Afriandi Irvan, Aditama Tjandra Yoga, Mustikawati Dyah, Oktavia Martiani, Alisjahbana Bachti, Riono Pandu
Faculty of Medicine, Padjadjaran University-Hasan Sadikin Hospital. Jl. Pasirkaliki no. 190, Bandung, 40151, Indonesia.
Acta Med Indones. 2009 Jul;41 Suppl 1:75-8.
Indonesia is facing one of the most rapidly growing HIV-epidemics in Asia. Risk behaviour associated with injecting drug use, such as sharing contaminated needles, is the main risk factor for HIV infection. Among the general population the prevalence of HIV-infection is still low (0.2%), but up to 50% or more of the estimated 145.000 - 170.000 injecting drug users are already HIV-positive. Overrepresentation of injecting drug users and continued risk behavior inside Indonesian prisons contribute to spread of HIV. Through sexual contacts, HIV is transmitted from current or previous injecting drug users to their non-injecting sexual partners; 10-20% of this group may already be infected. The national response targeted to limit spread of HIV through injecting drug use has included needle and syringe program (NSP), methadone maintenance treatment (MMT), voluntary counseling and testing (VCT), and outreach program as priority programs. However coverage and utilization of the harm reduction services is still limited, but effective integration with HIV testing and treatment is expanding. By 2008, there were 110 service points for NSP and 24 operational MMT clinics. Nevertheless, utilization of these services has been less satisfactory and their effectiveness has been questioned. Besides effective prevention, HIV- testing and earlier treatment of HIV-seropositve individuals, including those with a history of injecting drug use, will help control the growing HIV-epidemic in Indonesia.
印度尼西亚正面临亚洲增长最为迅速的艾滋病毒疫情之一。与注射吸毒相关的危险行为，如共用受污染的针头，是艾滋病毒感染的主要危险因素。在普通人群中，艾滋病毒感染率仍然较低（0.2%），但在估计14.5万至17万注射吸毒者中，高达50%或更多已经感染艾滋病毒呈阳性。印度尼西亚监狱中注射吸毒者比例过高以及持续的危险行为导致了艾滋病毒的传播。通过性接触，艾滋病毒从现有的或曾经的注射吸毒者传播到他们的非注射吸毒性伴侣；这一群体中有10%至20%可能已经被感染。旨在通过注射吸毒限制艾滋病毒传播的国家应对措施包括针头和注射器项目（NSP）、美沙酮维持治疗（MMT）、自愿咨询和检测（VCT）以及外展项目作为优先项目。然而，减少伤害服务的覆盖范围和利用率仍然有限，但与艾滋病毒检测和治疗的有效整合正在扩大。到2008年，有110个针头和注射器项目服务点以及24个运营中的美沙酮维持治疗诊所。尽管如此，这些服务的利用率一直不太令人满意，其有效性也受到质疑。除了有效的预防措施外，对艾滋病毒血清阳性个体，包括有注射吸毒史的个体进行艾滋病毒检测和早期治疗，将有助于控制印度尼西亚不断蔓延的艾滋病毒疫情。
