The first case of HIV in Papua New Guinea (PNG) was reported in 1987. By 2004, the country had a generalized epidemic, the fourth country in Asia-Pacific to do so [1]. In 2009, the national adult HIV prevalence was estimated at 0.9%, up from 0.5% in 2001[2]. The estimated number of people living with HIV had more than doubled - from 14,000 (2001) to 34,000 (2009) [2]. Also, the number of women living with HIV had more than doubled - from 7,600 in 2001 to 18,000 in 2009 [2]. As of December 2008, a cumulative total of 28,294 HIV cases were reported, of which females comprised nearly 60%, and 40% of total cases came from the National Capital District (NCD) [1]. A downward trend could be observed as more testing was conducted outside the NCD, particularly at the Port Moresby General Hospital [1].

The 2009 data showed that HIV was mainly driven by unprotected heterosexual transmission (91.1%) [3], followed by perinatal (3.6%), homosexual (2.6%), and other (2.8%) transmission modes [3]. Sexually transmitted infections (STIs) are highly prevalent in PNG and have been increasing, particularly among young women and rural dwellers as well as in the Southern and Highlands regions [1].

From a 2010 study among people who sell and/or exchange sex in Port Moresby, it was found that HIV prevalence, although unadjusted, was 19% among women, 8.8% among men and 23.7% among transgender persons who sell and/or exchange sex [4]. Paid sex appears to be common among mobile populations, including migrant workers, transport workers, and military personnel [5]. In addition, behavioral surveys and program monitoring data revealed risk behaviors and vulnerability factors among sex workers.

Studies from 2006 showed that up to 13% of surveyed 1,408 men in “high risk” occupations (truckers, sugar workers, port workers, military) and 12% of 788 out of school young men had ever had sex with other men [6]. From 2005 to 2007, the proportions had dropped for men who have sex with men (MSM) in Port Moresby who had sex in the last month with regular paying male clients (from 64% to 47%), with a non-paying male sex partner (from 94% to 84%) and with non-paying female sex partner (from 71% to 63%). The levels of consistent condom use with regular paying male clients had increased from 24% (2005) to 71% (2007) [7]. Based on 2009 program monitoring data, 67% of MSM received an HIV test and received its result, up from 42% in 2007 [2].

Among the vulnerability factors include: the illegality of sex work that makes female sex workers particularly hard to reach with interventions and to sample [8]; low condom use among the general population, particularly in rural areas [8]; increasing rates of sexually transmitted infections, particularly among young women and rural dwellers [1]; a wide range of risk behaviors taken by youths, including multiple pre-marital and extra-marital sex partners and early first sex [1]; and gender inequality and gender-based violence [9], including high incidence of rape, sexual aggression and other forms of violence against women [10].

Sources:

[1] Papua New Guinea, UNGASS Country Report, 2010 

[2] UNAIDS, Report on the Global AIDS Epidemic, 2010

[3] PNG National Department of Health, STI, HIV and AIDS Surveillance Unit, 2009

[4] Kelly, A., Kupul, M., Man, W. Y. N., Nosi, S., Lote, N., Rawstorne, P., et al. (2011). Askim na save (Ask and understand): People who sell and/or exchange sex in Port Moresby. Key Quantitative Findings. Sydney, Australia: Papua New Guinea Institute of Medical Research and the University of New South Wales

[5] UNAIDS, Report on the Global AIDS Epidemic, 2010 citing The 2007 estimation report on the HIV epidemic in Papua-New Guinea, Port Moresby, National AIDS Council and National Department of Health, 2008
[6] Millan J et al (2006). HIV/AIDS Behavioural Surveillance Survey within High Risk Settings, Papua New Guinea;BSS Round 1. NACS and NHASP as cited by Coghlan, B, Gouillou M et al.(2009). HIV in the Pacific: summary of surveillance data, 1984-2007. Burnet Institute;Millan J, Yeka W, Obiero W, and Pantumari J. (2007). Report of the HIV/AIDS behavioural surveillance survey within high-risk settings, 2006. National AIDS Council Secretariat and National HIV/AIDS Support Project. Port Moresby, PNG. September 2007

[7] Maibani-Mitchie G, Kavanamur D, Jikian M, Siba P. (2007). Evaluation of the Poro Sapot Project : Baseline and Post Intervention Studies. An HIV Prevention program among FSWs in Port Moresby and Goroka and among MSM in Port Moresby, Papua New Guinea. PNG IMR; FHI Research Report to USAID, 2007

[8] Coghlan B et al.(2009). HIV in the Pacific: 1984–2007. Melbourne, Australia, Burnet Institute

[9] Commission on AIDS in the Pacific. (2009). Turning The Tide: an open strategy for a response to AIDS in the Pacific
[10] Cullen T, & E., C. (2006). HIV/AIDS in Papua New Guinea: A reality check. Pacific Journalism Review, 12(1), 153.