Few Papuan HIV sufferings are getting regular treatment

Published: Thu 5 Jan 2012 12:13 PM
Few Papuan HIV sufferings are getting regular treatment
Dear all, Please note that 2.180 people out of 10.522 known infected persons means that only 20% of these persons receive treatment. This is unacceptable low as each sub-district of the two Papuan provinces theoretically is covered by a public health clinic (Puskesmas)and each district has a public hospital(RSUD). Counseling, testing and treatment are free of costs (while covered by the autonomy funds). Acceptance,availability and quality of these health services is (on average)poor, with some good exceptions in the bigger cities. Stigma remains considerable. One should consider that the 10.522 persons are only the known cases, and that a multiple of people infected are not detected. The average prevalence rate of HIV in Tanah Papua is estimated to be 2.4% of persons aged 15-49 years (2007). HIV prevalence among the ethnic Papuan population is thought to be higher (2.8percent) than among non-nethnic Papuans (1.5 percent).
This would roughly imply for let's say 3 million inhabitants, 60 % in the age group 15-49 years, the number of infected persons to be 2.4 %(0.6x 3mln) = 43.200 infected persons. Now this was in 2007. In reality the prevalence differs per district and city. In the highlands the prevalence rate could even be 4-5 % (never confirmed by a reliable survey). There has been a program by the health ministry in 2009-2010 (called Save Papua) to detect and treat HIV patients via mobile clinic units. Outcomes and impact of this program are not directly available.
The Clinton HIV Aids initiative (CHAI) has been working in 2008-2009 on improving access to, availability and quality of HIV treatment in Papua and strengthening the Save Papua program.
The Indonesian government has so far not allowed CHAI to continue its activities in Papua from 2010 onward. Concluding, good to see that treatment coverage for HIV infected persons is expanding. we have to realize that there is a long way go to as this is only a minor proportion (< 5%) of persons infected with HIV. questions remain; Would it be time for a new, improved and anonymised survey? How actually to improve basic health services in Papua on a sustainable way? Is the problem actually the health services or are their additional determinants that inhibit the health status of the Papuan people?

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