Indonesia's Aids alert

Poverty lies at the root of the problem

By Richard Galpin BBC Jakarta correspondent

Health officials in Indonesia are warning there could soon be an Aids epidemic on the scale of some African countries if there is not immediate action to curb the rapid rise in the number of people being infected with HIV, the virus that can lead to Aids.

Until recently Indonesia appeared to have escaped the disease, but now infection rates have begun to climb steeply.

One reason is the commercial sex industry, believed to be the largest in South East Asia. Indonesia has more than 500,000 prostitutes, according to some estimates.

Now each day we get 40 to 50 cases admitted to hospital

Dr Syamsu Rizal

A client in Jakarta said: "This is the easiest place to find women if you know what you're looking for. The cheapest sex costs less than half a dollar if you go along the railway line where the homeless people live."

But the commercial sex industry is not just limited to the cities. In rural Java, whole areas are given over to prostitution where hundreds of women live and work.

High price

Ida's is a typical story. She comes from a poor family which she supports with the money she earns - about $100 a month.

She says they know what she is doing and do not disapprove, such is the need for money.

But what neither she nor her parents realise is the huge risk to her health. Condoms are rarely used and Ida knows nothing about HIV and Aids.

The reason why health experts are now becoming so alarmed can be found at a medical centre in the heart of Jakarta.

Among those waiting for help are a large number of drug addicts. Over the past five years the number of young people injecting drugs such as heroin has increased dramatically.

AIDS awareness is limited

One user, Anto, explained: "I started taking heroin in 1997. At first I was given it free by my friends, but after a few days I had to pay for it. A few months later my friends taught me how to inject, because that way you need much less to have the same effect. And when I have to I share needles with my friends."

The sharing of needles is common - another consequence of poverty.

But it has led to an exponential increase in the number of drug addicts with HIV.

In one small Jakarta suburb, where there are around 800 intravenous drug-users or IDUs, it is estimated 70% have now been infected with HIV.

Dr Syamsu Rizal, one of Indonesia's leading experts on Aids, says: "I'm afraid the situation is very serious, especially in the last three years. Increasing number of new HIV cases is very significant, especially coming from the IDU group.

"We must do something about that. If not, I think the cases may be not different with Thailand or maybe also with Africa. When I see the new cases in the hospitals, now each day we get 40 to 50 cases admitted to hospital."

(The government knows) the situation is serious - they want to do something but the problem is about their resources

Dr Syamsu Rizal

There is a direct link between drug addicts and the commercial sex industry, making the risk of an Aids epidemic in Indonesia even greater.

This is because a significant proportion of the women selling sex at a shopping centre in Jakarta are doing so to buy their next shot of heroin.

One woman, Sari, says it is the easiest way to get the money. She prefers having sex without a condom. She is not worried about contracting HIV as she says she takes antibiotics each time to protect herself.

This mistaken belief is common and shows the task the government now faces. Unofficial estimates put the total number of people infected at half a million.

But Aids expert Dr Syamsu Rizal is pessimistic about how much the government can achieve.

"They know the situation is serious. They want to do something but the problem is about their resources because we still have a problem with malnutrition, we still have problems with also many basic needs of our people. So other parts of society should take action," he said.