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new joint initiative has been launched to increase HIV testing and treatment uptake in Indonesia, where government efforts to roll out universal access to antiretroviral (ARV) therapy have been hampered by low numbers of people presenting for HIV testing.

The project is funded by Australia's Department of Foreign Affairs and Trade, with AU$2 million over four years. It is a collaboration between the World Health Organization (WHO), the Kirby Institute, the Indonesian Health Ministry and the National AIDS Program, as well as three leading Indonesian universities ' Padjadjaran University in Bandung, Gadjah Mada University in Yogyakarta and Udayana University in Bali.

'We continue to work toward the holy grail of a vaccine and cure, but treatment is still the most important strategy we've got to reduce HIV infection and, in order to get people on treatment, we've got to get them testing,' said David Cooper, director of the Kirby Institute and professor of medicine at Australia's University of South Wales (UNSW), during the launch of the project on the sidelines of the 20th International AIDS Conference in Melbourne on Thursday.

The 'Test and Treat Indonesia' study will evaluate a range of possible interventions to encourage early diagnosis and immediate treatment with ARV therapy, known as the test-and-treat strategy, among key affected populations in Indonesia.

'The project is a dream come true. Before I became a minister of health some 20 years ago, I met with the distinguished Dr. Anthony Fauci, a leading world AIDS researcher from the United States who convinced me to apply a test-and-treat method in dealing with HIV in Indonesia,' said Health Minister Nafsiah Mboi at the launch.

However, it was so expensive that a country like Indonesia could not afford it, she added. Fauci was present at the launch.

'Indonesia is unique, socially and geographically. After exchanging emails and phone calls with Ibu Naf [Nafsiah Mboi], the project is here now. It would be good not only for Indonesia but also for the rest of the world to follow this path,' Fauci told The Jakarta Post.

At present there are more than 400,000 people living with HIV/AIDS in Indonesia. In recent years, the primary driver of the HIV epidemic has shifted from injecting drug use to sexual transmission.

The majority of HIV cases in Indonesia are concentrated in five key affected population groups: gay men; men who have sex with men (MSM) and male sex workers; transgender or waria people; female sex workers and their clients; and people who inject drugs.

Another important aim of the study is to build research capacity in Indonesia through training and the active participation of local researchers.

Also involved are Bali-based Yayasan Kerti Praja (YKP); community organizations representing MSM and female sex workers; and John Caldor, professor of medicine and a senior researcher at the Kirby Institute, who said that the project was an implementation research project that would look at strategies for promoting testing and treatment in some of the key affected population groups in Indonesia.

'Implementation research is vital to allow us to understand the gaps and the successes,' said Caldor.

'The community-based interventions, which we hope will be the key to increasing our rates of test-and-treat, will be developed in close consultation with the community organizations, whose involvement is immensely valuable,' he added.