Reported AIDS cases soar, shared needles lead transmission
The Jakarta Post, Jakarta
The number of reported AIDS cases in Indonesia has more than doubled, with injecting drug users most affected, a report says.
A country report to be submitted by Indonesia to next month's Asia and the Pacific 7th International Congress on AIDS in Kobe, Japan, reveals that there were cumulatively 2,682 reported AIDS cases in 29 provinces, a significant climb from the 1,058 figure in March 2003.
The number, however, only represent the tip of the iceberg as there are still those who keep quiet about their illness due to fear of stigmatization and discrimination.
The official estimate of people living with HIV/AIDS in Indonesia is 90,000 to 130,000 people, cited the report. The global number has grown to 38 million people in 2003 from 35 million in 2001.
While in a previous report Jakarta topped the list of provinces with the highest AIDS rate, this year Papua has outnumbered the capital with a rate of 24.06 cases per 100,000 of population. Other provinces with high rates of AIDS are Bali, Maluku, North Sulawesi and West Kalimantan.
Data shows that drug injection is now the main mode of transmission for the disease.
A Jakarta survey in 2003 showed that HIV prevalence had tripled from 15.8 percent in 1999 to 47.9 percent in 2002. Last year, the city saw a 44.1 percent increase in reported AIDS cases.
Despite the fact that drug injection is now the main mode of HIV transmission, harm reduction strategies taken to counter the spread of the virus still confronted legal impediments.
Harm reduction strategies include providing sterile disposable needles and disinfectants as well as providing heroin substitutes such as methadone and buprenorphine.
Such strategies aim to discourage the sharing of contaminated drug equipment.
"These methods are still controversial and have not found full support," National AIDS Commission representative Suharto said on Friday.
The report also cites overlapping sexual networks as the second most important mode of transmission. The prevalence of HIV/AIDS has increased significantly in Papua increasing 6.69 percent in 1999 and 16.7 percent in 2002.
UNAIDS country coordinator for Indonesia Jane Wilson said that despite increasing funds from both the government and global donors, the country saw little progress in preventing the epidemic.
"One of challenges is the low percentage of condom use in commercial sex," she said, adding that this was yet another controversial issue that hampered prevention strategies, as promotion of the use of condoms faced religious and cultural obstacles.
Suharto added that such conservative views were counterproductive in the fight against HIV/AIDS as they did not provide alternative solutions.
The National AIDS Commission, he said, was still had inadequate outreach to high risk behavior groups like injecting drug users, homosexual men, sex workers and their clients, as well as the partners of members of these groups.
All these obstacles have together led to the poor development the country has seen in its fight against HIV/AIDS, despite soaring funds, he added.(003)