HIV Sneaks Up on Indonesia After Suharto

As recently as 1999, Indonesia barely registered on the AIDS map, with fewer than 1,000 of the nation's 210 million inhabitants known to be HIV-positive. But after the collapse of the regime of Gen. Suharto in 1998, the rise of illegal drug trafficking gave AIDS workers concern about an emerging high-risk group -- heroin addicts who share infected needles.

The Indonesian government estimates there are between 124,000 and 196,000 IV drug users in the country, yet some health experts say that number could be closer to 1 million. And according to the Indonesian AIDS Commission, HIV infection rates among drug addicts have soared from nearly zero in 1998 to more than 50 percent in cities like Jakarta and Denpasar. "HIV snuck up on Indonesia and whacked it on the back of the head before anyone knew what was going on," said Wayne Wiebel, regional advisor to the nonprofit group Family Health International.

Indonesia's infection rate remains low in comparison with other Southeast Asian countries, but health experts agree that the HIV rate is increasing sharply -- not only among IV drug users, but also among the estimated 190,000 to 270,000 sex workers and 1 million migrant workers. A National AIDS Commission report demonstrates that 6 percent to 26 percent of sex workers are HIV-positive. And about 10 percent of migrant workers have tested HIV-positive.

Despite condom sales doubling since 1998 -- to 60 million a year -- fewer than 10 percent of all men report using them, said UNAIDS. "Our distribution is pretty good now, so it's a behavioral issue. The condoms are there -- but will they buy in?" said Christopher Purdy, country director of DKT International, a charity organization that specializes in family planning.

Until now, Indonesia's AIDS efforts have focused on prevention and education. However, a recent UNICEF survey showed of 1,000 youths ages 14 to 17 showed that 84 percent "knew little or nothing about HIV/AIDS." AIDS activists say the government will have to expand care and treatment as cases continue to emerge.

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