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A new Human Rights Watch report reveals how US aid cuts are dismantling HIV prevention and support services in Indonesia, leaving transgender people and gay and bisexual men facing increasingly dangerous barriers to healthcare. And when the people helping vulnerable communities disappear, the consequences can be devastating.
Imagine living with HIV in a country where seeking medical help could expose you to discrimination, public humiliation or even police scrutiny. Now imagine that the person who accompanied you to appointments, explained your treatment and helped you navigate that system has suddenly lost their job.
For many LGBTQ+ people in Indonesia, this is no longer a hypothetical scenario.
A new Human Rights Watch report published on 11 November 2026 documents how reductions in American foreign aid have severely disrupted community-led HIV prevention and care services, particularly those supporting transgender women and men who have sex with men.
The report, titled We Want to Be Treated as Human, draws on 35 interviews with healthcare workers, activists, people living with HIV and community organisations. Its findings expose a crisis in which disappearing international funding has collided with growing discrimination and restrictive government policies.
And the people paying the price are those who were already struggling to access healthcare.
How Are US Aid Cuts Affecting HIV Services in Indonesia?
For years, American foreign assistance helped finance community organisations providing HIV testing, prevention, education and support across Indonesia.
These organisations often work with people who are reluctant to approach conventional healthcare facilities because of prejudice or fears surrounding their sexual orientation or gender identity.
Their staff do far more than distribute condoms or provide information about HIV.
Community outreach workers help people access antiretroviral treatment, accompany patients to appointments, explain medical procedures and advocate for them when healthcare providers behave in discriminatory ways. In some cases, they also assist people who lack the identification documents required to register for health insurance.
According to Human Rights Watch, US funding commitments for HIV programmes in Indonesia fell from approximately $11.9 million in the 2024 financial year to $7.9 million in 2025.
The reductions have been particularly damaging for community-led initiatives.
One grassroots organisation, Yayasan Srikandi Sejati, previously employed 23 transgender outreach workers living with HIV. Following the funding cuts, it relied on emergency support to retain 11 workers, but that funding subsequently expired. By June 2026, the remaining workers were volunteering without regular financial support.
Another organisation, Jaringan Indonesia Positif, saw its workforce fall from around 150 people to approximately 30.
These are not simply administrative changes or reductions in programme budgets.
They represent the disappearance of trusted relationships between vulnerable communities and healthcare systems that many people already find difficult to navigate.
Why Are Transgender People and Gay Men Particularly Vulnerable?
Indonesia’s HIV epidemic is concentrated disproportionately among certain populations.
According to the figures cited by Human Rights Watch, estimated HIV prevalence is approximately 25% among transgender women and 22% among men who have sex with men, compared with around 0.4% among the general population.
These statistics describe specific populations within Indonesia. They do not mean that one in four LGBTQ+ Indonesians lives with HIV.
The reasons behind the disparity are complex, but discrimination, limited access to prevention and barriers to medical treatment play an important role.
People who fear being identified as LGBTQ+ may avoid HIV testing. Others may be reluctant to collect medication from clinics where staff could disclose their identity or treat them disrespectfully.
For transgender patients, identification documents that do not match their gender identity can create additional problems. Being publicly addressed by an unwanted former name, questioned about their identity or denied respectful treatment can turn a routine medical appointment into an intimidating experience.
As The Gayly Mirror previously reported on the growing hostility facing LGBTQ+ Indonesians, discrimination and fear have already pushed some queer people further into secrecy.
When access to healthcare depends on feeling safe enough to approach a clinic, that climate can have serious consequences for public health.
HIV Treatment Saves Lives. Losing Access Puts Them at Risk
Modern HIV treatment has transformed the lives of people living with the virus.
With consistent access to antiretroviral medication, HIV can be managed as a long-term health condition, allowing people to live healthy lives.
Effective treatment can also reduce the amount of HIV in the bloodstream to an undetectable level.
As the US Centers for Disease Control and Prevention explains, people living with HIV who maintain an undetectable viral load have zero risk of transmitting the virus to sexual partners.
This principle is known as U=U: Undetectable = Untransmittable.
It is one of the most important advances in HIV prevention, yet its effectiveness depends on reliable access to medication, monitoring and ongoing care.
Human Rights Watch reports that some former outreach workers have been told that patients are no longer obtaining their medication following the disruption of support services. Others have paid for patients’ transport out of their own pockets to help them continue treatment.
The report does not establish that every affected patient has stopped receiving care, nor does it provide a comprehensive national count of treatment interruptions.
But the documented loss of services represents a serious warning.
When people are left without support, missed appointments and treatment interruptions can undermine both individual health and wider HIV prevention efforts.
Indonesia’s Anti-LGBTQ+ Climate Makes the Crisis Worse
The funding cuts have arrived at a particularly troubling moment for LGBTQ+ rights in Indonesia.
On 1 January 2026, the country’s revised criminal code came into force, introducing provisions criminalising consensual sexual activity outside marriage under specified complaint-based circumstances.
Because Indonesia does not recognise same-sex marriage, Human Rights Watch argues that the legislation effectively exposes same-sex relationships to criminal penalties.
The law does not mean that every same-sex encounter automatically results in prosecution. Its complaint requirements and legal scope matter. Nevertheless, the new restrictions add to an environment in which LGBTQ+ people already face significant pressure.
Human Rights Watch has documented police raids, discriminatory rhetoric and the use of condoms as potential evidence of alleged wrongdoing.
That creates an extraordinary contradiction.
Public-health organisations encourage people to use protection, seek testing and take preventative medication. Yet some of the very behaviours associated with responsible sexual healthcare can expose LGBTQ+ people to suspicion.
Similar concerns have emerged in other countries. As TGM reported during Senegal’s recent anti-LGBTQ+ crackdown, allegations of forced HIV testing and breaches of confidentiality can discourage people from seeking essential healthcare.
Different countries have different laws, but the underlying public-health problem is clear: when people fear punishment or discrimination, accessing healthcare becomes more difficult.
Who Is Responsible for Protecting LGBTQ+ Indonesians?
The Human Rights Watch report places responsibility on both international donors and Indonesian authorities.
The organisation calls for renewed funding for community-led HIV prevention and care, particularly programmes supporting populations that face the greatest barriers to treatment.
It also urges Indonesia to repeal discriminatory legal provisions, end abusive police practices and invest more domestic resources in services designed to reach transgender people and men who have sex with men.
The recommendations are especially important because Indonesia’s own spending has historically neglected these communities.
Human Rights Watch reports that, of approximately $80 million in domestic HIV spending in 2020, just 0.1% went towards programmes for men who have sex with men, while no domestic funding was allocated specifically to transgender-focused programmes.
International assistance had helped fill that gap.
Removing it without effective alternatives risks leaving the people most in need of support with fewer ways to access care.
When HIV Funding Disappears, Human Lives Are at Stake
One of the most striking aspects of this report is the determination of outreach workers who continue helping their communities despite losing their income.
Some have spent years building trust with people who might otherwise remain isolated from essential healthcare.
Their work is not simply a service that can be replaced by directing patients to the nearest hospital.
It is an essential connection between people facing discrimination and a healthcare system that should be accessible to everyone.
The report also challenges the idea that HIV is exclusively a medical issue. Public health depends on dignity, privacy, safety and the ability to seek assistance without fear.
When those conditions are absent, even effective treatments cannot reach everyone who needs them.
Indonesia’s HIV crisis is not inevitable. Its worsening consequences are linked to political decisions about funding, criminal law and whose healthcare is considered worth protecting.
HIV treatment works. Community care works. What fails people is a system that removes their support while making them afraid to ask for help.
