HIV epidemic in Indonesia: Are we there yet?

In this the second STI podcast of 2021, we focus on the HIV epidemic in Indonesia and how the country strives to meet the UNAIDS 90-90-90 UNAIDS sustainability goals for people living with HIV (PLWH).

Episode Highlights:

  • Indonesia is a densely populated country spread over 17,000 islands of stunning beauty. It has one of the highest levels of ethnic, cultural and linguistic diversity and economic disparity.
  • Domestic prioritisation of HIV care varies from province to province, with varied access to HIV testing and ART. This can limit effective pathways of HIV care for key populations for a mobile population.
  • Only 14% of AIDS-related deaths have been averted by ART and the number of AIDS related deaths continues to rise.
  • What are the key issues contributing to the growing epidemic?
    • Geographical – physical barriers limit effective dissemination of accurate health information and are an obstacle to maintaining access to ART, especially for more rural communities.
    • Health system decentralisation – fragmentation of healthcare is an obstacle to the implementation of systematic changes to HIV testing and treatment policies, retention into care and ART provision.
    • HIV stigma – Stigma prevents people from accessing HIV testing and treatment and can increase the bridging of HIV risk from at-risk populations to lower risk general populations.

 

Indonesia faces one of the fastest-growing HIV epidemics in the world and has seen a marked rise in AIDS-related deaths. Indonesia is far from reaching the UNAIDS treatment cascade goals. It is estimated that only half of PLWH are diagnosed and only 17% of those diagnosed are receiving ART. For the third 90, there is a wide evidence gap with studies reporting suppression figures from infrequent viral load monitoring.  A recent publication – Getting Indonesia’s HIV epidemic to zero? One size does not fit all – from Keerti Gedela et al. highlights the challenges in reaching UNAIDS treatment cascade goals. Join us! Along with Keerti Gadela and Hendry Luis as we explore the topics from her recent publication and expand on it by asking the questions: What are the factors preventing successful HIV care provision in Indonesia? How easy is it to access transmission prevention tools e.g. condoms, PEP/PrEP and test & treat approaches? How has the SARS-CoV-2 pandemic impacted HIV care?

 

Additional Resources:

 

Shame and fear: lessons to learn as COVID-19 collides with a growing HIV epidemic in Indonesia

HIV programmes in countries within the Asia-Pacific region

Evolving ART crisis for people living with HIV in Indonesia

A social context perspective to the increasing HIV epidemic in MSM in Indonesia

COVID-19 Lockdown in Indonesia: Greater Investment Will Be Needed to Mitigate the Impact on People Living With HIV

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