Our work in Timor-Leste

Our work in Timor-Leste

NAPWHA has a history of work in neighboring countries Papua New Guinea and Timor-Leste supporting the development of the HIV-positive organisations and HIV positive community responses — our in-country work including a range of health and education initiatives that promote the highest quality standard of care for HIV-positive people.  NAPWHA continues to provide specific and periodic in-country support to Estrela+ — the membership organisation of Timor-Leste representing and advocating for PLHIV, established in 2009. 

 

Video: NAPWHA’s recent work in PNG include supporting the Igat Hope Third National Conference on the meaningful participation of people with PNG’s response to HIV (June 2018), overseeing production of a newly optimised Igat Hope website, and continuing to build the capacity of PLHIV through training, advocacy and research.

Background

The first case of HIV in Timor-Leste, a lower-middle income country bordering Indonesia with a population of 1.2 million was reported in 2003 (The World Bank, Data – Timor-Leste 2014). Today Timor-Leste has a low level non-generalized HIV epidemic with an estimated HIV prevalence rate of approximately 0.1845% of adults aged 15-49 as of 2011 (Timor-Leste National HIV and STI Strategy 2011-2016). This transmission rate exceeds that projected by the HIV Epidemiological Model and Impact Study in 2005 (UNGASS Report). According to surveillance data from the Ministry of Health, at the end of September 2016, there were 630 diagnosed cases of HIV in Timor-Leste.

At the end of December 2016, there were 642 diagnosed cases of HIV in Timor-Leste since the first case was diagnosed in 2003 (Ministry of Health, 2016). This is a prevalence rate of 0.058 percent of the population. The low prevalence rate, current scientific knowledge and availability of appropriate medications and HIV management supports make Timor-Leste uniquely positioned to contain the spread of HIV if timely testing, treatment and retention in care can be maintained. From January to September 2017 there were 61 new diagnosed cases of HIV (WHO and Ministry of Health, 2017). There is also a high prevalence of STIs and Hepatitis B in Timor-Leste (WHO and Ministry of Health, 2017).

 

Early years: Partnership between NAPWHA & Estrela+

NAPWHA was initially developed by and for people living with HIV in Australia. At the beginning of the epidemic and through to the development of effective treatment responses in 1996 NAPWHA was focused specifically on work in Australia.

However, from the year 2000-onward when it became apparent that there was potentially a disastrous HIV epidemic emerging in the Asia-Pacific regional, NAPWHA became involved in regional programs with the Asian Pacific Network of Positive People and especially in Papua New Guinea (where there was a high HIV prevalence rate) and Timor-Leste (then a country with a low HIV prevalence rate).

NAPWHA’s continuing work with Igat Hope & CHPNG  

The most recent NAPWHA activities under CHPNG funding, are listed in its Service Agreement Report 2017-2018, including:

  • The establishment of ‘safe spaces’ for PLHIV – initially through the Catholic Church Health Services (CCHS)
  • Treatment workshops and information sessions for PLHIV – initially in Port Moresby
  • Expansion of PLHIV network activity across the 19 provinces in PNG
  • Production of the HIV-related Stigma and Discrimination in PNG report
  • Developing the HIV peer counselors in clinical setting concept in collaboration with Igat Hope
  • Enacting the concept and drawing support from other partners to develop an effective program
  • Developing, conducting and evaluating Psychology of HIV Treatments workshops involving CCHS staff
  • Supporting the Igat Hope Third National Conference on the meaningful participation of people with PNG’s response to HIV (June 2018) and launching the Igat Hope website
  • In July 2019, NAPWHA is organising in Port Moresby a HIV, health, nutrition and self-esteem workshop for women with HIV; meeting for men of diverse sexuality group (Kapul Champions) and the sex workers group (Friends Frangipani). In Goroka (the Eastern Highlands Province), NAPWHA will conduct a train-the-trainer workshop for HIV+ peer counselors.

HIV-related Stigma & Discrimination in PNG report

In 2016, NAPWHA published a major report released that contains research conducted on HIV stigma and discrimination in Papua New Guinea. Funded by PNG’s National AIDS Council, interviews were conducted in the Western Highlands and Chimbu provinces of the Pacific island. The data contained in the report provides information so that agencies and organisations can develop programs and responses to the vexed problems of stigma and discrimination face by positive people in PNG

“This report is an extremely important document,” said Carol Kidu, member of PNG’s parliamentary committee on HIV. “I trust that serious note will be taken of this report and its recommendations and that it will be the beginning of more studies to build a repository of knowledge that will bring positive changes and reduce to zero our tolerance of stigma and discrimination.”

Authored by Dr John Rule and Don Liriope, the purpose of the report was to provide data on how stigma and discrimination create barriers to accessing services and how they impede the scaling-up of delivery of HIV treatment in PNG . “We also wanted to detail the levels of stigma faced by people living with HIV in different provinces and regions,” said Rule. “There are different experiences based on gender, sexuality or gender identity.”

The research contained in the report is the first step in what is hoped will be an ongoing project in PNG to fight the fear, shame and blame directed at PLHIV. “HIV does not kill people but stigma can kill and knowledge and compassion can prevent many unnecessary deaths,” said Kidu.

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