The first case of HIV was reported in 1987. Since then, the estimated number of adults and children living with HIV rose exponentially, from 11,000 in 2001 to 310,000 in 2009 [1]. The cumulative number of reported HIV and AIDS cases rose sharply - from 1,487 cases in 2003 to 24,131 by 2010 [2]. The epidemic now affects almost all parts of the country – from 16 provinces in 2004 to all 33 provinces by end of 2009. HIV prevalence is particularly high and is generalized in nature in the two provinces of Papua and West Papua in the extreme east of Indonesia, at 2.4% among the general population aged 15-49 [3].The main mode of HIV transmission driving the epidemic is the sharing of contaminated needles and syringes among injecting drug users (52.6%), followed by unsafe heterosexual intercourse (37.2%), homosexual intercourse (4.5%) and perinatal transmission (1.4%) [4].Indonesia is confronted with vulnerability and risk factors as follows:
- Cultural diversity that hinders effective communication and resource distribution
- Hesitance of religious leaders to adopt public health perspectives, especially on safer sex practices
- Punitive approach to drug use that hampers access to HIV prevention programmes
- Widespread stigma and discrimination
- Limited outreach to key populations at higher risk
- High levels of needle sharing among IDUs [4]
- Limited resources, capacities, facilities and services for testing and counselling related to HIV, and for antiretroviral treatment and STI management
- Weakness in national surveillance as shown by the large gap between the national estimates of the number of people living with HIV and the number of reported cases [4]
- Limited information available on HIV infection rates and risk behaviours among internal and cross-border migrants thereby posing obstacles in their access to treatment and care [5].
Sources:
[1] UNAIDS Report on the Global AIDS Epidemic 2010
[2] Ministry of Health, Directorate General Communicable Disease Control & Environmental Health. (2011). Cases of HIV/AIDS in Indonesia Reported through December 2010
[3] Ministry of Health (MoH), National AIDS Commission (NAC), and Family Health International (FHI) - Aksi Stop AIDS (ASA) Program, Integrated Biological-Behavioral Surveillance of Most-at-Risk-Groups (MARG), 2007. Jakarta (Indonesia)
[4] Directorate General Communicable Disease Control & Environmental Health. (2009).Statistic of HIV-AIDS cases in Indonesia: Reported up to December 2009. Jakarta (Indonesia [5] National AIDS Commission, Republic of Indonesia, Country report on the Follow up to the Declaration of Commitment on HIV/AIDS (UNGASS) Reporting period 2006-2007
[5] UN Regional Task Force on Mobility and HIV Vulnerability Reduction in South-East Asia and Southern Provinces of China, HIV/AIDS & Mobility in South-East Asia: Rapid Assessment. Bangkok, 2008
Education Sector Response to HIV, Drugs and Sexuality in Indonesia. UNESCO (2010)
