As World AIDS Day is commemorated across the globe today, health officials in Indonesia are warning of a worrying increase in the number of young women contracting the virus, particularly through sexual violence.
In 1989, women accounted for just 2.5 percent of all people living with HIV/AIDS in the country, according to the National Commission on AIDS (KPAN). By 2009, however, they made up 25.5 percent of cases.
“Infections of women are likely to increase as they continue to experience gender-based violence,” Nafsiah Mboi, KPAN's secretary, said on Monday.
According to Nafsiah, up to 48 percent of women aged between 10 and 24 years are either raped or pressured into having sex by their boyfriend or partner, some of whom were infected with HIV.
Nafsiah said another factor exacerbating the problem was the continued practice of arranged or forced marriages for young girls.
“Early marriage for teenage girls opens the possibility for unprotected sex,” she said. “The girls get infected with HIV because they don't know that their partners might be infected, and tend not to use condoms.”
She added most teenage girls in arranged marriages were paired off with much older men who could be categorized as being at risk of contracting HIV.
“Women don't have a good bargaining position when it comes to the use of condoms, especially within the confines of a marriage,” she said.
Desti Murdijana, deputy chairwoman of the National Commission on Violence Against Women (Komnas Perempuan), said the country's largely patriarchal social system was to blame for women's limited access to education and information regarding HIV/AIDS.
“Let's face it: Indonesian women are relatively less educated than men,” she said. “They don't have as much access to education and information, thus these ‘good women' and ‘good wives' aren't aware that they too can get infected with the virus.”
Desti added it was not uncommon for women to continue living with their husbands out of financial necessity, even though they had been sexually abused.
“When women aren't economically empowered, they choose to live with their partners, despite the abuse, because they need to survive,” she said.
In other instances, Desti said women refused to leave abusive marriages because of the ingrained traditional and religious notion that they should always be subservient to their husbands.
“Women are really at risk of HIV infections through sexual violence,” she stressed.
With far more women now at risk of contracting HIV/AIDS, concerns are arising over the fate of children born to these women.
Nafsiah said that while the data on mother-to-child transmission was limited, the number of HIV-positive women who were pregnant was increasing.
“It's projected the number of women who will need support and services for prevention of mother-to-child transmission will increase from 5,730 in 2010 to 8,170 in 2014,” she said. “As HIV infections increase among women, it will also lead to a rise in infections among children.”
She said KPAN was working on increasing the number of centers across the country addressing prevention of mother-to-child transmission. There are currently only 30 such centers nationwide, mostly funded by foreign donors.
KPAN predicts HIV prevalence among Indonesians aged 15 to 49 will increase to 0.37 percent in 2014 from 0.22 percent in 2008, while the number of people with HIV/AIDS will increase to 541,700 in 2014 from 371,800 in 2010.