesia is the world's most populous Muslim nation, many of its residents have a liberal attitude toward sex, and commercial sex work is a large part of the economy in many areas, Reuters reports. Injection drug use in the country also has been growing, police have said. Indonesian Health Minister Siti Fadilah Supari warned in November 2006 that there could be 500,000 HIV cases in the country by 2010 and twice as many if preventive steps are not taken (Reuters, 2/19).

Related Opinion Piece
Although there is "no longer any question that HIV/AIDS is a big problem in Indonesia," many people are "unwilling to find out their HIV status" because "stigmatization and discrimination are still rife," Galuh Wulan and Gita Lingga from the International Labour Organization's Education Program for HIV/AIDS write in a Post opinion piece. According to the authors, HIV/AIDS primarily affects people of working age in Indonesia, meaning that the disease has "made inroads into the world of work, including the migrant worker sector." Because the risks associated with receiving an HIV test, including dismissal from employment, "multiply" for undocumented and migrant workers because "they are not protected by the law," it is "important" to "improve" HIV testing policies in Indonesia and "apply the migrant-friendly procedures now being deliberated" by the Health Ministry and the Manpower Ministry," Wulan and Lingga write, adding, "Under these procedures, HIV testing must be voluntary, confidential and linked to counseling" (Wulan/Lingga, Jakarta Post, 2/19).