INDONESIA INTERNAL & INTERNATIONAL POPULATION MOBILITY: IMPLICATIONS FOR THE SPREAD OF HIV/AIDS By Graeme Hugo Professor of Geography and Director of the National Key Centre for Social Applications of GIS Adelaide University, Australia UNDP South East Asia HIV And Development Office ILO, Indonesia UNAIDS, Indonesia November 2001 INDONESIA INTERNAL & INTERNATIONAL POPULATION MOBILITY: IMPLICATIONS FOR THE SPREAD OF HIV/AIDS By Graeme Hugo Professor of Geography and Director of the National Key Centre for Social Applications of GIS Adelaide University, Australia UNDP South East Asia HIV And Development Office ILO, Indonesia UNAIDS, Indonesia November 2001 i LIST OF CONTENTS LIST OF TABLES ........................................................................................................iv LIST OF FIGURES ......................................................................................................vi PREFACE .......................................................................................................................ix GLOSSARY.....................................................................................................................x EXECUTIVE SUMMARY AND RECOMMENDATIONS .................................... xii CHAPTER 1 INTRODUCTION ...........................................................................................................1 1.1 Introduction..........................................................................................................1 1.2 Aims and Objectives ............................................................................................2 1.3 Data Sources........................................................................................................3 1.3.1 Data on Population Mobility.................................................................3 1.3.2 Surveys of HIV in Indonesia ..................................................................7 1.4 Conclusion ...........................................................................................................9 CHAPTER 2 HIV/AIDS IN INDONESIA - THE CURRENT SITUATION ...............................11 2.1 Introduction........................................................................................................11 2.2 Spatial Variation in the Incidence of HIV/AIDS ...............................................13 2.3 Areas of Concentration of HIV/AIDS in Indonesia...........................................16 2.4 Characteristics of Indonesians with HIV/AIDS.................................................22 2.5 Results of Prevalence Studies ............................................................................23 2.6 Knowledge of HIV/AIDS ..................................................................................29 CHAPTER 3 POPULATION MOBILITY AND THE SPREAD OF HIV/AIDS - THE LITERATURE .....................................................................................................32 3.1 Introduction........................................................................................................32 3.2 Prevalence of HIV/AIDS Among Migrants.......................................................37 3.3 Sexual Activity of Migrants...............................................................................38 3.4 Why Do Some Groups of Movers Have a Greater Risk of Higher Infection Than Non-Movers?.................................................................39 3.5 Migrant Women and HIV/AIDS........................................................................41 3.6 Return Migration and HIV/AIDS ......................................................................42 ii 3.7 Policy and Program Dimensions........................................................................42 CHAPTER 4 PATTERNS AND LEVELS OF INTERNAL MIGRATION IN INDONESIA..................................................................................................................44 4.1 Introduction........................................................................................................44 4.2 Changing Levels of Population Mobility...........................................................45 4.3 Inter-Provincial Migration.................................................................................47 4.4 Return Migration................................................................................................58 4.5 Urbanisation .......................................................................................................60 4.6 Non-Permanent Migration.................................................................................66 4.6.1 Introduction .........................................................................................66 4.6.2 Labour Migration to Areas of Resource Exploitation .........................71 4.6.3 Rural to Urban Labour Migration.......................................................73 4.6.4 Eastern Indonesian Migration.............................................................74 4.6.5 Labour Migration to Batam.................................................................76 4.6.6 Other Border Locations.......................................................................77 4.6.7 Transfer of Security, Personnel and Civil Servants.............................81 4.7 Internal Migration in the Crisis..........................................................................82 4.8 Characteristics of Migrants ................................................................................83 4.9 Conclusion .........................................................................................................85 CHAPTER 5 PATTERNS AND LEVELS OF INTERNATIONAL MIGRATION IN INDONESIA............................................................................................................87 5.1 Introduction........................................................................................................87 5.2 International Labour Migration..........................................................................87 5.3 International Labour Migration and HIV/AIDS ................................................97 5.4 HIV Testing for International Labour Migrants...............................................106 5.5 Trafficking .......................................................................................................108 5.6 Conclusion .......................................................................................................111 CHAPTER 6 REFUGEES AND INTERNALLY DISPLACED PERSONS................................113 6.1 Introduction......................................................................................................113 6.2 Internally Displaced Persons in Indonesia .......................................................114 iii CHAPTER 7 THE SEX INDUSTRY, POPULATION MOBILITY AND THE SPREAD OF HIV/AIDS IN INDONESIA..............................................................120 7.1 Introduction......................................................................................................120 7.2 Indonesia’s Sex Industry..................................................................................121 7.3 The Sex Industry and HIV/AIDS.....................................................................125 7.4 Conclusion .......................................................................................................139 CHAPTER 8 LINKS BETWEEN MOBILITY AND SUB-GROUPS WITH HIGH RISK TO HIV/AIDS INFECTION...............................................................141 8.1 Introduction......................................................................................................141 8.2 The Army and Police Forces............................................................................141 8.3 Fishermen.........................................................................................................142 8.4 Transport Workers ...........................................................................................144 8.5 Traders .............................................................................................................146 8.6 Factory Workers...............................................................................................146 8.7 Seafarers...........................................................................................................147 8.8 Construction Workers ......................................................................................147 8.9 Plantation Workers...........................................................................................148 8.10 Foreigners.........................................................................................................148 8.11 Injecting Drug Users (IDUs)............................................................................149 8.12 Transvestites and Gays.....................................................................................153 CHAPTER 9 RECOMMENDATIONS AND CONCLUSIONS ....................................................155 9.1 Introduction......................................................................................................155 9.2 Recommendations for Continuing Research....................................................156 9.3 Recommendations on Behavioural Sentinel Surveillance ...............................159 9.4 Population Mobility and HIV/AIDS Policy.....................................................160 9.5 Prevention