Social, cultural and political factors in the design of HIV programmes with Papuan highland communities

The Indonesian province of Papua faces a growing HIV epidemic, particularly amongst remote highland Papuans, such as the Western Dani. The specific, challenging political and sociocultural context of Papuan highland communities greatly influences the transmission of HIV. Different initiatives have struggled to meet the sexual and reproductive health needs of Papuan communities and of minority ethnic communities and the challenges they pose. The prolonged cultural tensions between Papuan and Indonesian communities are a major barrier to effective dialogue between the Indonesian state and its minority ethnic communities, the absence of which only exacerbates the epidemic. Tackling HIV in Papua requires responses that are both culturally and politically sensitive, in direct challenge to existing development paradigms.