HIV in Indonesia: Women and Girls Persevere through Challenging Conditions

It is most often [girls] who are removed first.  This is both to save resources spent on schooling, as well as utilize the girl child for labour – Clifton Cortez, health and development practice leader at UNDP Asia-Pacific Regional Centre.

The number of reported HIV cases in Indonesia has more than tripled in these past few years and caused a decrease in productivity while trapping affected families in a life of daunting poverty. Cambodia, China, India, Indonesia, and Vietnam were all used for the UN Development Programme (UNDP) report – all countries suffered the same results that affect HIV-affected households, which include significant drops in income, savings, assets, and ability to buy protein-rich food. The report shows the difference between families that are free of HIV, as the households that are HIV-affected were found to be more than 38% more likely to live below the international poverty line of US$1.25 for each person per day – and over a quarter of these households reported having to sell the already scarce personal belongings in order to foot the bill for medical costs.

Antiretroviral therapy (ART) for HIV is often provided free; however only half the patients in need have acquired the medication.  To compare, Cambodia boasts a prominent 94% of patients receiving medication where free ART coverage has been shown to result in a reduction for households’ financial burden.  Nancy Fee, country coordinator of UNAIDS in Indonesia admits that positive change has been generated towards improving ART coverage within the country, as it has jumped up from 25% to 50% throughout the last three years.  However, she states that it is still far from sufficient.

Women make up about a quarter of the population living with HIV in Indonesia.  Discrimination towards those with AIDS is still prevalent in the area, and females are unjustly regarded with poor social standing and reputation if they are carriers of the disease.  It is more common for daughters living within HIV-affected households to be taken out of school on the grounds of tending to their family members.  This shows the gender dynamic in HIV-affected households holds, as young women are seen to have some sort of inherent responsibility to care for the household at the expense of their education.

Conditional cash transfers have been suggested by the UNDP report based on the child’s school enrolment and attendance in hopes that the parents make the decision to keep their children in school.  The World Bank offers promising evidence that show the risk for HIV infection is more than halved for young people who complete basic education – this is especially true for girls.

From the UNDP report, young women surveyed between the ages of 15 – 24 in Indonesia showed a significant population lacking essential information on how to reduce HIV. 28% of them had not heard of the infection and had little knowledge of condom use.

For women living with HIV affected family members, they experience longer hours put in the household and were found less likely to own their homes, livestock, and vehicles.  In addition, they were found more likely to be widowed and denied inheritance rights – this is the case for 71% of widows.

According to the government, as of December 2009, only around 6,653 people were receiving ART out of a notable 18,000 who had reported HIV at an advanced stage.  Additional factors including the availability of ART stock and certified staff needed for administering the drugs worked to influence this outcome as well.

A National Social Security System (SSJN) that works to improve the country’s social security programme such as covering health insurance, employment injury, pensions, and death benefits, has been in place since 2004.  Over half the population was still excluded in 2011 from the national social health protection scheme.  This was an approximation disclosed by the International Labour Organization and those who were left out from the benefits are mostly the population who make a living in the “informal economy” – workers without contracts linked with their means of employment.

A type of “Universal Social Protection Floor” needs to be implemented in the face of small government funded individual projects.  This would ensure a fundamental set of social services as well as income security that can be readily available and steadfast for women and girls affected by HIV in times of an unstable economy.


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