Mobility and HIV Risk in a Border Region: A Study of Factors Affecting Risk on the Border of Papua, Indonesia, and Papua New Guinea

HIV is a significant health issue in the Asia-Pacific region and some areas of high prevalence are of particular concern. Papua New Guinea (PNG) is a country previously considered to have a generalised HIV epidemic; however recent data indicates a reduced prevalence of 0.65% (National Department of Health PNG, 2014). Moreover, disease prevalence is concentrated in certain populations (specifically people who sell sex and men who have sex with men) and in certain geographical locations (National Department of Health PNG, 2014). Neighbouring Indonesia also reports a non-generalised epidemic with a rate of 0.5% of all adults aged 15-49 infected in 2013 (UNAIDS, 2013). However, these figures contrast sharply with the situation in the Indonesian region of Papua that shares the border with PNG. In 2006, an integrated biological and behavioural survey of 6,500 people from both Papua and West Papua provinces (an area collectively known as Tanah Papua) aged 15-49 demonstrated a generalised epidemic with a prevalence rate of 2.4% (BPS & Ministry of Health, 2007). More recent precise figures are not available for this particular region, but some authors estimate even higher rates particularly among highland populations (Butt et al., 2010). These diverse circumstances in adjacent geographical regions raise concern for potential increases in HIV transmission.