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Though Indonesia's HIV prevalence stands at a low 0.2 percent, government and health experts are troubled by signs the virus may be moving from high-risk groups into the general population. HIV used to be spread mainly through injection drug use in predominantly Muslim Indonesia. But last year, 65 percent of the 4,158 newly confirmed HIV cases involved sex workers and their clients, who then infected their spouses. The government estimates Indonesia has 200,000 female sex workers who have up to 3 million male clients.
Three percent of last year's cases were perinatal infections - up from just 0.2 percent of cases in the 1990s. "This means that HIV transmission within the family is increasing .... If we have no new approach for HIV prevention within the family, it may become generalized," said Inang Winarso, assistant deputy secretary of program coordination for the National AIDS Commission.
Other Asian countries, including Cambodia and China, are working hard to combat the spread of HIV. China's state leaders have gone public in support of HIV/AIDS prevention and treatment. But such high-profile interventions are unlikely to work in conservative Indonesia. Health Minister Endang Sedyaningsih said the government faces enormous opposition against tools such as condoms and access to clean needles.
Winarso and colleagues are reaching out to sex workers through an empowerment pilot project in Semarang in East Java. "In every story that was told to me, nobody said they liked or that they trained to be sex workers. They all started because of trafficking or because of poverty, but they have no awareness that they are victims," said Winarso.
The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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