Last week, Human Rights Watch published a report detailing how Indonesia’s anti-LGBT crackdown is disrupting efforts of activists to tame the country's HIV/Aids epidemic that has infected about one in four men who have sex with men.
The report documents the escalating hysteria that dates back to early 2016 that saw police and vigilantes arrest and detain hundreds of men on suspicion they were gay.
Since then testing and treatment of HIV has became more challenging. Targeting gay men in advertising for HIV services and prevention risks inviting backlash. Mobile testing at saunas, once a secure means of targeting closeted men, ended after police shut down Jakarta’s two main venues.
I caught up with Tono, a Jakarta based activist whose NGO offers technical assistance to Jakarta’s first and biggest free sexual health clinic, to ask how the current environment is impacting on his group’s efforts to curb the HIV epidemic. Tono asked that I not use his full name, identify his NGO, nor the name of the clinic.
Q: Tell me about the clinic. What is the difference between the clinic and a government run Puskesmas?
A: It’s free. It’s friendly. And it used to be fast. But we administer 750 tests a month and have about 2800 on ARV (anti retro virals). About 17% of those we test are positive for HIV. We have about 4000 clients in total.
Q: You are running out of space?
A: Yes the doctors get very tired. We have so many clients now.
Q: It’s fair to say it’s mainly a gay clinic?
A: We are open to everyone. Everyone can come but most of the clients are MSM.
Q: What would happen if you adverstised your HIV services in the Jakarta Post or Tempo?
A: (laughs) If we said the clinic caters to MSM there would be a backlash. The government or the hospital that is associated with the clinic would ask us to close.
A: Because they (the hospital) are afraid the government will pressure them to close. They don’t support MSM. Radical groups would create a nightmare. It’s better to be very low profile. We spread information smoothly in a way that is not too obvious.
Q: Is the crackdown affecting your efforts?
A: It’s very difficult to openly and directly reach the community -- even the ones who are openly gay. Four years ago there was a web series on YouTube called CONQ (pronounced chawnk). They were five-minute clips about gay life in Jakarta. It focused on healthy living and love and relationships. It was about my life. Episode 4 was about getting tested for HIV and the characters came to the clinic. After that episode broadcast the numbers of clients coming for HIV tests doubled. But the government shut it down because it was about LGBT issues.
Q: So how do you get these limitations?
A: We go mainly through community based organizations, these specialized NGOs who spread the word about services.
A: One example is they go to hotspots in malls and bus terminals. They pose online on hook up soc med sites and when someone comes over to meet up they start to talk. They give information.
Q: The report said that only 9% of MSM who test positive for HIV go on ARVs. What’s the percentage of positive cases at your clinic?
A: We would have the highest. It’s about 70%
Q: 70% still seems low. What’s stopping them from going on treatment?
A: Some of us are very far from family. When they are positive and are very sick they don’t want to take ARVs here. They want to go home. They just want to go back to the kampung. We give them information about where to go to get ARVs. But we don’t know. About 30% of the patients who test positive are lost. They vanish.
Q: There is progress right?
A: We opened another clinic in Jakarta in January. It’s bigger. So far it’s only seeing 80 clients a month so service is faster. My NGO has helped train 37 Puskesmas to provide HIV treatment to what we call “at risk groups”.
Q: So for anyone reading this how can they learn more?
A: They can email me at firstname.lastname@example.org