No hope for HIV prevention for Indonesian sex workers

Keeping watch for policemen is a typical day for Dewi, now 29, a sex worker in Bekasi, an industrial area east of Jakarta in Indonesia.

“I live by the grace of God. I have to keep on the look out for policemen who are always looking for sex workers to arrest them,” says Dewi, who has been a sex worker since the age of 19.

Dewi works in a bar in an area that hosts big international manufacturing giants like Converse and Samsung. Every night she goes to dance with the long-distance truck drivers and factory workers who come to drink and relax after work. If they want sex, she sells that to them too.

Arrested for having condoms

Dewi entered into sex work after a failed teenage marriage, a common story for poor young women in Indonesia. “It’s a long story,” she says. “You need to sit here for months listening to me every day so that you can get the entire story.”

She says she loves her work here, although it would be hard to imagine anyone choosing a job in this tangle of narrow, muddy, dimly-lit lanes packed with shacks offering bottled Bali Hai and Bintang beers.

One of Dewi’s friends Steffi, 25, appears and talks about how they don’t have protection because when the police catch them with condoms they are arrested. Both women are living with HIV and say it’s hard for someone in Indonesia who is a sex worker to protect herself from the disease.

“We have no choice and turning down customers isn’t a light or right choice because we need the money to sustain our families and this is the only job we can make a living from,” Steffi says.

Poverty drives the spread of HIV

According to the Indonesian minister of health, Dr Nafsiah Mboi, Indonesia’s HIV epidemic is among the fastest growing in Asia. “The epidemic has spread to all parts of the country and new infections have tripled in the last eight years, so alarmingly risky sexual behaviour has taken over from intravenous drug use as the main route for its spread,” she said.

Dr Mboi believes the epidemic is driven by fearless men with money and flexibility. Yet in Tenda Biru, another suburb of Jakarta, free condoms are available from a shack operated by a local non-governmental organisation which receives funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Culturally however condoms are a problem. “Men won’t use them and women are typically too powerless to demand that they do,” she said.

A human rights issue

Tomi Endang, an advocate for the rights of sex workers, blames hypocrisy among parliamentarians for driving the sex industry underground, making it more difficult to educate people about safe sex and treatment.

Endang says that only around 30 per cent of sex workers are believed to be using condoms and only 10 per cent of men who visit prostitutes use them.

Three quarters of HIV infections in Indonesia come from unprotected sex. According to one estimate, 19 million Indonesians could be at risk of contracting the disease because of unsafe sexual conduct.

Lack of free counselling services

The sex workers also said a lack of free counselling has made it hard to access HIV treatment and care. They are charged between USD 20-50 depending on which clinic they go to.

Christine, another sex worker, said: “It is mandatory for every person to be tested for HIV to have gone through counselling first. Here when you go to the clinic to test for HIV, the first thing they ask for is the receipt for counselling. This leaves us with no choice to test for HIV.”

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Image: Two women sorting through a pile of condoms
© Kong Piseth/IHAA/Photovoice