Perceptions of and barriers to HIV testing of women in Indonesia

Figures & data

Table 1. HIV prevalence in different groups in Indonesia (population of 270 million)

	Prevalence risk (%)	Estimated number PLWHIV^a/high-risk groups^b
General population
All adults aged 15 and over	0.4	620,000^a
Women	0.3	220,000^a
Pregnant women	0.4	25,000^a
Men	0.5	420,000^a
High-risk group
Intravenous drug users	28.8	33,500^b
Men who have sex with men	25.8	754,300^b
Female sex workers	7.2	226,800^b
Transgender people	24.8	38,900^b
Men who access prostitutes	–	5,244,064^b

^a People living with HIV.

^b Estimated number of high risk groups to contracted HIV (not all HIV-positive); prevalence risk of HIV in the general population in Papua > 4%.

Source: (MoH, 2018⁴; UNAIDS, 2020⁵).

Table 2. Demographic profile and HIV-related status of the 18 HIV+ participants

No	Pseudonym	First CD4* (cells/mm^3)	Year of HIV diagnosis	Age	Marital status	PMTCT access**	HIV status of husband	No. of children alive	Education level	Notes
1	Mira	350	2015	21	Married	Yes	Positive	2	Senior High School	1st marriage, monogamous; 1st child HIV free; 2nd child took prophylaxis, vaginal delivery, confirmed HIV free December 2017; Bisexual husband
2	Bulan	40	2013	46	Widow	No	Positive	1	Senior High School	Divorced from 1st husband; 2nd husband deceased, was HIV+; 2nd marriage, polygamous
3	Nika	292	2016	22	Married	Yes	Negative	3	Elementary School	1st marriage, monogamous; 1st and 2nd child HIV free; 3rd child taking prophylaxis
4	Alung	100	2012	37	Married	No	Negative	3	Elementary School	2nd marriage as a 2nd wife; one HIV+ child and one deceased child
5	Rini	400	2011	41	Widow	No	Positive	3	Senior High School	Deceased husband was HIV+
6	Mawar	300	2011	41	Married	No	Negative	2	Senior High School	2nd marriage; polygamous; 1st deceased husband was HIV+; 2nd husband HIV neg, former IDU
7	Mela	300	2014	42	Widow	No	Positive	3	Senior High School	Deceased husband was HIV+; Husband was an IDU
8	Nina	329	2012	32	Married	No	Negative	3	Senior High School	2nd marriage; monogamous; 1st husband deceased, was HIV+; 1st husband was an IDU; 2nd husband HIV neg
9	Mano	300	2016	25	Widow	No	Positive	1	Senior High School	Deceased husband was HIV+; One child was HIV neg.; Former prostitute
10	Oneng	155	2016	41	Widow	No	Positive	6	Senior High School	Deceased husband was HIV+; Children 1–5 were HIV neg.; Sixth child was HIV+
11	Sinta	–	2012	41	Widow	No	Unknown	1	Senior High School	Deceased husband never took an HIV test Former IDU
12	Mona	500	2012	30	Married	Yes	Negative	2	University	2nd marriage, monogamous; 1st husband deceased, HIV+ and IDU 2nd husband HIV neg.; 1st child was HIV free; 2nd child taking prophylaxis
13	Putri	292	2007	35	Married	Yes	Positive	2	Senior High School	1st marriage; monogamous; 1st and 2nd child HIV free; 2nd child taking prophylaxis Husband was former IDU
14	Maya	400	2015	33	Married	No	Negative	3	Elementary School	1st husband divorced, was HIV neg.; 2nd husband HIV neg.; Former prostitute
15	Oda	290	2017	30	Married	No	Negative	3	Senior High School	1st marriage, monogamous; 1st and 2nd children HIV free; 3rd child HIV+
16	Xani	300	2007	35	Married	Yes	Positive	3	University	1st marriage, monogamous. Husband was former IDU
17	Bunga	350	2017	30	Married	Yes	Negative	1	Senior High School	2nd marriage, monogamous; 1st husband deceased, unknown HIV status; 1st child taking prophylaxis
18	Mulan	400	2012	28	Married	Yes	Negative	1	Senior High School	2nd marriage, polygamous; 1st husband deceased, HIV+; 1st child died of pneumonia, a sign of HIV; 2nd child taking prophylaxis; 2nd husband was former IDU

Notes: *CD4 (cells/mm³): CD4 cell count, the level of white blood cells, is frequently used to measure how long someone has been infected with HIV. PLWHIV who had a CD4 of less than 200 cell/mm³, 200–350 cells/mm³ and over 350 cells/mm³ were estimated to have contracted HIV about eight, four and one year prior, respectively.³⁸ **PMTCT access relates to comprehensive PMTCT services, including antenatal HIV testing, antiretroviral treatment during pregnancy and after delivery, prophylaxis treatment for babies born to HIV-positive mothers, and formula feeding.

Table 3. Associated human rights violations in HIV testing HIV of 18 HIV-positive women

Pseudonym	Violations of human rights in reproductive health and HIV services
	Rights to information^a	Rights to informed decision-making^a	Rights to confidentiality^b	Rights to dignity and non-discrimination^c	Rights to timely and best services^d
Mira			V	v	v
Bulan	v				v
Nika	v	v	v	v
Alung	v				v
Rini	v				v
Mawar	v			v	v
Mela	v				v
Nina					v
Mano	v		v	v
Oneng	v			v	v
Sinta	v		v	v
Mona			v	v
Putri			v	v	v
Maya	v				v
Oda				v	v
Xani				v	v
Bunga	v	v		v
Mulan	v				v

Notes:^aRights to information may include rights to informed consent, reasons for referral, reasons for denied services, information on choices of services available, and the rights to bring support person/s to services.

^b Right to confidentiality and privacy.

^c Right to equality, freedom from discrimination, equitable care & right to dignity and respect.

^d Right to timely healthcare and to the highest attainable level of health.

Adapted from Butt³² and Lumbantoruan et al.³³

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