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  • Mama Fin works for local NGO, Yayasan Harapan Ibu (YHI) or Mother's Hope (right) visits a young woman with AIDS living under a bridge in the city of Jayapura (middle).
    XD1A7547.jpg
  • Mama Fin, a worker for a local NGO, Yayasan Harapan Ibu (YHI) or Mother's Hope, follows a trail with thick vegetation in order to visit young woman with AIDS living under a bridge in the city of Jayapura.
    HIV/AIDS_Papua54.jpg
  • Nomina, age 20, has AIDS finds refuge at a hospice in Jayapura.
    HIV/AIDS_Papua30.jpg
  • A teen sex worker at undergoes a blood test at a local clinic in Jayapura.
    HIV/AIDS_Papua60.jpg
  • Rejected by his family because he has AIDS, Daud (23) finds refuge at a local hospice in Jayapura.
    HIV/AIDS_Papua63.jpg
  • The statue of General McArthur at Imbi Park, a popular place to buy sex in Jayapura.
    HIV/AIDS_Papua56.jpg
  • Rejected by his family because he has AIDS, Daud (23) finds refuge at a local hospice in Jayapura.
    HIV/AIDS_Papua29.jpg
  • Michael (17) turns his face away during his first time getting tested for HIV at a local clinic in Jayapura. There is high probability for Michael to contract the virus since girlfriend is HIV positive and they don't use protection.
    HIV/AIDS_Papua57.jpg
  • Juliana Yarisetou works as an AIDS advocacy officer for the international NGO Family Health International in Jayapura. She contracted HIV from her husband in 2004. She is open with her status and often gives her testimony on living with HIV. "I've been infected since 2004. I got very sick in 2005 and weighed 22 kg - before that I was 86 kg. I went to the hospital but it was very difficult to get treatment - the doctors didn't know much about HIV/AIDS. They told me to go home and rest. I thought it was just for sex workers, and I kept asking, "Why me?" After the community knew I was HIV positive all of them discriminated against me; they didn't want to be around me, eat or drink with me. An NGO came to the village and educated the community, the church also gave support. Since then I have been open about my status."
    HIV/AIDS_Papua10.jpg
  • Barbie (14), waits for her turn for a blood test at a clinic in Jayapura.
    HIV/AIDS_Papua59.jpg
  • Barbie (15) and Marsela (14) are already infected with HIV and sells their bodies for means of survival in the city of Jayapura.
    HIV/AIDS_Papua14.jpg
  • Nomina, age 20, has AIDS finds refuge at a hospice in Jayapura.
    HIV/AIDS_Papua65.jpg
  • Rejected by his family because he has AIDS, Daud (23) finds refuge at a local hospice in Jayapura.
    HIV/AIDS_Papua64.jpg
  • Mama Fin works for local NGO, Yayasan Harapan Ibu (YHI) or Mother's Hope (right) visits a young woman with AIDS living under a bridge in the city of Jayapura (middle).
    HIV/AIDS_Papua50.jpg
  • Street prostitutes, Betrix (25) and Natalia (16), both HIV positive shares a cigarette as they wait for potential clients in the capitol of Papua, Jayapura.
    HIV/AIDS_Papua15.jpg
  • Juliana Yarisetou works as an AIDS advocacy officer for the international NGO Family Health International in Jayapura. She contracted HIV from her husband in 2004. She is open with her status and often gives her testimony on living with HIV. "I've been infected since 2004. I got very sick in 2005 and weighed 22 kg - before that I was 86 kg. I went to the hospital but it was very difficult to get treatment - the doctors didn't know much about HIV/AIDS. They told me to go home and rest. I thought it was just for sex workers, and I kept asking, "Why me?" After the community knew I was HIV positive all of them discriminated against me; they didn't want to be around me, eat or drink with me. An NGO came to the village and educated the community, the church also gave support. Since then I have been open about my status."
    HIV/AIDS_Papua11.jpg
  • Michael (17) turns his face away during his first time getting tested for HIV at a local clinic in Jayapura.  There is high probability for Michael to contract the virus since girlfriend is HIV positive.
    HIV/AIDS_Papua58.jpg
  • A woman with AIDS living under a bridge in the city of Jayapura.
    HIV/AIDS_Papua52.jpg
  • A nurse checks on Brothel Workers of Tanjung Elmo in Jayapura.
    HIV/AIDS_Papua61.jpg
  • Living under a bridge in Jayapura.
    HIV/AIDS_Papua53.jpg
  • Living under a bridge in Jayapura.
    HIV/AIDS_Papua51.jpg
  • Betrix (25), an HIV positive street prostitute, negotiates with a potential client near Imbi Park, a popular place to buy sex in Jayapura.
    HIV/AIDS_Papua21.jpg
  • Betty (15) teenage street prostitute, waits for potential client near Imbi Park, a popular place to buy sex in Jayapura.
    HIV/AIDS_Papua20.jpg
  • The hand of a man with AIDS at a hospice in Jayapura. His whole body was covered with boils.
    HIV/AIDS_Papua31.jpg
  • Mama P. arrives at home carrying vegetables and fruits on her back.  She earns a living to support her three children by keeping a small garden and selling the crops at a nearby market.<br />
<br />
Mama P. is HIV-positive and she has been taking ARV medication regularly for the last 3 years.  However, Mama P. still keeps her status from her children.  As far as Mama P' children knows, their mother is sick from a common illness but they still remind her to take medication and help get refills. Family support is important but due to fear of discrimination many people living with HIV/AIDS keep their status a secret.  Mama P. receives support from Jayapura Support Group (JSG) who monitors her health and provides rice, cooking oil, milk, and vegetables as well as counseling.
    _MG_0079.jpg
  • Mama P. walks to the market carrying 50kg (110 lbs) of crops.<br />
<br />
Mama P. is HIV-positive and she has been taking ARV medication regularly for the last 3 years.  However, Mama P. still keeps her status from her children.  As far as Mama P' children knows, their mother is sick from a common illness but they still remind her to take medication and help get refills. Family support is important but due to fear of discrimination many people living with HIV/AIDS keep their status a secret.  Mama P. receives support from Jayapura Support Group (JSG) who monitors her health and provides rice, cooking oil, milk, and vegetables as well as counseling.
    _MG_0128.jpg
  • Brothel workers waits to be picked by a potential client.
    HIV/AIDS_Papua24.jpg
  • Yayasan Harapan Ibu (Mother's Hope), a local NGO, demonstrates the use of condom at public places to help prevent the spread of HIV virus.
    HIV/AIDS_Papua39.jpg
  • Brothel workers waits to be picked by potential clients.
    HIV/AIDS_Papua22.jpg
  • Yayasan Harapan Ibu (Mother's Hope), a local NGO, demonstrates the use of condom at public places to help prevent the spread of HIV virus.
    HIV/AIDS_Papua49.jpg
  • Motorcycle taxi drivers have the highest risk of contracting HIV since all of them are men and most young, mobile, and has money.  Family Health International (FHI) is an NGO that conducts mobile clinic and give blood test to taxi drivers on the spot throughout the city.
    HIV/AIDS_Papua33.jpg
  • Betrix (25), an HIV positive street prostitute, waits for a potential client.
    HIV/AIDS_Papua13.jpg
  • Linde, age 10, a victim of rape, waits for her blood result at a local hospital.
    HIV/AIDS_Papua35.jpg
  • Yayasan Harapan Ibu (Mother's Hope), a local NGO, demonstrates the use of condom at public places to help prevent the spread of HIV virus.
    HIV/AIDS_Papua40.jpg
  • An empty bottle of liquor and used cardboard. Street sex workers and their clients often have sex in public because it's cheaper than renting out a hotel room.
    HIV/AIDS_Papua55.jpg
  • Yayasan Harapan Ibu (Mother's Hope), a local NGO, visits local brothels regularly to encourage condom usage to sex workers. However, most sex workers don't enforce condom usage with their clients especially when they offer more money.
    HIV/AIDS_Papua45.jpg
  • Betrix (25) street sex worker.
    HIV/AIDS_Papua02.jpg
  • Rika receives her medication from a local clinic.
    HIV/AIDS_Papua79.jpg
  • The hallway of Bar Kharisma and entrances to VIP rooms.
    HIV/AIDS_Papua42.jpg
  • Children playing jump rope during after Sunday school.
    HIV/AIDS_Papua70.jpg
  • Sex workers at a local brothel, Bar Kharisma, hang out with their boyfriends before their shift. Even those who uses condom with their clients rarely use it with their boyfriends.
    HIV/AIDS_Papua46.jpg
  • Yayasan Harapan Ibu (Mother's Hope), a local NGO, demonstrates the use of condom at public places to help prevent the spread of HIV virus.
    HIV/AIDS_Papua38.jpg
  • Motorcycle taxi drivers have the highest risk of contracting HIV since all of them are men and most young, mobile, and has money. Family Health International (FHI) is an NGO that conducts mobile clinic and give blood test to taxi drivers on the spot throughout the city.
    HIV/AIDS_Papua32.jpg
  • Brothel sex workers watch television to pass the time while waiting to be picked by potential clients.
    HIV/AIDS_Papua26.jpg
  • Rika, age 17, is the third wife and contracted HIV from her husband. Her parents rejected her at first but now shows support. At one point she weighed 35kg (77lbs). But as her health improves after receiving and taking medication regularly from a nearby clinic she is stronger and now weighs 52kg (114lbs).
    HIV/AIDS_Papua76.jpg
  • Inside a known brothel, Bar Kharisma, a customer looks through a one-way mirror before making his selection.
    HIV/AIDS_Papua25.jpg
  • Papua from above the clouds.
    HIV/AIDS_Papua81.jpg
  • Rika, age 17, is the third wife and contracted HIV from her husband. Her parents rejected her at first but now shows support. At one point she weighed 35kg (77lbs). But as her health improves after receiving and taking medication regularly from a nearby clinic she is stronger and now weighs 52kg (114lbs).
    HIV/AIDS_Papua80.jpg
  • A brothel worker inside the VIP room.
    HIV/AIDS_Papua47.jpg
  • Rika, age 17, is the third wife and contracted HIV from her husband. Her parents rejected her at first but now shows support. At one point she weighed 35kg (77lbs). But as her health improves after receiving and taking medication regularly from a nearby clinic she is stronger and now weighs 52kg (114lbs).
    HIV/AIDS_Papua74.jpg
  • A local clinic in Wamena that provides support and assistance to people infected with HIV/AIDS.
    HIV/AIDS_Papua73.jpg
  • A brothel worker shows pictures of her son.
    HIV/AIDS_Papua48.jpg
  • Children playing jump rope during after Sunday school.
    HIV/AIDS_Papua71.jpg
  • The body of a patient with AIDS covered with boils.
    HIV/AIDS_Papua66.jpg
  • Motorcycle taxi drivers have the highest risk of contracting HIV since all of them are men and most young, mobile, and has money. Family Health International (FHI) is an NGO that conducts mobile clinic and give blood test to taxi drivers on the spot throughout the city.
    HIV/AIDS_Papua34.jpg
  • Betrix (25), Marsela (14), Barbie (14), and Natalia (16) finds refuge from the rain under the tent of a street food vendor.
    HIV/AIDS_Papua17.jpg
  • A woman living with AIDS gives her testimony in front of a support group.
    HIV/AIDS_Papua12.jpg
  • Mama Fin, a worker for Yayasan Harapan Ibu (YHI) or Mother's Hope, provides shelter and education to sex street workers.
    HIV/AIDS_Papua08.jpg
  • Sex street workers Natalia (16) and Arken (17).
    HIV/AIDS_Papua06.jpg
  • A street sex workier Barbie (14) watches TV.
    HIV/AIDS_Papua05.jpg
  • Natalia (16), an HIV infected street sec worker smokes a cigarette.
    HIV/AIDS_Papua04.jpg
  • Rika, age 17, is the third wife and contracted HIV from her husband. Her parents rejected her at first but now shows support. At one point she weighed 35kg (77lbs). But as her health improves after receiving and taking medication regularly from a nearby clinic she is stronger and now weighs 52kg (114lbs).
    HIV/AIDS_Papua75.jpg
  • Linde, age 10, a victim of rape, waits for her blood result at a local hospital.
    HIV/AIDS_Papua72.jpg
  • A brothel worker, Helda (27), in Tanjung Elmo is seen in her private room.
    HIV/AIDS_Papua62.jpg
  • Motorcycle taxi drivers have the highest risk of contracting HIV since all of them are men and most young, mobile, and has money. Family Health International (FHI) is an NGO that conducts mobile clinic and give blood test to taxi drivers on the spot throughout the city.
    HIV/AIDS_Papua36.jpg
  • Market scene in Wamena.
    HIV/AIDS_Papua67.jpg
  • A VIP room at Bar Kharisma that also functions as a brothel.
    HIV/AIDS_Papua44.jpg
  • Owners of a popular brothel, Bar Kharisma.
    HIV/AIDS_Papua43.jpg
  • Bar Kharisma is a Karaoke bar that also functions as a brothel.
    HIV/AIDS_Papua41.jpg
  • A TV screen inside a popular "Karaoke" bar that also functions as a brothel.
    HIV/AIDS_Papua28.jpg
  • In the middle of the cold and wet night, Betrix (25), Marsela (14), Barbie (14), and Natalia (16) walks the empty street looking for potential clients.
    HIV/AIDS_Papua18.jpg
  • Barbie (14), an HIV infected street sex worker finds refuge inside the home of Mama Fin, a local NGO worker of Yayasan Harapan Ibu (YHI) or Mother's Hope.
    HIV/AIDS_Papua09.jpg
  • Rika, age 17, is the third wife and contracted HIV from her husband. Her parents rejected her at first but now shows support. At one point she weighed 35kg (77lbs). But as her health improves after receiving and taking medication regularly from a nearby clinic she is stronger and now weighs 52kg (114lbs).
    HIV/AIDS_Papua78.jpg
  • Rika, age 17, is the third wife and contracted HIV from her husband. Her parents rejected her at first but now shows support. At one point she weighed 35kg (77lbs). But as her health improves after receiving and taking medication regularly from a nearby clinic she is stronger and now weighs 52kg (114lbs).
    HIV/AIDS_Papua77.jpg
  • Wamena, Papua.
    HIV/AIDS_Papua69.jpg
  • Yohana, age 42, a woman with AIDS abandoned by her husband. Due to her illness, she is unable to work and relies on her neighbors and a local support group for food and medicine.
    HIV/AIDS_Papua37.jpg
  • A brothel worker waits for her client.  Her job is to order expensive drinks and provide company and entertainment but the proposal for sex usually gets brought up by the client.
    HIV/AIDS_Papua27.jpg
  • Natalia (16), Arken (17), and Marsela (14) are not the typical teenage girls, they are street prostitutes. Poor and uneducated, many girls in Papua sell their bodies in order to survive.
    HIV/AIDS_Papua07.jpg
  • Marsela (14) street sex worker.
    HIV/AIDS_Papua01.jpg
  • Betrix (25), an HIV positive street prostitute, waits for a potential client.
    HIV/AIDS_Papua19.jpg
  • Market scene in Wamena.
    HIV/AIDS_Papua68.jpg
  • Bar Kharisma; A brothel sex worker is seen illuminated by strobe lights inside the dark lit "karaoke" bar.
    HIV/AIDS_Papua23.jpg
  • Marsela (14), Barbie (14), and Natalia (16) finds refuge from the rain under the tent of a street food vendor.
    HIV/AIDS_Papua16.jpg
  • Street sex workers Arken (17) and Marsela (14).
    HIV/AIDS_Papua03.jpg
  • Mama Yuli embraces her granddaughter, Anace (8). They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8410.jpg
  • Mama Yuli takes her ARV pills at eight o’clock every morning for the last eight years.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8209.jpg
  • Mama Yuli greets the pastor after the Sunday sermon.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8293.jpg
  • Mama Yuli embraces her granddaughter Anace (8).  They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8382.jpg
  • Mama Yuli eats lunch with her granddaughter, Anace (8). They are very close. In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8441.jpg
  • Mama Yuli socializes with her friends after the Sunday sermon. <br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8303.jpg
  • Becky (24) and her daughter, Emma, are seen inside their home.  Becky is HIV-positive but she did not take ARV during her pregnancy.  Emma died from a sudden illness before the age of two.<br />
<br />
In Papua there are more records of housewives infected with HIV than sex workers.  In most cases, housewives contracted HIV from their husbands.  As a result, many pregnant women who are unaware of their infection often pass the virus to their infants.  Fortunately, HIV testing on pregnant women is a mandatory practice conducted during prenatal care.  Nevertheless, the transmission of HIV from mother to child still occurs, especially since many women have limited access to a clinic during their pregnancy.
    _MG_8575.jpg
  • A family portrait of Mama Yuli with her two young daughters and granddaughter, Anace (8). <br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8473.jpg
  • Mama Yuli walks to church to attend the Sunday sermon.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8266.jpg
  • One of the first ARV medications provided by the government in 2003.  Only 7 packages were purchased then for all of Papua costing 375,000,000 IDR ($40,000).  ARV is now available at no cost in Papua but only 10-12% of people with HIV/AIDS are taking them.
    _MG_9432.jpg
  • Gary (11) arrives at his school.<br />
<br />
Gary is HIV-positive and lost both of his parents to AIDS. He has been taking ARV since age 4 and now lives with his grandmother and cousin.  In the past, Gary experienced discrimination when his teacher placed him in the back of the classroom due to his status.  Fortunately, a local support group, Sorong Sehati, educated his teacher and the rest of the faculty about HIV/AIDS that dispelled much of the misunderstanding and stigma.  Gary now sits in the front of the class.  He wants to be a doctor when he grows up because he wanted to help others who are also sick like him.
    AAO_Scans2_267.jpg
  • Mama Yuli takes her ARV pills at eight o’clock every morning for the last eight years.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8208.jpg
  • Mama Yuli takes her ARV pills at eight o’clock every morning for the last eight years.<br />
<br />
In 2004 Mama Yuli contracted the HIV virus from her husband who later died from AIDS. At her worst point, Mama Yuli was just skin and bones weighing only 22 kilograms (48 pounds). With ARV she is now healthy to work and support her family.<br />
<br />
If taken properly and regularly, ARV has been proven to prolong the survival rate of people living with HIV/AIDS and enables them to live a productive life. The Indonesian government started providing ARV therapies in 2003. In that year only 7 packages of ARV were purchased for all of Papua. Each package cost approximately $5000. Today in Indonesia this vital medication can be obtained at no cost only in Papua but only 12% of those with HIV/AIDS are undergoing ARV therapy.<br />
<br />
Despite these advances, ARV is mostly available only in cities. Collaboration between health facilities in urban centers and staffs in rural areas to make ARV more accessible for patients living in the countryside is still lacking as well as the endorsement of ARV as a legitimate medicine for HIV/AIDS. Sometimes health staff and even educational materials still provide misleading information and perception such as "there is no medicine for HIV/AIDS."<br />
<br />
As a general practice health personnel often evaluate patients for their adherence in taking their medication and keeping up with appointments before allowing them to undergo ARV therapy. Indigenous Papuans tend to fall short of this assessment and fail to return for their check-up because many of them live too far from the health centers.  At times, they do not fully understand the benefits of ARV medication and the importance of taking them properly due to poor counseling from the health staff.  Also, many of them are unable to keep their appointments or take medication regularly because they still keep their status a secret from their immediate family members or spouse.
    _MG_8211.jpg
  • Seen through a one-way mirror, sex workers wait to be chosen by a customer inside Bar Kharisma, a popular brothel in Jayapura, the capital of Papua.<br />
<br />
In Papua, prostitution is a profitable industry.  The influx of non-Papuan migrants into the region brings sanctioned prostitution.  Brothels, often disguised as clubs, karaoke bars, and massage parlors, hire mostly non-Papuan sex workers.  These formal establishments employ 4,000-plus sex workers who earn ten times more than their Papuan counterparts.  Above and beyond the financial discrepancy, the biggest difference between Indonesian brothel workers and Papuan sex workers is the disproportionate access to HIV preventive care and support.  Most HIV and Sexually Transmitted Diseases (STDs) intervention programs are geared towards sex workers in brothels.  For example, in Jayapura, the capital of Papua, there are over 30 brothels, and non-Papuan sex workers in these establishments undergo monitored testing and counseling for STDs every month, and for HIV every 3 months.  As a result, they are much better informed about HIV/AIDS and have better access to care and support than indigenous Papuan sex workers.
    AgainstAllOdds_Color_04.JPG
  • Seen through a one-way mirror, sex workers wait to be chosen by a customer inside Bar Kharisma, a popular brothel in Jayapura, the capital of Papua.<br />
<br />
In Papua, prostitution is a profitable industry.  The influx of non-Papuan migrants into the region brings sanctioned prostitution.  Brothels, often disguised as clubs, karaoke bars, and massage parlors, hire mostly non-Papuan sex workers.  These formal establishments employ 4,000-plus sex workers who earn ten times more than their Papuan counterparts.  Above and beyond the financial discrepancy, the biggest difference between Indonesian brothel workers and Papuan sex workers is the disproportionate access to HIV preventive care and support.  Most HIV and Sexually Transmitted Diseases (STDs) intervention programs are geared towards sex workers in brothels.  For example, in Jayapura, the capital of Papua, there are over 30 brothels, and non-Papuan sex workers in these establishments undergo monitored testing and counseling for STDs every month, and for HIV every 3 months.  As a result, they are much better informed about HIV/AIDS and have better access to care and support than indigenous Papuan sex workers.
    Against All Odds_04.JPG
  • Mama P. leaves her house carrying 60kg (132 lbs.) bags filled with crops to be sold at a local market. As a single parent, she works hard to provide for her 3 children<br />
<br />
Mama P. is HIV+ but she has been taking ARV (Anti Retroviral) medication regularly for the last 3 years improving her health significantly. Mama P. receives assistance from Jayapura Support Group (JSG), a local community support group in Jayapura, who monitors her condition and provides rice, cooking oil, milk, and vegetables as well as counseling. Despite her excellent health, Mama P. still keeps her status from her children who only knows that she is sick but not from HIV. Nevertheless, her children still provide support by reminding her to take medication and help get refills. Family support is essential but due to fear of discrimination many people living with HIV/AIDS keep their status a secret.
    AgainstAllOdds_Final_02.JPG
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Andri Tambunan

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