VZCZCXRO5198
RR RUEHCHI RUEHHM RUEHNH
DE RUEHDT #0181/01 2050319
ZNR UUUUU ZZH
R 240319Z JUL 09
FM AMEMBASSY DILI
TO RUEHC/SECSTATE WASHDC 4464
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHBY/AMEMBASSY CANBERRA 1300
RUEAIIA/CIA WASHDC
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RUEHLI/AMEMBASSY LISBON 1135
RHEHAAA/NSC WASHINGTON DC
RHHJJPI/PACOM IDHS HONOLULU HI
RUEKJCS/SECDEF WASHDC
RUEHC/USAID WASHDC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHDT/AMEMBASSY DILI 3999

UNCLAS SECTION 01 OF 02 DILI 000181 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: KHIV SOCI PGOV MASS TT
SUBJECT: HIV/AIDS PREVALENCE LOW, BUT VULNERABILITIES PERSIST 
 
DILI 00000181  001.2 OF 002 
 
 
¶1. (U) SUMMARY: Timor-Leste remains a low HIV prevalence 
country, but porous borders, an influx of sex workers from 
abroad, and low awareness about the disease could lead to an 
increase in HIV/AIDS infected persons.  The national response 
has focused on prevention, education, testing, and treatment. 
The Ministry of Health and the NGO community have worked on 
various programs to bring services to the districts outside Dili 
and provide prevention awareness to at-risk populations.  USAID, 
DoD, and other implementing partners have also administered 
various programs focusing on HIV/AIDS prevention.  END SUMMARY. 
 
 
 
--------------------------------- 
 
HIV/AIDS Profile in Timor 
 
--------------------------------- 
 
 
 
¶2. (U) The World Health Organization estimates that as much as 
0.5 percent of Timor-Leste's population of 1.1 million could be 
HIV positive, approximately 5,000 individuals.  According to 
official statistics, 121 Timorese have contracted AIDS since 
2001, 17 of which have died.  The most at-risk populations 
include commercial sex workers, clients of sex workers, military 
personnel, men who have sex with men, and intravenous drug users. 
 
 
 
¶3. (U) HIV/AIDS prevalence is highest in Dili and the Western 
districts near the border with Indonesia, both of which are 
affected by the commercial sex trade.  There are an estimated 
500 sex workers in Timor-Leste, the majority of which work in 
Dili brothels operated by Chinese and Indonesian crime 
syndicates.  Sex workers illegally cross the border from West 
Timor, which has the second highest HIV/AIDS prevalence of all 
Indonesian provinces.  In 2003, UNAIDS found that three percent 
of sex workers in Timor were HIV positive. 
 
 
 
------------------------ 
 
National Response 
 
------------------------ 
 
 
 
¶4. (U) Timor-Leste adopted a National Strategic Plan for 
HIV/AIDS covering 2006-2010 and appointed an independent 
National AIDS Commission to advise the GOTL and monitor the 
progress of the Strategic Plan.  The Ministry of Health, in an 
effort to provide HIV/AIDS services in the more remote 
districts, established 17 HIV/AIDS clinics throughout the 
country, although six lack equipment and are not fully 
operational.  The cornerstone of the clinics' activities is 
voluntary counseling and testing.  The Ministry also administers 
a peer education outreach program for sex workers. 
 
 
 
¶5. (U) Beginning in 2007, the Ministry of Health, NGOs, and 
donor countries have distributed condoms throughout the country. 
 The Catholic Church (over 96 percent of Timorese profess to be 
Catholic) initially condemned condom distribution but relaxed 
its opposition in late 2008, after which time the number of 
condoms distributed jumped dramatically.  Many have gone to 
military and police personnel. 
 
 
 
------------------------------- 
 
International Assistance 
 
------------------------------- 
 
 
 
 
DILI 00000181  002.2 OF 002 
 
 
¶6. (U) The Global Fund to Fight AIDS, Tuberculosis, and Malaria 
approved a 5-year, $ 8.66 million grant to Timor-Leste in 2006 
to improve prevention services, increase access to information, 
expand treatment and care services, and strengthen healthcare 
systems.  USAID supported the development of the first National 
HIV/AIDS program, and the USAID-supported Coffee Cooperative 
Timor-Leste has established five clinics where employees can 
receive testing, counseling, treatment, and care services. 
International NGOs such as Catholic Relief Services have 
sponsored HIV/AIDS programs targeted at clients of sex workers 
in Timor-Leste. 
 
 
 
¶7. (U) The Department of Defense HIV/AIDS Prevention Program 
(DHAPP) worked with NGOs to provide HIV/AIDS assistance to the 
Timorese military (F-FDTL).  PACOM also has worked with F-FDTL, 
providing funds for HIV prevention, education, and testing, as 
well as thousands of condoms for uniformed personnel. 
 
 
 
------------- 
 
Comment 
 
------------- 
 
 
 
¶8. (SBU) The number of HIV/AIDS cases in Timor remains 
relatively small, but the country's low level of development and 
lack of human capacity in the healthcare field make it 
vulnerable to greater levels of infection, particularly if the 
commercial sex trade and intravenous drug use continue to 
increase.  Health care services are limited and there are few 
resources available to assist intravenous drug users or to 
expand prevention operations in remote areas.  The gap between 
official statistics and the reality on the ground suggest 
Timor-Leste's HIV/AIDS problem may be more severe than the 
government realizes.  HIV/AIDS has struck several prominent 
Timorese including the director of the government's statistical 
bureau who died in 2008, and the Chief Justice of the Court of 
Appeals, who returned to service in March 2009 after an extended 
convalescence in Lisbon during much of 2008.  Several members of 
UNMIT have been diagnosed with the disease. 
KLEMM