HIV/AIDS in Indonesia - History

History

Indonesia’s first case of HIV was reported in 1987 and between then and 2009, 3,492 people died from the disease. Of the 11,856 cases reported in 2008, 6,962 of them were people under 30 years of age, including 55 infants under 1 year old. There are a high number of concentrated cases among Indonesia’s most at risk including injection drug users (IDUs), sex workers their partners and clients, homosexual men and infants who contract the disease through the womb or from being breast fed.

In the last 15 years, HIV/AIDS has become an epidemic in Indonesia. The highest concentration areas are Papua, Jakarta, East Java, West Java, Bali and Riau and all are considered to be zones that need immediate attention.

Due to the increasing number of IDUs, the number of new infections has grown rapidly since 1999. Moreover, a generalised epidemic is already under way in the provinces of Papua and West Papua, where a population-based survey found an adult-prevalence rate of 2.4% in 2006. A whopping 48% of Papuans are unaware of HIV/AIDS, and the number of AIDS cases per 100,000 people in the two provinces is almost 20 times the national average. The percentage of people who reported being unaware of HIV/AIDS increases to 74% among uneducated populations in the region.

The epidemic in Indonesia is one of the fastest growing among HIV/AIDS in Asia. The epidemic of injecting drug use continues to be the primary mode of transmission, accounting for 59% of HIV infections, and heterosexual transmission accounted for 41% in 2006. According to the Indonesian Ministry of Health, recent surveys report that more than 40% of IDUs in Jakarta have tested positive for HIV, and about 13% tested positive in West Java. Many IDUs sell sex to finance their drug habits. Yet in 2005, 25% of IDUs in Bandung, Jakarta, and Medan said they had unprotected paid sex in the last 12 months.

The Indonesian archipelago stretches more than 3,000 miles along the Equator. Cultural practices and levels of urbanization have an impact on the HIV/AIDS epidemic. For instance, a culture of paid and “transactional” sex among young men and women aged 15 to 24 has been a driving factor in Papua. Among 15 to 24 year olds, HIV-prevalence rates were 3% in 2006, according to the Ministry of Health. Prevalence rates among sex workers in Papua’s major urban areas ranged from 9% in Timika to 16% in Sorong in 2004.

Numerous factors put Indonesia in danger of a broader epidemic. Risky sexual behaviors are common. Only 54.7% of sex workers and 56.5% of men who have sex with men (MSM) use condoms consistently, and just 18.5 percent of IDUs consistently use both sterile needles and condoms, according to Indonesia’s 2006 report to the United Nations General Assembly Special Session on HIV/AIDS (UNGASS). Many IDUs are also sex workers or clients of sex workers, increasing the likelihood of HIV/AIDS spreading to the general population. Awareness of HIV status among at-risk populations is low. According to a 2004–2005 study cited in the UNGASS report, 18.1% of IDUs, 15.4% of MSM, 14.8% of sex workers, and 3.3% of clients of sex workers had received HIV testing in the previous 12 months and knew their test results. Stigma and discrimination persist and many people living with HIV hide their status for fear of losing their jobs, social status, and the support of their families and communities, thus decreasing the likelihood that they will receive proper treatment and increasing the chances of HIV spreading undetected.