Regulation Of The Minister Of Health The Number 21 By 2013

Original Language Title: Peraturan Menteri Kesehatan Nomor 21 Tahun 2013

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BN 654-2013 fnHeader (); The text is not in the original format.
Back NEWS REPUBLIC of INDONESIA No. 654, 2013 the MINISTRY OF HEALTH. HIV. AIDS. Countermeasures. Repeal.

REGULATION of the MINISTER of HEALTH of the REPUBLIC of INDONESIA NUMBER 21 2013 ABOUT TACKLING HIV and AIDS with the GRACE of GOD ALMIGHTY the MINISTER of HEALTH of the REPUBLIC of INDONESIA, Considering: a. that with the increase in the incidence of HIV and AIDS which vary ranging from epidemics, epidemics are concentrated and widespread epidemic, efforts need to be made to combat HIV and AIDS integrated, comprehensive and quality;
b. that the decision of the Minister of health the number 1285/Menkes/SK/X/2002 on Guidelines for tackling HIV/AIDS and sexually transmitted diseases were no longer appropriate with the development and needs of health service, as well as the needs of the law;
c. that based on considerations as referred to in letter a and letter b needs to set a regulation of the Minister of health about HIV and AIDS Prevention;
Remember: 1. Act No. 29 of 2004 concerning the practice of Medicine (State Gazette of the Republic of Indonesia Number 116 of 2004, an additional Sheet of the Republic of Indonesia Number 4431);
2. Law Number 32 of 2004 concerning Regional Government (State Gazette of the Republic of Indonesia Number 125 of 2004, an additional Sheet of the Republic of Indonesia Number 4437) as amended several times with the Act No. 12 of 2008 (State Gazette of the Republic of Indonesia Number 59 in 2008, an additional Sheet of the Republic of Indonesia Number 4844);
3. Act No. 35 of 2009 about Illegals (Gazette of the Republic of Indonesia Number 143 in 2009, an additional Sheet of the Republic of Indonesia Number 5062);
4. Act No. 36 of 2009 about health (State Gazette of the Republic of Indonesia Number 144 in 2009, an additional Sheet of the Republic of Indonesia Number 5063);
5. Act No. 44 of 2009 about hospitals (State Gazette of the Republic of Indonesia Number 153 in 2009, an additional Sheet of the Republic of Indonesia Number 5072);
6. Government Regulation Number 32 in 1996 about the health workforce (Gazette of the Republic of Indonesia Number 49 in 1996, an additional Sheet of the Republic of Indonesia Number 3637);
7. Government Regulation Number 38 in 2007 about Government Affairs Divisions between the Government, local governance and local governance of the province, Kabupaten/Kota (State Gazette of the Republic of Indonesia Number 82 in 2007, an additional Sheet of the Republic of Indonesia Number 4737);
8. Government Regulation number 7 in 2011 about Blood Services (State Gazette of the Republic of Indonesia number 18 in 2011, an additional Sheet of the Republic of Indonesia Number 5197);
9. Government Regulation number 25 in 2011 on the implementation Report Narcotics Addicts (Gazette of the Republic of Indonesia Number 46 in 2011, an additional Sheet of the Republic of Indonesia Number 5211);
10. Government Regulation Number 33 in 2012 about giving Exclusive breast milk (State Gazette of the Republic of Indonesia Number 58 in 2012, an additional Sheet of the Republic of Indonesia Number 5291);
11. The decision of the Minister of health the number 1116/Menkes/SK/VIII/2003 concerning guidelines for Conducting Epidemiologic surveillance system health.
12. The decision of the Minister of health Number 1479/Menkes/SK/X/2003 concerning guidelines for Conducting epidemiologic surveillance system for infectious diseases and Infectious Diseases are not Integrated;
13. the Coordinating Minister of people's Welfare Regulations number 02/Per/Coordinating/Kesra/I/2007 on national policy Penganggulangan HIV and AIDS through harm reduction of the use of narcotic drugs, psychotropic drugs and addictive substances;
14. Regulation of the Minister of health the number 271/Menkes/Per/III/2008 about the medical record;
15. The decision of the Minister of health the number 350/Menkes/SK/IV/2008 about the designation of hospitals and Satellite Pengampu Rumatan Methadone Therapy Programmes and Guidelines Rumatan Methadone Therapy Program;
16. The decision of the Minister of health the number 378/Menkes/SK/IV/2008 about the guidelines of medical rehabilitation Services in hospitals;
17. Regulation of the Minister of health the number 1144/Menkes/Per/VIII/2010 about the Organization and the work of the Ministry of health (news of the Republic of Indonesia year 2010 Number 585);
18. Regulation of the Minister of health the number 001 in 2012 about Individual health services Referral System (news of the Republic of Indonesia Number 125 in 2012);
Decide: define: REGULATION of the MINISTER of HEALTH ABOUT HIV and AIDS PREVENTION.

CHAPTER I GENERAL PROVISIONS article 1 In this regulation of the Minister, is: 1. Countermeasure is any effort that includes the service of promotif, preventive, diagnostic, curative and rehabilitative programmes aimed at lowering the number of pain, death rate, limiting the transmission and spread of the disease in order that the outbreak did not spread to other areas as well as reduce the negative impact thereof.
2. Human Immunodeficiency Virus which further abbreviated HIV is the Virus which causes Acquired Immuno Deficiency Syndrome (AIDS).
3. the Acquired Immuno Deficiency Syndrome which further AIDS is a collection of symptoms of a decreased ability of self defense that is caused by the entry of the HIV virus in a person's body. 4. People With HIV and AIDS hereinafter abbreviated to PEOPLE LIVING with HIV are people who have been infected with the HIV virus.
5. Sexually Transmitted Infections which further shortened the STI is an infection that is transmitted through vaginal sexual intercourse, anal/oral/anal and passing with the mouth.
6. HIV testing on the initiative Health Care Givers and counselling which further shortened TIPK is HIV testing and counselling is done to a person for the benefit of health and treatment based on an initiative from the Ministry of health.
7. Voluntary HIV testing and Counselling which further shortened KTS is a process of voluntary counseling and HIV testing on the initiative of the individual concerned.
8. Counseling is the communication of information to help clients/patients to be able to take the right decision for himself and his chosen decision act accordingly.
9. Epidemiologic surveillance is monitoring and systematic analysis of continuously to disease or health problems and conditions that influenced them to perform acts effective and efficient countermeasure.
10. The Central Government, which is hereinafter referred to as the Government is the President of Republic of Indonesia that holds the Government of the Republic of Indonesia as stipulated in the Constitution of the Republic of Indonesia in 1945.
11. Local Government is the Governor, Governor, Mayor and other areas as the organizer of local governance. 12. the Minister is the Minister of the organizing Affairs of the Government in the field of health.

Article 2 scope settings in the regulation of the Minister include tackling HIV and AIDS in a comprehensive manner and the sustainability of health promotion, prevention, diagnosis, treatment and rehabilitation towards individuals, families, and communities.

Article 3 Setting for tackling HIV and AIDS aims to: a. decrease to negate the new HIV infection;

b. lose to negate death caused by circumstances related to AIDS;

c. abolish discrimination against PEOPLE LIVING with HIV;

d. enhance the quality of life of PEOPLE LIVING with HIV; and e. reduce the socio-economic impact of HIV and AIDS on individuals, families and communities.

CHAPTER II PRINCIPLES and STRATEGIES Chapter 4 In Tackling HIV and AIDS should apply the following principles: a. notice the values of religion, culture and societal norms;

b. respect for the dignity and human dignity as well as pay attention to justice and gender equality;

c. activities directed to maintain and strengthen the resilience and family welfare;

d. activities integrated with program development at the national level, provinces and kabupaten/kota;
e. activities done in a systematic way and integrated, ranging from improved behavior of healthy living, disease prevention, treatment, care and support for those infected with HIV (PLWHA) as well as those affected HIV and AIDS; f. activities undertaken by community and Government based on partnership;

g. involves an active role of key populations and PEOPLE LIVING with HIV as well as those that affected HIV and AIDS; and h. providing support to PEOPLE LIVING with HIV and people who are in school of HIV and AIDS in order to maintain a viable socio-economic life and productive.
Article 5 of the strategy used in the conduct of activities Tackling HIV and AIDS include: a. increasing the empowerment of communities in the response to HIV and AIDS through the cooperation of national, regional, and global in its legal aspects, organization, financing, health service facilities and human resources; b. prioritizing national and international commitments;

c. increasing advocacy, dissemination, and developing capacity;
d. enhancing efforts to combat HIV and AIDS that are equitable, affordable, good quality, and fairness as well as evidence-based, with emphasis on preventive and attempts at promotif;
e. increase the range of services at community groups at high risk, the region lags behind, isolated, borders and Islands as well as the problematic health; f. increase the financing countermeasures of HIV and AIDS;
g. increase the development and empowerment of human resources equitable and quality in tackling HIV and AIDS;
h. increase the availability and affordability of treatment, examination of supporting HIV and AIDS as well as ensure the security, quality, and the expediency of drug preparations and materials/tools are needed in tackling HIV and AIDS; and i.   improve the management countermeasures of HIV and AIDS that are accountable, transparent, berdayaguna and berhasilguna.

CHAPTER III DUTIES And RESPONSIBILITIES


Article 6 duties and responsibilities of the Government in tackling HIV and AIDS include: a. create a policy and guidelines in the service promotif, preventive, diagnostic, treatment/care, support, and rehabilitation;
b. cooperation with regional Governments in implementing policies and monitor and evaluate the implementation of the policy; c. ensure the availability of drugs and health equipment needed in tackling HIV and AIDS nationwide;

d. developing information systems; and e.  global and regional cooperation in the framework of prevention and mitigation of HIV and AIDS.

Article 7 duties and responsibilities of the regional Government of the province in tackling HIV and AIDS include: a. perform the objective of coordinating the various efforts of the control and prevention of HIV and AIDS;

b. set the HIV epidemic situation at the provincial level;

c. organized a recording system, reporting and evaluation by utilizing information systems; and d. ensure availability of primary level health care facilities and the reference in conducting Combat HIV and AIDS in accordance with proficiency.
Article 8 duties and responsibilities of local government district/town in tackling HIV and AIDS include: a. perform the objective of various control and efforts to combat HIV and AIDS;

b. organizing HIV epidemic situation assignment district/city level;
c. ensure the availability of primary level health care facilities and the reference in conducting combat HIV and AIDS in accordance with ability; and d.  organizes the recording system, reporting and evaluation by making use of information systems.

CHAPTER IV PREVENTION ACTIVITIES is considered Part of the General article 9 (1) HIV and AIDS Prevention Activities consisting of: a. health promotion;

b. Prevention of HIV transmission;

c. examination of HIV diagnosis;

d. treatment, care and support; and e. rehabilitation. (2) the activities referred to in subsection (1) is held by the Government and the community.
(3) the activities referred to in subsection (1) is conducted in the form of comprehensive and continuous service.
(4) comprehensive and continuous Service as referred to in paragraph (3) is an effort that includes all forms of HIV and AIDS services conducted in plenary start from home, the public got to health care facilities.
(5) the provisions of the guidelines more comprehensive and continuous services regulated by regulation of the Minister.
The second part of article 10 health promotion (1) health promotion aimed at increasing knowledge and comprehensive regarding the prevention of HIV transmission and eliminating stigma and discrimination.
(2) health promotion as mentioned in subsection (1) is given in the form of advocacy, community atmosphere, empowerment, partnership and participation of the community in accordance with the socio-cultural conditions and supported public policy.
(3) health promotion as mentioned in subsection (1) is carried out by health workers and non-trained health personnel. (4) Target health promotion include policy makers, private sector, civic and community organizations.

(5) the community as referred to in paragraph (4) take precedence on the target population and the population of the keys.

(6) the target Population as mentioned in subsection (5) is the target populations programme.
(7) a key Population referred to in paragraph (5) includes the following: a. users of injection drugs;

b. Women sex workers (WPS) directly or indirectly;

c. customer/WPS sex partners;

d. gay, transvestites, and customer/partner sex with fellow Men (LSL); and e. citizens assisted lapas/rutan.
Article 11 (1) health promotion can be done with integrated health services as well as other health promotion programs.
(2) health promotion as mentioned in subsection (1) include the following: a. public service advertisements;

b. condom use campaign on any sex at risk of transmission of the disease;

c. promotion of health for teens and young adults;
d. an increase in capacity in the promotion of prevention of abuse of drugs and HIV transmission to health workers, the health of the non-trained personnel; and e.  other health promotion programs.
(3) the integrated health promotion on health service referred to in subsection (1) shall take precedence in the service of: a. health care for adolescents;

b. reproductive health and family planning;

c. antenatal care checkups;

d. sexually transmitted infections;

e. rehabilitation of drugs; and f.  tuberculosis.
(4) the provisions of the technical guidelines on health promotion for tackling HIV and AIDS are regulated by ministerial regulation.
The third part of HIV Prevention Public article 12 Paragraph 1 (1) the prevention of HIV transmission can be achieved effectively by means of applying the pattern of life is safe and not at risk.
(2) Prevention as referred to in subsection (1) include efforts: a. Prevention of HIV transmission through sexual intercourse;

b. Prevention of HIV transmission via non sexual relations; and c. Prevention of HIV transmission from mother to her son;
Paragraph 2 the prevention of HIV transmission Through sexual intercourse Article 13 (1) of the prevention of HIV transmission through sexual intercourse is a variety of efforts to prevent someone infected with HIV and/or other IMS disease transmitted through sexual intercourse.
(2) the prevention of HIV transmission through sexual intercourse was carried out mainly at the place of occurrence of a potentially risky sexual relationships.
(3) the prevention of HIV transmission through sexual intercourse is performed with the four (4) integrated activities include: a. an increase in the role of stakeholders;

b. interventions behavior change;

c. health prevention supplies supply management; and d. management of IMS.
(4) enhancement of the role of stakeholders as referred to in paragraph (2) letter a is aimed at creating a social order in which the key population environment conducive.
(5) change in behavior Intervention as referred to in paragraph (3) the letter b is intended to provide an understanding and change the behavior of the Group collectively and the behavior of each individual in the group so that the vulnerability to HIV is reduced.
(6) preventive health supplies Supply Management as referred to in paragraph (2) Letter c is intended to assure the availability of supplies of health prevention quality and affordable.
(7) Management of IMS as referred to in paragraph (3) the letter d is intended to cure the STI on the individual with a disconnected chain of transmission service through the provision of STI diagnosis and treatment as well as counselling behavior change. (8) the provisions of the guidelines further IMS management is controlled by a regulation of the Minister.

Article 14 (1) of the prevention of HIV transmission through sexual intercourse is done through efforts to: a. no sexual intercourse (Abstinensia);

b. the faithful with a partner (Be Faithful);

c. consistently use condoms (Condom use);

d. avoid substance abuse/addictive substances (no Drug);

e. improve prevention through education including IMS treat as early as possible (Education); and f.  do other prevention, among other things through the sirkumsisi (2) not doing sexual intercourse as referred to in paragraph (1) letter a is intended for people who are not yet married.
(3) the Faithful with a partner referred to in subsection (1) letter b only sexual intercourse with a partner, which was not known to be infected with HIV.
(4) use condoms consistently as intended in paragraph (1) the letter c means always using a condom when forced sexual intercourse on a diversion against the provisions of paragraph (1) letter a and letter b and sex with couples who have been infected with HIV and/or IMS.
Paragraph 3 of the prevention of HIV transmission Via Non Sexual Relationship Article 15 (1) of the prevention of HIV transmission via non sexual relationship aimed at preventing HIV transmission through blood.
(2) the prevention of HIV transmission via non sexual relationships as referred to in subsection (1) include the following: a. test strain blood donors;

b. Prevention of HIV infection in medical and non medical actions which injure the body; and c. harm reduction injection drugs users.
(3) the test strain blood donors referred to in paragraph (2) letter a is performed in accordance with the legislation.
(4) Prevention of HIV infection in medical and non medical actions which injure the body referred to in paragraph (2) letter b is performed with the use of sterile equipment and adhere to standard operating procedures as well as paying attention to public alertness (universal precaution).
(5) harm reduction injection drugs users as referred to in paragraph (2) Letter c covers: a. sterile syringe services programs with counseling and psychosocial support behavior change;

b. encourage injection drugs users in particular opiates addicts undergoing therapy rumatan;

c. encourage users of injection drugs to do prevention of sexual transmission; and d. service counseling and HIV testing and prevention/immunization hepatitis.
(6) the provisions on the implementation of harm reduction in the use of injection drugs is regulated by regulation of the Minister.
Paragraph 4 of the prevention of HIV transmission from mother to Son Article 4 Prevention of HIV transmission from mother to son implemented through four (4) activities include: a. Prevention of HIV transmission in women of reproductive age;

b. Prevention of unplanned pregnancy in women with HIV;

c. Prevention of HIV transmission from pregnant women with HIV to the baby that they contain; and d. the granting psychological, social and support care to mothers living with HIV and their children and their families.

Article 17 (1) against pregnant women who saw a pregnancy to do health promotion and the prevention of HIV transmission.

(2) the prevention of HIV transmission against pregnant women referred to in subsection (1) is done through examination of HIV tests with diagnostis and counseling.
(3) tests and Counselling referred to in subsection (2) is recommended as part of routine laboratory examination time checks antenatal care or labor on: a. all pregnant women who live in areas with widespread epidemics and concentrated; or b. pregnant women with complaints complaints of IMS and the tuberculosis epidemic in the region is low.
Article 18 (1) of pregnant women with HIV and AIDS and their families should be given counselling regarding: a. administering ARVS to the mother;

b. the choice of ways of giving birth;
c. selection of exclusive breast feeding to infants up to the age of 6 months or the giving of milk formula is acceptable, feasible, affordable, sustainable, and safe (acceptable, feasible, affordable, sustainable, and safe). d. grant of infant formula and foods in addition to the baby after the age of 6 months;

e. administering prophylactic ARV and kotrimoksasol on children; and f.   examination of HIV in children.
(2) Counselling referred to in subsection (1) as part of the standard of care for pregnant women diagnosed with HIV (3) Counseling breast feeding and supplementary feeding to baby after the age of six months referred to in subsection (1) the letter c and the letter d is accompanied by a grant of immunization information, as well as the care of newborn babies, infants and toddlers.
Article 19 Any babies born from mothers with HIV HIV Virology test should be performed (DNA/RNA) began at the age of 6 (six) up to 8 (eight) weeks or HIV serology tests at the age of 18 (eighteen) months upwards.

Article 20 the provisions of the guidelines further prevention of HIV transmission from mother to son set up with regulation of the Minister.

The fourth part of the HIV Diagnosis Examination of article 21 (1) examination of HIV diagnosis was carried out to prevent the occurrence of transmission as early as possible or an increase in the incidence of HIV infection.
(2) the HIV diagnosis Examination referred to in subsection (1) is carried out based on the principle of konfidensialitas, consent, counselling, record-keeping, reporting and referral.
(3) the principle of confidential as referred to in subsection (2) means the inspection results must be kept confidential and can only be opened to: a. is concerned;

b. health workers who handle;

c. in the event the closest families concerned are not accomplished;

d. sexual partners; and e. any other party in accordance with the legislation.
Section 22 (1) examination of HIV diagnosis is done via KTS or TIPK.

(2) the HIV diagnosis Examination referred to in subsection (1) must be made with the consent of the patient.
(3) excluded from the provisions referred to in subsection (2), in: a. a specific assignment in a limited army/police;
b. a State of medical emergency for purposes of treatment in patients who had been clinically showed symptoms that lead to AIDS; and c.  request the appropriate authorities in accordance with the legislation.
Article 23 (1) KTS done with steps include: a. the pre test counseling;

b. HIV testing; and c. the post-test counselling. (2) the KTS is only done in case a patient gives consent in writing.
(3) the pre test Counseling as referred to in paragraph (1) letter a is done with face-to-face or face-to-face and not be implemented together with the couple (couple counseling) or in groups (group counseling).
(4) post test Counselling as referred to in paragraph (2) Letter c to do face-to-face with trained counselors or health workers.
Article 24 (1) TIPK done with steps include: a. the giving of information about HIV and AIDS before the test;

b. taking blood for tests;

c. submission of test results; and d. counseling. (2) HIV testing on TIPK not done in terms of patients declined in writing.
(3) should be recommended TIPK as part of standard services for: a. any adults, teens and children who come to the health care facility with a sign, symptom, or medical condition or should indicate the alleged to have occurred from HIV infection especially patients with tuberculosis and STI disease history; b. antenatal care of pregnant mothers and mothers in childbirth;

c. baby born of mothers with HIV infection;
d. children with suboptimal growth or malnutrition epidemic in the region, or children with malnutrition which do not indicate a good response with the treatment of the adekuat nutrients; and e.  adult male who asked sirkumsisi as HIV prevention actions.
(4) on the epidemic extends, TIPK should be recommended to all those who visited health care facilities as part of the standard service.
(5) the service as standard TIPK epidemic extends as referred to in subsection (4) are primarily held in the healthcare facilities: a. organized outpatient medical services and hospitalization;

b. conducts the examination expectant mothers health services, labor and childbirth;

c. providing health services with high risk populations;

d. provide health services of children under 10 years of age;

e. organizing surgical services;

f. provide adolescent health services; and g. provide reproductive health services, including family planning.
(6) health care Facility which hosts TIPK referred to in subsection (5) must have the ability to provide a service package of prevention, treatment and care of HIV and AIDS.
(7) on the epidemic of low epidemic, concentrated and TIPK performed on all adults, teens and children who exhibit signs and symptoms that indicates HIV infections, including tuberculosis, as well as children with a history of exposure to HIV during perinatal, on rape and other sexual violence.
(8) TIPK as mentioned on paragraph (7) is primarily organized on: a. the IMS service;

b. health services for the population of well-behaved key/high risk;

c. facilities services hosted the Ministry examination of pregnant women, labor and childbirth; and d. the Ministry of tuberculosis.
Article 25 (1) HIV testing for diagnosis is conducted by medical personnel and/or laboratory technicians are trained.
(2) in the event that there is no medical personnel and/or lab technician as referred to in paragraph (1), a trained midwife or nurse can perform HIV testing.
(3) HIV testing as referred to in subsection (1) is conducted by the method of rapid diagnostic test (RDT) or EIA (Enzyme Immuno Assay).
Article 26 (1) mandatory Counselling is given to every person who has been doing HIV testing.
(2) Counselling referred to in subsection (1) consists of private counseling, counseling, counseling obedience, behavior change counseling, prevention of transmission include HIV infection or cross-infection, recurring or repair counseling health conditions, reproductive health and family planning. (3) the Counselling referred to in subsection (1) is conducted by a trained counselor.
(4) a trained Counsellor as mentioned in subsection (3) can be a health worker or a non-powered health.
Article 27 the provisions more about tests and Counseling of HIV and AIDS are regulated by ministerial regulation.

Article 28 (1) HIV testing on blood donors, blood products and organs is done to prevent the transmission of HIV through the transfusion of blood and blood products as well as transplant organs.
(2) precautions for blood donors, blood products and organs of the body against HIV transmission referred to in subsection (1) is performed with the test strain blood/organ donors.
Article 29 (1) blood precautions against HIV transmission through blood transfusions as stipulated in article 28 paragraph (2) includes the following: a. test strain blood donors; and b. the post-test counselling strain of blood.
(2) prior to the taking of blood donors, provided information on the results of the test checks blood filter and filter test approval request (informed consent).
(3) the approval of the test strain (informed consent) as referred to in paragraph (2) contains a statement of approval approval for blood and destruction are referred to health care facilities in a reactive test result blood filter.
(4) the Test strain blood donors referred to in subsection (1) letter a is done in accordance with the standard set by the Minister.
(5) in the event of a blood filter test results referred to in paragraph (1) letter a reactive, then blood transfusion Units should do a re-examination.
(6) in case the results of the re-examination referred to in subsection (5) remain reactive, blood transfusion Unit must provide the notice is accompanied by the suggestion to do a post test counselling strain of blood.
(7) post test Counselling filter blood as intended in paragraph (1) letter b contains recommendations to the concerned donors not to donate their blood, donors and referring back to the health service facilities to get HIV Tests and counselling services.
The fifth part of the treatment and care of Common Article 1 Paragraph 30 (1) every health care facilities are prohibited from refusing treatment and care of PEOPLE LIVING with HIV.
(2) in terms of healthcare facilities referred to subsection (1) is not able to provide the treatment and care of PEOPLE LIVING with HIV to refer, mandatory health care facility capable of or referral to hospital ARVS.
Article 31 (1) every person infected with HIV is obligated to get counseling HIV diagnosis, examination of post registered nationally and get treatment.
(2) the register referred to in subsection (1) include the recording that contains a code number, the number of health care facilities of the sort found in healthcare facilities and stadium when first clinical diagnosis is enforced.

(3) the register referred to in subsection (1) and paragraph (2) should be kept kerahasiannya in accordance with the legislation.
Paragraph 2 of article 32 Treatment (1) HIV Treatment aims to reduce the risk of transmission of HIV, opportunistic infections and worsening hinders improving quality of life of people with HIV.
(2) HIV Treatment as referred to in subsection (1) must be made in conjunction with the screening and therapy of opportunistic infections, condoms and counseling.
(3) the AIDS treatment aims to lower the amount of virus to undetectable (viral load) of HIV in the blood by using a combination of drugs ARVS.
Article 33 (1) HIV and AIDS Treatment is carried out by means of: a. the therapeutic treatment;

b. prophylactic; and c. the supporting.
(2) therapeutic Treatment as referred to in paragraph (1) letter a covering ARV treatment, treatment of STI, and treatment of infectious oportunitis.
(3) prophylactic Treatment as referred to in paragraph (1) letter b include: a. administering ARVS post exposure; and b. kotrimoksasol for therapy and prophylaxis.
(4) supporting Treatment as referred to in paragraph (2) Letter c includes supportive treatment, adjuvants and improved nutrition.
Article 34 (1) ARV Treatment given after getting counseling, medication reminder (PMO) and the patient agree wayward against lifelong treatment.
(2) Treatment ARV as referred to in subsection (1) must be indicated for: a. HIV sufferers who have shown clinical stage 3 or 4 or CD4 T Lymphocyte cell count is less than or equal to 350 cells/mm3; b. pregnant women with HIV; and c.  HIV with tuberculosis. (3) treatment of ARVS was started in the hospital and can proceed in clinics or other health care facilities.

(4) the hospital referred to in subsection (3) is at least C grade hospital.

(5) the provisions on the treatment of ARVS is governed by regulation of the Minister.

Paragraph 3 the treatment of infants and pregnant women of article 35 (1) every pregnant women with HIV are entitled to service delivery in all healthcare facilities.
(2) the Ministry of labour referred to in subsection (1) pay attention to the standard precautions and procedures do not require a special self protective tools for health workforce helper labor.
Article 36 (1) every new baby born from the mother's HIV and AIDS should immediately get ARV prophylaxis and kotrimoksazol.
(2) in the case of HIV status is unknown, the granting of nutrition supporting treatment as for the newborn baby as referred to in paragraph (1) was carried out in accordance with the provisions of the legislation.
Paragraph 4 of the care and support of article 37 (1) Care and support for HIV and AIDS should be implemented with a choice of approaches according to your needs: a. health care facilities-based care; and b. community based home care (Community Home Based Care).
(2) Care and support for HIV and AIDS referred to in subsection (1) must be made in a holistic and comprehensive approach to biopsikososiospiritual that includes the following: a. tatalaksana symptoms;

b. acute care governance;

c. tatalaksana of chronic diseases;

d. health education;

e. Prevention of opportunistic infections and complications;

f. palliative care;
g. the psychological support of mental health, social support, economic and community empowerment to build the support groups; and h.  evaluation and reporting of results.
(3) health care facilities-based Care as referred to in paragraph (1) letter a is the treatment accorded to HIV infected people with opportunistic infections so it takes care in health care facilities in accordance with the reference system.
(4) community-based Home Care (Community Home Based Care) as referred to in paragraph (1) letter b is a form of treatment that is given to people infected with HIV without opportunistic infections, which choose care at home.
(5) Home Care as referred to in paragraph (4) aims to prevent infection, reduce complications, reduces the pain/discomfort, increasing self-acceptance and understanding the situation facing the diagnosis, prognosis and treatment, as well as enhance the self-reliance to achieve a quality of life.
The sixth Rehabilitation Article 38 (1) the rehabilitation on HIV and AIDS Prevention activities carried out against any of the patterns of HIV transmission in key populations especially sex workers and Injection Drugs Users. (2) Rehabilitation on HIV and AIDS Prevention activities carried out through medical rehabilitation and Social Rehabilitation (3) on HIV and AIDS Prevention activities aimed at restoring quality of life to be productive economically and socially (4) rehabilitation of key populations at sex worker referred to in subsection (1) is carried out by means of empowerment work skills and self-efficacy can be done by the social sector , either Government or the community.
(5) the rehabilitation of key populations at injection drugs users referred to in subsection (1) is carried out by means of outpatient, inpatient and outpatient program in accordance with the legislation.
Chapter V SURVEILLANCE Article 39 (1) HIV and AIDS Surveillance is performed for monitoring and decision making in the response to HIV and AIDS.
(2) HIV and AIDS Surveillance as outlined in subsection (1) include the following: a. HIV case reporting;

b. reporting cases of AIDS;

c. sero surveillance sentinel HIV and syphilis;

d. surveillance IMS;

e. surveillance service-based HIV counseling and HIV testing;

f. integrated biological and behavioural surveillance;

g. the quick survey behavior; and h. monitoring activities of ARV resistance.
(3) the reporting of HIV cases as referred to in paragraph (2) letter a aims to determine the level of the epidemic and prevent further transmission.
(4) the reporting of AIDS cases as referred to in paragraph (2) letter b aims for treatment and improvement of quality of life.
(5) the Sero surveillance sentinel HIV and syphilis as referred to in paragraph (2) Letter c aims to monitor the magnitude and trends of the problem. (6) the STI Surveillance referred to in paragraph (2) letter d aims to monitor the magnitude and trends of STI.
(7) the STI Surveillance referred to in paragraph (6) includes the following: a. reporting of the case in order to find the incident;

b. the determination and monitoring of prevalens;

c. determination of the etiology of the syndrome of IMS;

antibiotic resistance surveillance d.; and e. special studies.
(8) Surveillance Service-based HIV counseling and HIV testing as referred to in paragraph (2) letter e aims to find out the trend of HIV infection in at-risk groups who came to the service of counselling and testing for HIV.
(9) an integrated biological and behavioural Surveillance referred to in paragraph (2) letter f aims to monitor the magnitude of the impact and trends of HIV risk behavior and STI periodically.
(10) A quick survey of the behaviour as referred to in paragraph (2) Letter g aims to get an idea soon to start and/or evaluate a public health action.
(11) ARV resistance monitoring activities referred to in paragraph (2) letter h include the following: a. survey threshold aims to see the level of ARV drug resistance in people recently exposed to HIV;

b. monitoring survey aims to see resistance during treatment ARV; and c. early vigilance indicators aim to see the optimization function of ART programs in preventing resistance to ARVS. (12) Further provisions regarding HIV and AIDS Surveillance is governed by regulation of the Minister.

CHAPTER VI MITIGATION IMPACT of article 40 (1) Mitigating impact is an attempt to reduce the impact of the economic and social health.
(2) the Government, local authorities, the private sector and society as its own and/or jointly carry out socio-economic impact of mitigation PLWHA and relatives by means of: a. provide health coverage;

b. eliminate discrimination in providing services and in the life of society;

c. organized programs help to improve family income; and d. include PEOPLE LIVING with HIV and families in an effort to combat HIV and AIDS as a means for social and economic empowerment of PEOPLE LIVING with HIV.
(3) mitigation Activities as referred to in paragraph (1) letter a is performed in accordance with the legislation.
CHAPTER VII HEALTH RESOURCES health care Facility Considered Part of article 41 (1) every PEOPLE LIVING with HIV has the right to obtain access to medical services.
(2) any compulsory health care facilities providing health services on PEOPLE LIVING with HIV in accordance with capabilities.
(3) any compulsory primary health care facilities are able to do promotif, preventive efforts, counselling, early detection and refer cases requiring referral.
(4) every hospital at least class C mandatory is able to diagnose, do the treatment and care of PEOPLE LIVING with HIV in accordance with the terms of the reference system.
(5) the primary health care Facilities and hospitals class D can perform diagnosis, treatment and care of PEOPLE LIVING with HIV in accordance with ability and reference system.
Article 42 (1) every health care facility is obliged to carry out preventive measures to prevent the transmission of infections including HIV.
(2) preventive measures to prevent transmission of infection referred to in subsection (1) include the following: a. General precautions (universal precaution);

b. compliance to infection prevention programs in accordance with the standard;

c. use of the blood that is safe from HIV; and d. the communication, information and education to patients.

(3) in terms of health care facilities that do not carry out preventive measures to prevent transmission of infection referred to in paragraph (1) and paragraph (2), the Minister of provincial and local government, the local government district/city match its respective administrative action may charge such as: a. an oral reprimand;

b. a written reprimand; and/or c. revocation.
The second part of the human resources Article 43 (1) human resources in Tackling HIV and AIDS include health workers and non-powered health.
(2) health human resources as referred to in subsection (1) is a health workforce that has the competence and authority in accordance with the legislation.
(3) in the event on an area not available health workforce competencies and authorities, other health care personnel are trained to receive the assignment.
(4) the assignment referred to in subsection (3) is conducted by the head of the local health office after obtaining the consideration of related professional organizations.
(5) non-powered health referred to in paragraph (1) was instrumental in the areas of policy, welfare, health, education, social and culture that embraces all the HIV and AIDS problem holistically.
The third part of the availability of medicines and Health Supplies to article 44 (1) the Government and the local authorities ensure the availability of medicines and health supplies necessary for the response to HIV and AIDS.
(2) drugs and health supplies as referred to in subsection (1) include the following: a. a condom;

b. lubricant;

c. sterile syringes;

d. reagensia for STI and HIV testing;

e. drug ARV;

f. tuberculosis drug;

g. drug STI; and h. the drugs for opportunistic infections.
Article 45 (1) the Government, local authorities, provinces and kabupaten/kota Governments in ensuring the availability of medicines and health supplies as referred to in article 44 should draw up a plan of hierarchical needs.
(2) the procurement of medicines and health supplies to combat HIV and AIDS by Government, local governments, provincial and/or local government district/municipality to be undertaken, recorded and reported in accordance with the legislation.
The fourth part of article 46 Funding care and treatment for people infected with HIV who are poor and cannot afford to be borne by the State.

Article 47 (1) any compulsory health insurance providers bear some or all of the cost of the treatment and care of HIV-infected insured in accordance with the amount of premium. (2) the protection referred to in subsection (1) are listed in the mandatory information on the policy.

Article 48 the Government and the local government is obliged to provide the budget allocation for funding activities to combat HIV and AIDS.

CHAPTER VIII COOPERATION Article 49 (1) HIV and AIDS Prevention Efforts can be organized by each agency and/or through the cooperation of two or more parties in the form of specific activities to combat HIV and AIDS or integrated with other activities.
(2) non-governmental organization, perguruaan high, health professional organizations, community population is key, and the business world can be an active partner with the agencies/government agency in Tackling HIV and AIDS.
(3) International Development Partners (International Development Partners) can contribute to the response to HIV and AIDS in accordance with the legislation.
(4) cooperation and partnerships specifically Penganggulangan HIV and AIDS referred to in paragraph (1), subsection (2) and paragraph (3) is led and coordinated by the national AIDS Mitigation Commission, Commission on the Prevention of AIDS and AIDS Prevention Commission Provincial district/city.
CHAPTER IX COMMUNITY PARTICIPATION article 50 everyone should participate actively to preventing and tackling the HIV epidemic fits the ability and role of each.

Article 51 (1) the community can contribute in efforts to combat HIV and AIDS by means of: a. promoting healthy lifestyles;

b. increasing the resilience of families;
c. prevent stigma and diskrimasi against people infected with HIV and their families, as well as against the population of the community is the key; d. establish and develop Citizens care about AIDS; and e. encourage citizens of potentially doing risky of contracting HIV for checked herself into a facility service KTS.
(2) healthy living Behaviours referred to in subsection (1) letter a is done by avoiding sexual behavior and non risky sexual HIV transmission.
(3) the resilience of the family as referred to in paragraph (1) letter b is carried out by means of: a. the faithful spouse; and b. the mutual challenge, compassion and foster family towards healthy living, especially reproductive health and avoiding Drugs.
(4) Prevent stigma and discrimination of HIV infected persons as referred to in paragraph (2) Letter c is done with: a. understand correctly and completely about how HIV transmission and prevention;

b. empower people with HIV as other members of society; and c. invite all community members not to mendiskriminasi HIV-infected people both in terms of health care, education, jobs and all aspects of life.
Article 52 (1) Citizens care about AIDS as stipulated in article 51 paragraph (1) the letter d is the role container as well as the public to do Tackling HIV and AIDS.
(2) Citizens care about the AIDS referred to in subsection (1) may be formed in the sub-district, kelurahan/village, hamlet/village, pillars, and neighboring pillars. (3) the activities of Citizens care about the AIDS referred to in paragraph (1) can be integrated with the activities of the village/RW idle.

Article 53 (1) PEOPLE LIVING with HIV participate in the response to HIV and AIDS by: a. keeping personal health;

b. conduct of HIV prevention efforts to others;

c. tell your HIV status to sexual partners and health workers to medical interests;

d. comply with the advice of the treatment; and e. participate in HIV and AIDS Prevention efforts together with the Government and other community members;
(2) the role of PEOPLE LIVING with HIV as referred to in paragraph (1) letter b is done through: a. the obligation of using condoms correctly and consistently;

b. using the disposable sterile syringes;

c. participation actively in the prevention service of mother to child transmission to pregnant women who are infected with HIV; and d. not be donors of blood, blood products and/or other body tissues and organs.
CHAPTER X the RESEARCH and DEVELOPMENT of article 54 (1) to support efforts to combat HIV and AIDS that are evidence-based and improvements in its implementation, conducted research and operational research in the areas of: a. Epidemiology;

b. humanities health;

c. Prevention of disease;

d. management of care and treatment;

e. medicine and traditional medicine;

f. biomedicine;

g. impact of the social economy;

h. basic technology and applied technology; and i.  the other fields are set by the Minister.
(2) research and development referred to in subsection (1) is carried out by the Government, local authorities and communities.
(3) the implementation of research and development as referred to in paragraph (2) may be carried out in cooperation with the institutions and/or foreign investigators in accordance with the legislation.
CHAPTER XI of the RECORDING and REPORTING of article 55 (1) all activities to combat HIV and AIDS to do logging and reporting in accordance with the applicable guidelines.
(2) health care Facilities obligatory registration of care, follow-up care of patients with HIV and the granting of ARVS and document them in the medical record.
Article 56 (1) health care Facilities obligatory reporting of HIV cases, AIDS cases and its treatment to the district/city health Office.
(2) district/city health Office did a compilation of reporting as referred to in paragraph (1), and perform analysis to policy retrieval and follow-up and report them to the provincial health Office.
(3) the provincial health Office did a compilation of reporting as referred to in paragraph (2), and perform analysis to policy retrieval and follow-up and report to the Minister. (4) Reporting as referred to in paragraph (1), subsection (2) and paragraph (3) is conducted each month.

CHAPTER XII COACHING and SUPERVISION Article 57 (1) the Minister, the national AIDS Mitigation Commission, provincial and local government local government district/city do coaching and supervision activities to combat HIV and AIDS.
(2) the mechanism of coaching and supervision to combat HIV and AIDS activities is carried out by monitoring and evaluation.
(3) in order to carry out the construction and supervision, the Minister, the national AIDS Mitigation Commission, provincial and local government local government district/municipality may charge penalties in accordance with its respective.
CHAPTER XIII TRANSITIONAL PROVISIONS Article 58 Any health care facilities that do not yet have the capability of appropriate conditions as referred to in article 41, shall comply with the provisions of this regulation of the Minister at the latest within 1 (one) year since the ministerial regulation is applicable.

CHAPTER XIV CLOSING PROVISIONS Article 59 at the time of this Ministerial Regulation entered into force, the decision of the Minister of health the number 1285/Menkes/SK/X/2002 on Guidelines for tackling HIV/AIDS and sexually transmitted diseases was revoked and declared inapplicable.

Article 60 this Ministerial Regulation comes into force on the date of promulgation.

In order to make everyone aware of it, ordered the enactment of this Ministerial Regulation with its placement in the news of the Republic of Indonesia.

Established in Jakarta on March 21, 1995 the MINISTER of HEALTH of the REPUBLIC of INDONESIA, NAFSIAH MBOI Enacted in Jakarta on 30 April 2013, MINISTER of LAW and HUMAN RIGHTS REPUBLIC of INDONESIA, AMIR SYAMSUDDIN fnFooter ();