Mobilizing the Private Sector to Deliver HIV Prevention, Treatment, and Care in High Prevalence Areas of Papua and West Papua

Developing a low cost model to deliver effective HIV prevention, counselling and testing and treatment support services through the private sector.

Project Background

The Human Immunodeficiency Virus (HIV) epidemic in Papua continues to expand at a steady rate with an overall prevalence of 2.3 per cent. The 2013 Integrated Biological Behavioural Surveillance (IBBS) shows that the majority of infections are occurring among native Papuans with prevalence at 2.9 per cent compared to non-Papuans at 0.4 per cent. HIV related knowledge is relatively low with 32 per cent of IBBS respondents demonstrating understanding of how HIV is transmitted and only 9 per cent showing comprehensive knowledge of HIV. Most frequent risk behaviours reported by respondents included both reported casual and commercial sex without consistent use of condoms. These data show an urgent need to expand programme coverage to indigenous Papuans focusing on both HIV knowledge and “know your status” promotion activities and services.

The private sector in Papua has strong potential to deliver effective, low cost and sustainable HIV prevention, health care and treatment (HCT) services and support to the most vulnerable segments of the population. Well targeted workplace programmes can offer effective HIV and Sexual Transmitted Infection (STI) prevention education that is integrated into existing safety and health and ongoing communication programmes.

VCT@Work Initiative

In June 2013, UNAIDS and the ILO launched the Global VCT@Work (Voluntary Counselling and Testing at Work) initiative to promote early testing and treatment programme through the workplace. The initiative is being carried out in 22 countries including large scale generalized epidemics in southern Africa as well as major countries in Asia including India, Thailand, Vietnam and Indonesia. The goal of the global campaign is to reach 5 million workers with HIV counselling and testing services by December 2015 to support prevention and treatment targets set put forth by the UN General Assembly in June 2011.

Workers are likely to undergo VCT when their employers take steps to protect employment rights and ensure confidentiality and non-discrimination for people with the virus. The ILO International Labour Standard on HIV and AIDS, (Recommendation on HIV and AIDS in the World of Work, 2010, No. 200) calls on employers to eliminate discrimination based on real or perceived HIV status and ensure work access to prevention, care and treatment services. Under this project, the ILO provide technical assistance to the Ministry of Manpower (MoM) labour departments in the two Papuan provinces to increase private sector adherence to existing national and provincial policies on HIV in workplace.

Project Strategy

Effective targeting of the Project is essential in order to reach the maximum number of individuals in greatest need of prevention, testing, and treatment support services. The geographic focus will cover main cities in Papua and West Papua targeting industries where there are greater numbers of male workers, who are mobile and work away from their regular partners. Coverage will include large-scale formal sector companies as well as informal sector work environments, where workers will be reached through supply chains, trade unions, and industrial associations in partnership with civil society organization (CSO).

The approach for large scale private sector companies, including PT. Pertamina (Persero), which has been committed to this work, will prioritize information delivery on prevention and the benefits of early testing and treatment as well as the delivery of HCT services in collaboration with health service partners. Capacity of company health services professionals to provide treatment, adherence support will be developed with support of local CSO partners and technical consultants.

Several key measures will be carried out to ensure effective delivery of services and basic labour rights protection for workers living with the virus.

  • A policy or commitment in place to protect continued employment of worker living with HIV and ensuring confidentiality of their medical information.
  • An ongoing communication strategy to deliver information on HIV prevention and promote benefits of early testing and treatment.
  • A capacity building effort with in-house medical officers to provide confidential testing and treatment adherence support in collaboration with external health service and CSO partners.
  • Delivery of HCT services to workers using a variety of methods including mobile services bundled with other key health services, integrated HCT into annual medical exams with opt-out options and referrals with external public and CSO managed services.
  • Delivery of adherence support to workers living with the virus through in house and/or external public and CSO provided services. Extension of services through supply chains, subcontractors and to key population groups in surrounding areas.

Project Outputs

The following outputs are expected from the implementation of the project’s objectives:

  • Output 1: Identification of local service delivery partners for capacity support for behaviour change and HIV/STI service delivery for workers.
  • Output 2: Commitment from three to five large scale enterprises in the target sectors to implement HIV/AIDS program in the workplace.
  • Output 3: Capacity of companies and partners for an ongoing HIV and AIDS program, including prevention awareness and mobile HCT programme
  • Output 4: Practical methodology for operations research to measure the costs and benefits of private sector approaches on HIV and AIDS. This will include defining the intervention(s) at hand, developing criteria for measuring effectiveness and conducting the final analysis at the end of the Project period.

Key Partners

  • Ministry of Manpower
  • Ministry of Health
  • Indonesia National AIDS Commission
  • Enterprises
  • Civil Society Organizations (CSOs)