Indonesia has decided to pilot pre-exposure prophylaxis (PrEP) in four cities with high levels of HIV prevalence. PrEP is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. It is hoped that the pilot project will pave the way for a wider roll-out across the country.
The commitment to piloting PrEP came during the 1st Indonesian Symposium on PrEP, which was organized by UNAIDS at the end of June. The two-day event brought together around 150 clinicians, public health officials and representatives of key populations, who shared their experiences of PrEP research and implementation strategies across the Asia-Pacific region. The pilot in Indonesia will be conducted in close collaboration with the Ministry of Health.
PrEP is a highly effective prevention choice for people who are at high risk of HIV infection such as sex workers, people who use drugs and gay men and other men who have sex with men. It is having a big impact in reducing new HIV infections in Australia and its availability is increasing in New Zealand, Thailand and Viet Nam. China, India, Malaysia and Philippines have also initiated pilot projects.
Prevention efforts are vital to strengthening the HIV response in Indonesia and PrEP would be a significant addition to the country’s combination prevention approach. Indonesia had 46000 new HIV infections in 2018 and has one of the fastest growing epidemics in the Asia Pacific region. In 2018 there were 640000 people living with HIV in the country and only 17% had access to treatment.
The discussions at the symposium helped to disperse some of the common misconceptions regarding PrEP, both among communities and services working to reduce new HIV infections. Civil society activists expressed their strong support for PrEP roll-out.
“PrEP will become a necessity for sex workers,” said Rito Hermawan of the Indonesian Sex Workers Network, “As well as using condoms, they can get additional protection by using PrEP. We must educate people about PrEP to stop any misconceptions.”
Other civil society activists echoed their support.
“The more I learn about the benefits of PrEP, the more I wonder why it is not available here,” said Mr. Riunaldi from Intermedika Prana Foundation, “I am hopeful that more people will understand how important PrEP is for our country.”
Participants in the symposium said that many people were already accessing PrEP online, indicating a growing demand in Indonesia.
“It is incumbent on policy makers, health professionals, researchers and civil society organizations to ensure that those at risk of HIV infection have access to the information and resources needed to make informed decisions regarding their health” said Tina Boonto, UNAIDS Country Director for Indonesia.
