Integrated Regional Information Networks - February 20, 2012
JAYAPURA, 20 February 2012 (PlusNews) - Authorities in
Indonesia's remote Papua Province say they have no plans to make
male circumcision mandatory, despite media reports to the
"The government does not want to make male circumcision
compulsory," Constant Karma, secretary of the Provincial
Commission and head of the Provincial AIDS Commission, told IRIN
in the provincial capital of Jayapura.
"However, the government is promoting medical male circumcision
as part of its reproductive health strategy, which includes HIV."
Only about 5 percent of ethnic Papuans in the region - comprised
of Papua and West Papua provinces - are circumcised, against 70
percent of non-Papuans.
According to Indonesia's National AIDS Commission, HIV prevalence
in Papua stands at 2.4 percent among 15-49 year-olds, against 0.2
percent in the rest of the country, where male circumcision is
Karma's comments came a week after local media reports cited
Jayapura administration officials reporting plans to require all
male residents to undergo mandatory circumcision as part of their
efforts to curb transmission rates.
"Therefore, the obligatory circumcision will be regulated in 2012
to reduce the spread of HIV/AIDS in Papua," Edison Muabuay, a
Jayapura administration official, was quoted as saying on 12
And while Muabuay declined to provide specific details of how
such a plan might be enforced, he noted that the Health
Department and Regional Public Hospital of Yowar in Jayapura had
already been ordered to provide the necessary instruments and
supplies for the programme.
But making male circumcision mandatory in this predominately
Christian area in the far west of the country once colonized by
the Dutch would prove controversial.
Most native Papuans associate male circumcision with Islam, the
majority religion of most Indonesians.
At the same time, some church officials continue to question its
importance in curbing the spread of the HI virus.
"I don't believe male circumcision significantly reduces the risk
of HIV," Pastor Sadrak Simbiak, a prominent protestant minister
in Manokwari, the provincial capital of West Papua Province,
"Instead, people should focus on abstinence and being faithful to
But according to Karma, efforts to promote male circumcision are
"Male circumcision is not just for Muslim people and people in
Papua are slowly accepting this," he said, noting that before the
arrival of the Dutch, male circumcision was part of the
"People now want to be circumcised, particularly in urban areas;
however, the challenge now is ensuring that it can be undertaken
safely," he said.
Of Papua's eight hospitals, only three are equipped to carry out
the procedure, while about 80 percent of the province's 2.3
million indigenous people live in rural areas.
Most Papuans continue to receive their primary healthcare in
community health centres (Puskesmas) where such services are not
According to a 2006 Integrated Biological and Behavioural
Surveillance (IBBS) of Papua, HIV prevalence among Papua's male
population is 2.9 percent, while prevalence among the female
population was 1.9 percent.
The highest prevalence was found in hard-to-access lowlands
areas, at 3.2 percent, followed by highlands areas at 2.9
percent. The lowest HIV prevalence was found in easily accessible
lowlands, at 1.8 percent.
Significantly, HIV prevalence among ethnic Papuans in Papua is
almost twice as high as prevalence among non-ethnic Papuans, at
2.8 percent, compared with 1.5 percent.
Moreover, prevalence among residents who had multiple partners
and were circumcised was 1 percent, while among those who were
not circumcised it was significantly higher at 5.6 percent, the
According to the World Health Organization (WHO) male
circumcision performed by trained professionals in a sterile
environment can reduce the risk of heterosexually acquired HIV in
men by some 60 percent.