HIV cases rising among drug users

Dewi Santoso, Jakarta

Human Immunodeficiency Virus (HIV) prevalence among injecting drugs users (IDU) in Indonesia has increased by threefold to 48 percent in 2003 from 16 percent in 1999, a report says.

A country report issued by the Joint United Nations Program on HIV/AIDS (UNAIDS) said on Tuesday that the increase in HIV prevalence among 125,000 to 196,000 IDUs had caused six of the country's 31 provinces to now be classified as being badly affected by the disease.

The six provinces are West Java, East Java, Jakarta, Riau, Bali and Papua.

The report -- to be submitted by Indonesia to the 15th International AIDS Conference to be held in Bangkok, Thailand, from July 11 to July 17 -- also revealed that the prevalence rate among the subject areas' 200,000 female sex workers had in some areas increased sharply to levels of between 8 percent and 17 percent.

Data from the Ministry of Health show that half of between 124,000 and 169,000 IDUs are HIV positive.

The data further reveals that between 1987 and 2003, there were an additional 3,924 people living with HIV/AIDS (PLWHA) in Indonesia, of which 2,685 were HIV positive and 1,239 had developed AIDS. Of the 1,239 who had develop AIDS, 428 had died. Those living with HIV/AIDS is estimated at between 80,000 and 130,000.

The UNAIDS report shows that the world's number of PLWHA has grown to 38 million people in 2003 from 35 million in 2001.

The report cites "strong evidence" that the IDUs and sexual networks overlap significantly, creating an ideal environment for HIV spread.

UNAIDS country coordinator for Indonesia Jane Wilson said that although Indonesia was facing a difficult situation, the country needed to do its best to effectively fight the disease.

National AIDS Commission (KPA) consultant Nafsiah Mboi agreed, saying that the KPA was focusing on the types of comprehensive approaches that had thus far proven effective so as to prevent the virus from further spreading.

These comprehensive approaches include prevention; care, support and treatment; and fighting stigmatization and discrimination against people living with HIV/AIDS.

"For prevention, we'll focus on two programs, which are promoting the use of condoms and providing more information on the harm reduction program," said Nafsiah.

She said that the KPA had conducted a youth discussion program in which students could discuss everything regarding the adverse effects of drugs and unsafe sex.

"For care, support and treatment, we'll focus on how to provide 5,000 PLWHA with antiretroviral drugs (ARV) by next year," Nafsiah said. Currently, there are only 1,300 PLWHA here who have access to ARV, only 2.7 percent of the estimated 130,000 PLWHA. This percentage remains far less than the hoped-for figure of greater than 5 percent.

Last year, UNAIDS launched its "three-by-five" initiative, a program aimed at providing three million PLWHA with ARV by 2005.

"We are also trying to shift perceptions of PLWHA, sex workers and IDUs -- from alienation to acceptance, and treating them with full support," said Nafsiah.

The government, she said, has not put enough effort into fighting the virus, "as it allocates only a small amount to this out of its total health budget."

The government allocated US$5.7 million out of its 2003 budget to the fight against the virus, up from $3.25 million in the previous year. Separately, foreign donations increased to $16.9 million in 2003 from $9.3 million in 2002. UNAIDS world report -- Page ....