For expats living in or relocating to Indonesia, sexual health is a practical topic that deserves straightforward, honest attention. Indonesia is a wonderful place to live and work, but like any country in Southeast Asia it presents specific health risks that are easily managed with the right information and sensible precautions. This article sets out what you need to know.
Sexually transmitted diseases (STDs) are among the most common preventable infectious conditions affecting travellers and long-term expat residents worldwide. Their incidence remains stubbornly high despite decades of public health effort, underlined by the continuing spread of HIV, the virus responsible for AIDS, which remains a serious concern in parts of Southeast Asia including Indonesia.
Studies from around the world consistently show that knowledge of STDs has little effect on actual behaviour. Being better-informed has resulted in only a modest increase in condom use and caution, and there is abundant evidence that risky and sometimes fatal sexual behaviours are carried out by people who are, by any measure, well-informed. Living abroad, away from familiar social networks and with greater personal freedom, can increase that risk further.
Common STDs: What You Need to Know
Many diseases are spread by sexual contact. These include bacterial infections such as chlamydia, gonorrhoea and syphilis, as well as viral infections including genital warts (HPV), hepatitis and herpes. Parasitic infections such as pubic lice and intestinal parasites transmitted through sexual contact are also relevant in this region.
Syphilis remains common across Southeast Asia, and rates are significant enough to warrant awareness. Gonorrhoea is equally prevalent and is becoming increasingly difficult to treat due to growing antibiotic resistance, a trend that is particularly pronounced in Asia. Non-gonococcal urethritis in men is caused by chlamydia in a substantial proportion of cases, and the female equivalent frequently causes pelvic inflammatory disease if left untreated. Chlamydia is harder than gonorrhoea to diagnose and often goes undetected without specific testing.
Genital herpes accompanies other STDs in a significant proportion of cases. Genital warts caused by the human papillomavirus (HPV) are considerably more common than herpes. One serious long-term consequence of HPV infection is cervical cancer, which remains a major health issue across Southeast Asia. HPV vaccination is now available, highly effective, and strongly recommended for both women and men who have not previously been vaccinated. If you have not had the HPV vaccine, speak to your doctor about it before or shortly after arriving in Indonesia.
Chancroid, a painful genital ulcer disease, is endemic in parts of Southeast Asia and is a condition that expats in the region should be aware of, particularly given that most genital ulcers in this region are attributable to this infection or mixed infections.
Hepatitis B: A Significant Risk in Asia
Viral infections affecting the liver are among the STDs with the highest global incidence, and Southeast Asia carries a disproportionate share of this burden. Hepatitis B is the most important of these. According to current WHO data, approximately 254 million people worldwide are living with chronic hepatitis B infection, and Asia and the Pacific account for the majority of these cases. Sexual activity is one of the most common transmission routes.
Hepatitis B vaccination is the most important single preventive measure you can take in this area. A vaccine has been available for decades and is highly effective. In many countries, hepatitis B vaccination is now part of routine childhood immunisation, but if you were not vaccinated as a child or are unsure of your status, get vaccinated before or immediately upon arriving in Indonesia. A simple blood test can confirm whether you are already immune.
Hepatitis A and Hepatitis C
The hepatitis A virus is spread primarily through contaminated food and water, but sexual transmission, particularly among men who have sex with men, is also a recognised factor. Hepatitis A vaccination is strongly recommended for all expats in Indonesia and is straightforward, effective and widely available. If you have not been vaccinated, this should be a priority.
Hepatitis C is also transmissible through sexual contact, though this is a less common route than for hepatitis B. There is currently no vaccine for hepatitis C, making prevention through safer sex practices the primary protection.
HIV in Indonesia: Understanding the Risk
Sexual transmission accounts for the majority of HIV infections worldwide, and Indonesia is not exempt from this. Indonesia’s HIV epidemic is best described as concentrated rather than generalised, meaning rates are significantly higher among specific groups including people who inject drugs, men who have sex with men, and female sex workers, particularly in provinces such as Papua, West Papua, Jakarta and Bali.
According to UNAIDS data, Indonesia has one of the fastest-growing HIV epidemics in the Asia-Pacific region, with new infections continuing to rise. This is a concern that directly affects the expat community, not as a distant statistic but as a practical reality of daily life in the country.
For expats, the key risk factors are the same as anywhere in the world: unprotected sex with casual partners, and in particular with partners who may themselves have multiple partners or who are sex workers. The risk is real but it is also genuinely manageable with consistent precautions.
Blood Transfusions and Medical Care in Indonesia
Blood screening in Indonesia’s major international hospitals and private facilities has improved considerably and reputable hospitals in Jakarta, Bali and Surabaya follow appropriate screening protocols. However, standards vary significantly between facilities, particularly outside major urban centres.
Expats should ensure that their health insurance policy includes medical evacuation cover. In the event of a serious medical situation in a remote area or a facility with limited resources, the ability to be transferred to a better-equipped hospital, whether in Jakarta or Singapore, can be critically important.
Prevention: What Actually Works
The evidence from decades of research is consistent. Intellectual knowledge alone does not change behaviour, but the following precautions are effective and straightforward.
Studies have shown that while condoms are used by the majority of travellers and expat workers some of the time, consistent use remains lower than it should be. People who are well-informed about risk frequently do not perceive themselves personally to be at risk, which is the single most dangerous assumption you can make.
The practical guidance is as follows:
You can virtually eliminate your risk of STDs and HIV if you avoid penetrative sexual intercourse with casual partners, particularly intravenous drug users and people with multiple sexual partners.
If you are sexually active in Indonesia, using a condom consistently and correctly for all types of sex, whether oral, vaginal or anal, significantly reduces your risk. It does not eliminate it entirely, but it reduces it substantially. Having condoms available at all times removes the moment of decision from a situation where good judgement is hardest to exercise.
PrEP (pre-exposure prophylaxis) is a medication taken regularly by HIV-negative individuals that is highly effective at preventing HIV infection. It is now a standard recommendation for people at ongoing risk and is available in Indonesia, though access varies. If you believe PrEP may be appropriate for your circumstances, speak to a doctor at a reputable clinic in your city.
If you believe you have been exposed to HIV through unprotected sex or other high-risk contact, seek medical attention immediately. PEP (post-exposure prophylaxis) is an antiretroviral treatment that can prevent HIV infection if started within 72 hours of exposure. Do not wait and do not assume the risk was low. PEP is available at major international clinics and hospitals in Indonesia’s main cities.
If you have engaged in high-risk sexual activity, post-travel or post-incident testing for STDs is essential, even in the absence of symptoms. Many STDs are asymptomatic in their early stages. Testing is best carried out at a reputable clinic with experience in sexual health.
Getting Tested and Treated in Indonesia
Access to confidential, professional sexual health testing has improved in Indonesia’s main expat centres. Reputable international clinics in Jakarta, Bali and Surabaya are able to provide testing for the full range of STDs including HIV, hepatitis B and C, syphilis, gonorrhoea, chlamydia and HPV.
When seeking testing or treatment, choose an international clinic or a hospital with a dedicated internal medicine or genitourinary department rather than a general GP service, as these will have the appropriate testing infrastructure and the staff most experienced in managing these conditions with discretion.
If you are travelling home or to Singapore for a visit, this is also an excellent opportunity to have a comprehensive sexual health screen at a centre specialising in genitourinary medicine.
FAQ: Sexual Health in Indonesia
Is HIV a risk for expats living in Indonesia?
Yes, though the risk is manageable. Indonesia has a concentrated HIV epidemic with higher rates among specific groups including sex workers, men who have sex with men and people who inject drugs. Expats who engage in unprotected sex with casual partners carry a real risk. Consistent condom use, PrEP where appropriate, and regular testing are the most effective protections.
Do I need a hepatitis B vaccination before moving to Indonesia?
Yes. Hepatitis B vaccination is strongly recommended for all expats in Indonesia. If you are unsure whether you were vaccinated as a child, a blood test can check your immunity status. If you are not immune, a course of vaccinations is straightforward and highly effective. Do not delay this.
Do I need a hepatitis A vaccination before moving to Indonesia?
Yes. Hepatitis A vaccination is recommended for all travellers and expats in Indonesia. It is safe, effective and widely available before departure.
Where can I get an STD test in Bali or Jakarta?
Reputable international clinics in both cities offer confidential STD testing. [Clinic listings to be added by editorial team following verification.] Your expat health insurer may also have a recommended provider list. Testing is straightforward and, at international facilities, conducted with full discretion.
What is PrEP and is it available in Indonesia?
PrEP (pre-exposure prophylaxis) is a daily medication that is highly effective at preventing HIV infection in people who are HIV-negative. It is recommended for people at ongoing or regular risk of HIV exposure. PrEP is available in Indonesia, primarily through international clinics and some NGO-affiliated health services in Jakarta and Bali, though access is more limited outside major cities. Ask at a reputable clinic for current availability and guidance.
What should I do if I have had unprotected sex in Indonesia?
Do not ignore it. Seek medical attention as soon as possible. If there is any possibility of HIV exposure, ask specifically about PEP (post-exposure prophylaxis), which must be started within 72 hours to be effective. Regardless of HIV risk, arrange testing for the full range of common STDs. Early detection and treatment significantly improves outcomes for all of them.
Is the blood supply safe in Indonesian hospitals?
Blood screening at reputable international hospitals and major private facilities in Indonesia’s main cities follows appropriate standards. However, quality varies between facilities, particularly outside urban centres. Expats should ensure their health insurance includes medical evacuation cover so that, in an emergency, transfer to a better-equipped facility is possible.
A Practical Note
The information in this article is intended to give you an honest, practical picture of sexual health risks in Indonesia and the precautions that genuinely work. It is not a substitute for personalised medical advice. If you have specific concerns, speak to a doctor at a reputable clinic. The risks described here are real, but they are also manageable. Expats who take sensible precautions live full, healthy lives in Indonesia every day.
With thanks to International SOS for their contribution to an earlier version of this article.
