Indonesia 'being left behind' in HIV fight

Published: July 17, 2014

Jakarta. A new United Nations report has highlighted a massive increase in the number of AIDS-related deaths in Indonesia between 2005 and 2013, even as other countries in the region and elsewhere recorded declines, with experts attributing the rise to the high number of people from traditionally low-risk population groups contracting HIV.

The 2014 UNAIDS Gap Report, published on Wednesday, identifies Indonesia among a group of six countries “being left behind” in the push to ensure access to antiretroviral therapy (ART) for people living with HIV/AIDS.

Indonesia — along with the Central African Republic, the Democratic Republic of the Congo, Nigeria, Russia and South Sudan — is facing “the triple threat of high HIV burden, low treatment coverage and no or little decline in new HIV infections,” Geneva-based UNAIDS said.

The report showed that Indonesia accounted for 4 percent of all new HIV infections in 2013, making it the eighth-biggest contributor of new infections worldwide, as well as 2 percent of all AIDS-related deaths last year.

In Asia Pacific, Indonesia is among six countries — along with China, India, Myanmar, Thailand and Vietnam — that account for more than 90 percent of people living with HIV/AIDS in the region.

The number of AIDS-related deaths in Asia and the Pacific fell by 37 percent between 2005 and 2013, the report noted, with countries like Cambodia, Thailand and Myanmar posting hefty declines of 72 percent, 56 percent and 29 percent respectively.

However, the number of AIDS-related deaths in Indonesia actually increased by 427 percent during that same period, with UNAIDS noting that only 8 percent of people in the country living with HIV/AIDS had access to ART.

Indonesia accounted for nearly one in every eight AIDS-related death in Asia and the Pacific last year, the report showed.

“The situation in Indonesia is cause for concern, where new HIV infections increased by 48 percent and the country’s share of new HIV infections in the region reached 23 percent in 2013, second only to India,” the report said.

UNAIDS said there was a high prevalence of HIV infections among female sex workers, and cited the case of Jayawijaya district in Papua province, where the HIV prevalence among sex workers was 25 percent, compared to the national average of 9 percent.

“While in countries with mature epidemics, HIV prevalence among sex workers is stable, rising HIV prevalence in countries such as Indonesia is a cause for concern,” the report said.

It also said observations suggested that HIV prevalence among gay men and other men who have sex with men was increasing in the country.

Injecting drug users were another high-risk group identified in the report, with an HIV prevalence “several times higher than HIV prevalence in the general population.”

Indonesian HIV/AIDS experts acknowledge the increase in new infections and deaths, saying that Indonesia is on the middle part of an “S curve,” marked by a rapid rise in infections after a slow start, and set to be followed by the numbers leveling off.

“You could say that the epidemic is relatively new in Indonesia compared to other countries such as Thailand,” Kemal Siregar, the secretary of the National AIDS Commission, or KPAN, told the Jakarta Globe on Thursday.

He said that while the UNAIDS report had correctly identified the groups at highest risk of contracting the virus, one largely overlooked and underreported group was housewives who were being infected by their husbands, who had contracted the virus through extramarital sex with a sex worker or another man, or through drug use by injection.

Kemal said these women tended to be from low-income families, and as such were less likely to be aware about their right to access free or subsidized antiretroviral drugs and treatment from the government.


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