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The Challenge
The Indonesia National AIDS Commission (KPA) has identified 15 of 30 priority provinces to counter HIV/AIDS. Indonesia is experiencing a concentrated HIV epidemic, with high and rapidly increasing prevalence among certain groups who more typically engage in behaviours that carry the risk of infection. The UNAIDS 2005 AIDS Epidemic update reports alarmingly high rates of infection among those seeking voluntary testing and counselling – as high as 70% of those seeking testing in some sites.
Due to its highly mobile population and high prevalence of sex work, North Sulawesi has been identified as a priority area for prevention interventions. The scattered nature of the groups perceived to be a high risk, the high mobility of both female and transgender sex workers, the increasing HIV incidence rate which is rising faster than the capacity of prevention efforts to curb it and the continued stigma and discrimination that hamper those prevention efforts are some of the many challenges facing the Province.
CARE's Response
The goal of the two-year CIDA funded HIV/AIDS Prevention Project is to contribute to national efforts to prevent the progression of HIV/AIDS to a generalised epidemic. This will be reached by developing the capacity of local government and community-based organizations to deliver accessible, available and high quality HIV/AIDS prevention services.
The project has four anticipated outcomes:
1. Enhanced effectiveness of HIV awareness, prevention and support services provided by local government and NGOs to transport workers, fishermen and their potential partners and communities.
2. Enhanced understanding and attention to HIV/AIDS within the local community, institutions, and community organizations.
3. Greater capacity on the part of local NGOs and CBOs to meet and sustain their own HIV prevention objectives and priorities.
4. Interventions address and reduce the specific gender-based vulnerabilities of women, men and waria (transgender).
Increase effectiveness of HIV awareness, prevention, and support services
Working through local partners in the area, the project will conduct a range of education and peer-led interventions that will be used to address the prevention needs of the vulnerable groups and additional interventions as prioritized by the partners, which may include counseling and support through peer counselors and support groups; assistance with accessing available VCT and STI services safely; access to male and female condoms; and assistance with mobilizing to influence the situations that increase risk.
Increase global awareness to HIV/AIDS
Focusing to enhance knowledge amongst youth in communities, CARE is working with the local government agencies, the education authorities, school committees and faith-based organizations in promoting HIV awareness messages. To also reduce the stigma that so often drives HIV, CARE facilitates and promotes the participation of People Living with HIV/AIDS (PLHA) representatives or those from vulnerable communities to personalize AIDS and to show that high risk activities exist, can affect anyone, but can be avoided.
Capacity building for local NGOs and CBOs
Focusing on its role as one of facilitator and partner rather than direct implementer, CARE works through and supports civil society organizations already engaged in the HIV/AIDS response in North Sulawesi. Through sub-grants and technical assistance, CARE provides support to enable the partners to scale-up and strengthen their delivery and management capacity.
Reduce the specific gender-based vulnerabilities of women, men, and waria (transgender)
Transgender sex workers (waria) are also both highly vulnerable themselves and at high risk of transmitting the virus to their clients and partners. This group is highly mobile, and as noted by KPA in North Sulawesi, tend to migrate in and out of areas characterized by high levels of sex work and high HIV prevalence. CARE works with its partners to adapt and broaden the positive deviance approach to identify risk-reduction efforts practiced by warias (transgender) in North Sulawesi.
Sector: Health and HIV/AIDS
Project period: October 2007 to September 2009
Donor: Canadian International Development Agency (CIDA)
Partners: Yayasan Pelangi Kasih (YPK), Lembaga Kemaslahatan Keluarga Nahdlatul Ulama (LKKNU), Komisi Penanggulangan AIDS Nasional Indonesia
The HIV/AIDS Prevention Project undertaken with the financial support of the Government of Canada provided through the Canadian International Development Agency (CIDA)
HIV/AIDS Prevention Project réalisé avec l’appui financier du gouvernement du Canada agissant par l’entremise de l'Agence canadienne de développement international (ACDI)
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