Gemma Holliani Cahya, Jakarta – COVID-19 has killed eight people with HIV/AIDS in Indonesia, and 77 people with HIV have tested positive for the coronavirus, the Health Ministry has said.
Some 543,100 people are living with HIV/AIDS in Indonesia, according to ministry data.
"People with HIV should be 100 percent disciplined in following health protocols. Wear your masks, wash your hands," the ministry's HIV/AIDS and sexually transmitted diseases subdirectorate head, Nurjannah Sulaiman, said at a recent public discussion on the impact of the pandemic on people with HIV/AIDS.
"[...] Because they belong to the vulnerable population," she said, adding that COVID-19 patients with comorbidities, including those of HIV/AIDS such as chronic kidney disease, have worse outcomes than patients without comorbidities.
The pandemic hit Indonesia as the government and the rest of the world continued to try to reduce HIV infections and help people with the virus live longer and healthier lives. As outlined in the 2016 UN Sustainable Development Goals, Indonesia aims to end the global HIV/AIDS epidemic by 2030. This includes zero infections, zero deaths and zero discrimination.
But now, seven months into the pandemic, access to imported antiretroviral (ARV) drugs remains a problem in Indonesia.
A nationwide survey of 1,035 people with HIV carried out in August by the Indonesian office of the Joint United Nations Program on HIV/AIDS (UNAIDS) and nonprofit organization the Positive Indonesia Network (JIP) showed that 52 percent of respondents had only enough ARV drugs to last for a month.
The ARV shortage was more serious than in the early weeks of the pandemic. The two organizations found in late March that 47.6 percent respondents had only a month's worth of ARV medication left.
"More and more people are lacking ARV stocks," said Ary Bumi Kartini, a JIP researcher involved in the study. "We must work together with the Health Ministry and other community-based organizations to ensure the availability of ARVs at national and regional levels during the pandemic."
People with HIV/AIDS need to take ARV drugs every day to maintain and improve the quality of their lives and help prevent the spread of the infection to others. The medication can be accessed through health facilities, mostly hospitals.
But 473 of the 1,035 respondents in the survey said they were reluctant to visit health facilities for ARV drugs because they feared exposing themselves to COVID-19.
The coronavirus outbreak has also mentally and financially affected people living with HIV/AIDS, with 41 percent of respondents saying they experienced "serious anxiety issues regarding the condition of their health, family and the stigma of HIV status".
The number of respondents who said they were not able to meet the needs of their families increased from 236 in March to 474 in August. Those who had lost jobs also increased from 275 respondents in March to 458 respondents in August.
In the August survey, some 200 respondents said they could no longer pay rent for their homes.
"And only 54 percent of the total respondents surveyed in August had received social aid," Ary said, adding that all respondents had said they needed help to have safe access to ARV treatment and counselling for anxiety and depression.
Although health resources are now focused on handling the COVID-19 outbreak, Nurjannah said the government was still trying to ensure that 90 percent of people with HIV would be aware of their status, 60 percent would get ARV treatment and 90 percent would have their viral load suppressed by 2024.
But even without taking the COVID-19 pandemic into account, ARV coverage in Indonesia remains among the lowest in the Asia-Pacific region to date.
A recent global report by UNAIDS shows that the COVID-19 pandemic risks blowing HIV progress way off course. It found that missed targets have resulted in 3.5 million more HIV infections and 820,000 more AIDS-related deaths since 2015 than if the world was on track to meet the 2020 targets.
The World Health Organization (WHO) said in July that more than a third of the countries in the world said they were at risk of running out of life-saving AIDS drugs because of supply disruptions caused by the COVID-19 crisis. The WHO found that the failure of suppliers to deliver ARV drugs on time and a shut-down of land and air transport services, coupled with limited access to health services within countries as a result of the pandemic, were among the causes of the disruptions.