HIV/AIDS PREVALENCE LOW, BUT VULNERABILITIES PERSIST

UNCLAS SECTION 01 OF 02 DILI 000181 SENSITIVE SIPDIS E.O. 12958: N/A TAGS: KHIV SOCI PGOV MASS TT SUBJECT: HIV/AIDS PREVALENCE LOW, BUT VULNERABILITIES PERSIST DILI 00000181 001.2 OF 002 ¶1. (U) SUMMARY: Timor-Leste remains a low HIV prevalence country, but porous borders, an influx of sex workers from abroad, and low awareness about the disease could lead to an increase in HIV/AIDS infected persons. The national response has focused on prevention, education, testing, and treatment. The Ministry of Health and the NGO community have worked on various programs to bring services to the districts outside Dili and provide prevention awareness to at-risk populations. USAID, DoD, and other implementing partners have also administered various programs focusing on HIV/AIDS prevention. END SUMMARY. -------------- HIV/AIDS Profile in Timor -------------- ¶2. (U) The World Health Organization estimates that as much as 0.5 percent of Timor-Leste's population of 1.1 million could be HIV positive, approximately 5,000 individuals. According to official statistics, 121 Timorese have contracted AIDS since 2001, 17 of which have died. The most at-risk populations include commercial sex workers, clients of sex workers, military personnel, men who have sex with men, and intravenous drug users. ¶3. (U) HIV/AIDS prevalence is highest in Dili and the Western districts near the border with Indonesia, both of which are affected by the commercial sex trade. There are an estimated 500 sex workers in Timor-Leste, the majority of which work in Dili brothels operated by Chinese and Indonesian crime syndicates. Sex workers illegally cross the border from West Timor, which has the second highest HIV/AIDS prevalence of all Indonesian provinces. In 2003, UNAIDS found that three percent of sex workers in Timor were HIV positive. -------------- National Response -------------- ¶4. (U) Timor-Leste adopted a National Strategic Plan for HIV/AIDS covering 2006-2010 and appointed an independent National AIDS Commission to advise the GOTL and monitor the progress of the Strategic Plan. The Ministry of Health, in an effort to provide HIV/AIDS services in the more remote districts, established 17 HIV/AIDS clinics throughout the country, although six lack equipment and are not fully operational. The cornerstone of the clinics' activities is voluntary counseling and testing. The Ministry also administers a peer education outreach program for sex workers. ¶5. (U) Beginning in 2007, the Ministry of Health, NGOs, and donor countries have distributed condoms throughout the country. The Catholic Church (over 96 percent of Timorese profess to be Catholic) initially condemned condom distribution but relaxed its opposition in late 2008, after which time the number of condoms distributed jumped dramatically. Many have gone to military and police personnel. -------------- International Assistance -------------- DILI 00000181 002.2 OF 002 ¶6. (U) The Global Fund to Fight AIDS, Tuberculosis, and Malaria approved a 5-year, $ 8.66 million grant to Timor-Leste in 2006 to improve prevention services, increase access to information, expand treatment and care services, and strengthen healthcare systems. USAID supported the development of the first National HIV/AIDS program, and the USAID-supported Coffee Cooperative Timor-Leste has established five clinics where employees can receive testing, counseling, treatment, and care services. International NGOs such as Catholic Relief Services have sponsored HIV/AIDS programs targeted at clients of sex workers in Timor-Leste. ¶7. (U) The Department of Defense HIV/AIDS Prevention Program (DHAPP) worked with NGOs to provide HIV/AIDS assistance to the Timorese military (F-FDTL). PACOM also has worked with F-FDTL, providing funds for HIV prevention, education, and testing, as well as thousands of condoms for uniformed personnel. -------------- Comment -------------- ¶8. (SBU) The number of HIV/AIDS cases in Timor remains relatively small, but the country's low level of development and lack of human capacity in the healthcare field make it vulnerable to greater levels of infection, particularly if the commercial sex trade and intravenous drug use continue to increase. Health care services are limited and there are few resources available to assist intravenous drug users or to expand prevention operations in remote areas. The gap between official statistics and the reality on the ground suggest Timor-Leste's HIV/AIDS problem may be more severe than the government realizes. HIV/AIDS has struck several prominent Timorese including the director of the government's statistical bureau who died in 2008, and the Chief Justice of the Court of Appeals, who returned to service in March 2009 after an extended convalescence in Lisbon during much of 2008. Several members of UNMIT have been diagnosed with the disease. KLEMM