Indonesian prisons begin to accept HIV threat

By Richel Dursin
April 20, 2002

Jakarta - Indonesian prison authorities have long known about the rampant drug use and drug-dealing in the country's jails, but many of them have chosen to play dumb due to their part in the trade, say activists here.

Now that drug abuse is being singled out as one of the major reasons for the rise in the number of infections with the human immunodeficiency virus (HIV) among Indonesian inmates, activists say jail authorities should rouse themselves from their stupor. "Drugs are readily available in the country's prisons because of some corrupt authorities," said AIDS activist Baby Jim Aditya. "And in the country's prisons, the drug dealers and drug users are together, making it difficult to control the use of illegal drugs."

Drug deals in the Cipinang prison in East Jakarta alone were reported to have amounted to at least Rp20 million (US$2,100) last year. According to the National Narcotics Agency (BNN), the use of illegal drugs among inmates is prevalent, making them prone to HIV, which causes AIDS. HIV can be spread through the sharing of dirty needles by the injecting drug users as well as by unsafe sex. Experts point out that the latter is more likely to happen if at least one of the partners is under the influence of drugs.

Endang, head of the contagious disease department of the Jakarta Health Agency, confirms that "the spread of HIV in prison cells is mainly due to the sharing of syringes among drug users and unsafe sex". Recent medical tests conducted by health officials indicate that several inmates in the country's prisons already have HIV.

In the Salemba penitentiary in Central Jakarta alone, results of random blood tests conducted from November-December last year showed that at least 22 percent of 200 prisoners who were tested for HIV came up positive. Random blood testing in the Salemba correctional center started in 1997. It had its first cases of HIV in 1998, when at least 19, or 3.8 percent, of 509 blood samples tested positive for the virus.

"All correctional and detention centers in Jakarta have cases of HIV/AIDS and the virus is spreading very rapidly," said Jakarta Health Agency chief A Chalik Masulili. "Correctional centers are high-risk places for HIV/AIDS as many prisoners jailed for drug-related crimes are vulnerable to infection."

For his part, Bambang Kusbanu, chief of the Salemba penitentiary, said it is also possible that some inmates had contracted HIV before entering correctional centers. Other authorities also say that tattooing may be another factor contributing to the spread of HIV in Indonesian prisons. But Sigit Priohutomo, chief of guidance and evaluation section of AIDS and STD (sexually transmitted disease) Control Program of the Ministry of Health, notes: "The increasing number of HIV/AIDS cases in Indonesia's prisons is related to the rising number of IDUs [injecting drug users] in the country. The number of IDUs in the country is increasing very rapidly and the risk to contract HIV/AIDS is also increasing."

Data from the Ministry of Health show that more than 50 percent of drug users in the country are IDUs. To make matters worse, authorities now say that Indonesia has become a producer of illegal drugs as well.

The Health Ministry said the number of people with HIV in the country reached 1,904 last year, up from 1,172 in 2000. The cumulative total of recorded AIDS cases stood at 671 by the end of last year, up from 452 by the end of 2000. As in other countries, experts here say the real number of Indonesians with HIV could be much higher. Health Minister Achmad Sujudi himself said that that the actual number of people with the AIDS virus could range between 80,000 and 120,000.

Earnest efforts to limit if not stop drug use among prisoners seem to have begun only recently. Some jail personnel have been among the culprits in the spread of the drug habit behind bars. On March 22, a guard in Cipinang penitentiary was caught red-handed while conducting a drug transaction with an inmate in the high-security prison building. Authorities, however, admit that this was hardly the first case involving prison personnel, since a number of security guards have been caught selling drugs in the penitentiaries over the years.

As yet, no one, including non-government organizations (NGOs), has begun any anti-HIV program specifically aimed at the country's prisons. But some say this is not surprising given the government's lack of commitment to addressing HIV/AIDS issues. Jakarta-based AIDS activist Chris Green said that part of the reason NGOs have been slow to come up with anti-HIV/AIDS campaigns for prisons is that "like the government, we have limited resources and funding". Aditya, however, said she plans to conduct informal AIDS counseling for inmates starting in Tangerang this week. Asked why she had not done so earlier, she said: "How can we conduct anti-HIV programs for inmates when prison authorities keep on denying that HIV/AIDS is a major problem in the country's prisons? But now that it has been proved that HIV/AIDS exists in the country's prisons, it is time to act."

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