Papua and West Papua have always been enlisted in the top regions with the highest number of HIV/AIDS cases in Indonesia. In 2020, HIV cases were nationally in 4th position with 37,662 cases, while for AIDS, both provinces remain at the top with 23,629 cases. Based on the Directorate General of Disease Prevention and Control (P2P) data, the Ministry of Health in August 2020, the five provinces with the most AIDS cases are Papua 23,629, East Java 21,016, Central Java 12,565, DKI Jakarta 10,672, and Bali 8,548.
However, the pandemic has changed many things regarding the HIV/AIDS treatments in both Papua and West Papua, according to Vanda Kirihio, Director of the Harapan Ibu Foundation in Papua. She tried to understand that the government is currently paying more attention to herd immunity against the coronavirus but insisted that other health problems should not be forgotten, especially HIV/AIDS.
HIV/AIDS is not the only main health problem in the regions. TB (Tuberculosis) and Malaria have also been such big, chronic problems that have never been really solved in this land. Vanda Kirihio added that focusing too much on the pandemic will risk the entire area being more difficult in dealing with the three deadly diseases there.
Sex Remains the Major Cause of HIV Transmission
Vanda Kirihio said that the handling of HIV/AIDS cases in Papua and West Papua before the pandemic was actually pretty good. One of the factors is that many national and international non-governmental organizations contribute their best in handling the problems there.
According to her, sex is still the biggest cause of HIV transmission in both provinces compared to the other causes, i.e., the use of needles and blood transfusions. Contagion within the family is also quite dominant, even though it is undeniable that free sex or unsafe sex is the major cause of the deadly virus spreading.
Don’t only blame it on the primitive sex life of the indigenous Papuans. Even a modern city like Jayapura has about 40 entertainment venues with more than 500 commercial sex workers. It has also contributed to the spreading of HIV. Vanda and her team disseminate information, then screen for Sexually Transmitted Infections (STIs), including HIV/AIDS. In Jayapura, they already have a special clinic for patients to carry out regular reproductive health checkups.
West Papua Should Also Be A Concern
Meanwhile, in West Papua, COVID-19 handling has also drowned out the issue of HIV/AIDS. Many annual health programs have already been set ended up being canceled because the local government is focusing more on the pandemic. According to Siti Maryam Rumkakir, the Indonesian Positive Women’s Association (IPPI/Ikatan Perempuan Positif Indonesia), women and children are vulnerable to HIV/AIDS.
Manokwari, Sorong, and Fak-Fak are cities/regencies with high HIV/AIDS cases in the province. Siti Maryam explained that more pregnant ladies with HIV are currently in trouble in this pandemic because they have to do a cesarean section to reduce the risk of HIV transmission from mothers to their newborns. The problem is that the referral state hospitals in Sorong and other cities have been affected by COVID-19 and temporarily closed services.
Several private hospitals in West Papua provide C-section baby delivery for pregnant women with HIV/AIDS. However, the payment scheme is through public channels, and most of these pregnant ladies come from poor community groups. That way, they won’t be able to afford the operating cost that may reach tens of millions of Rupiah.
A Slight Hope In The Future
Despite the challenges mentioned above, many hospitals have made adjustments to their services during the pandemic, especially in the distribution of ARV (antiretroviral) drugs for HIV patients. Although the service duration has been reduced, the patients can order the drugs by telephone.
Sex education and relevant education to reduce the case number of the disease have been socialized to the entire community. That certainly requires a special effort, especially with the different characteristics of the Papuan people, according to the areas they live in (whether highland or coastal areas).
ARV therapy used to suppress HIV in people living with HIV/AIDS (PLWHA) in West Papua improves their life quality and reduces the mortality rate due to AIDS. Even though the medication hasn’t reached the target yet, most PLWHA taking ARV drugs are currently in good immunological and clinical conditions.
Considering all the problems, efforts to decrease HIV transmission should continue during the pandemic because even coronavirus cannot reduce the number of HIV/AIDS cases. Based on the local health office data, there are 20,496 cumulative cases in West Papua alone. The local government and the central government have to support the development of HIV/AIDS treatments to save the younger generation from the deadly disease.