Rates of HIV/AIDS in Bali Prostitutes at Alarming Levels

HIV/AIDS cases are increasing among sex workers in Bali, Indonesia, and efforts to prevent new infections find little support from community and religious leaders, experts said at a recent conference.

Earlier this month, Indonesian officials released data showing that 14 percent of sex workers in Bali had HIV during a 2002-2007 survey, an alarming rise from just 1-2 percent six years earlier. And 49 percent had been diagnosed with at least one of three STDs: chlamydia, gonorrhea, or syphilis. There were no HIV data for gay men.

"I believe the percentage of sex workers in Bali with HIV/AIDS has risen to 20 percent this year, because condom use is still very low," Dr. Dewa Nyoman Wirawan, a public health professor at Udayana University, told a seminar on Asia's sex trade. Just 20-30 percent of clients consistently use condoms when visiting a sex worker, he said.

"Sex workers need the money so badly that if a client refuses to use condoms, they will take the risk anyway," said Rita, a former prostitute. "If prostitutes ask the client to use a condom, they usually will. But some women have many clients in one night, maybe 10 or 15, and using a condom makes the sex more painful and it lasts longer."

There is community support for helping IV drug users, said Wirawan. "But now new cases among drug users are falling, and this explosion among sex workers is harder to address because prostitution is illegal and there's a lot of resistance from religious leaders and the community."

Wirawan runs a free clinic for sex workers in Denpasar, offering Australian government-financed outreach, free checkups and HIV/STD tests, AIDS treatment, condoms, and training to negotiate condom use. AusAid provided the program US $25,000; Indonesia's government supplies its medication.

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