<unk> -Leste is a low HIV-prevalence country with less than 0.2 percent of the adult population estimated to be HIV-positive. However, social factors such as massive social dislocation, cross-border migration, high unemployment, and a weak and limited health system could dramatically increase the spread of HIV infection. Many young people are not well-equipped with the knowledge and life skills to manage HIV risk in an increasingly challenging environment. The first HIV/AIDS case in<unk> -Leste was detected in 2001. Forty-three cases of the disease were confirmed in 2007 and are now under treatment, according to the Ministry of Health. However, limited surveillance capabilities and inadequate testing could mean that more people are infected. Although HIV prevalence among the general population appears to be quite low, there are signs of a low-level epidemic among<unk> -Leste’s sex workers and men who have sex with men (MSM). According to data collected in mid-2003 by Family Health International (FHI), HIV-prevalence rates among sex workers and MSM were 3 percent and 1 percent, respectively. According to the same study, among female sex workers (FSWs), 14 percent tested positive for gonorrhea, 15 percent for chlamydia, 16 percent for trichomonas and 60 percent for herpes simplex virus-2. No comparable data have been collected since, and consequently, the current situation is unknown.<unk> -Leste is also vulnerable due to its close proximity to nearby countries that are experiencing localized epidemics such as Indonesia and Papua New Guinea. General public health knowledge on primary health care, including reproductive health, sexually transmitted infections (STIs), and HIV/AIDS, is very limited especially in remote areas. Only 50.7 percent of the population 15 years old and over ever heard about HIV/AIDS; and among those in that same population group who think it can be avoided, only 41.8 percent know that it can be avoided by use of condoms, according to the 2007<unk> -Leste Living Standards Measurement Study. There are others factors that contribute to the risk and impact of HIV/AIDS among women; they include domestic violence, lower literacy and education levels, and cultural constraints in discussing issues of sex. Providing the general population with information to combat HIV/AIDS is complicated due to low prevalence and limited access to the communities. According to the National Statistic Directorate Census 2004, most people live in the rural areas, mainly around the northern coastal regions in small, dispersed villages. According to the Demographic and Health Surveys conducted in 2003, more than 60 percent of women and 70 percent of men do not recognize any method of family planning, and only 10 percent of women are using any contraceptive method.<unk> -Leste can still be classified as a conflict country. The civil unrest that erupted in April/May 2006 continues to be unsettled and constitutes a risk for high rates of domestic violence and sexual assault, thereby leaving women more vulnerable to infection since they are unable to negotiate condom use. The country has a high tuberculosis (TB) burden, with 250 new cases per 100,000 people in 2005, according to the World Health Organization. From the 43 cases under treatment, data from the Ministry of Health due to be released in early 2008, shows that at least three people have HIV-TB co-infections; two children under five received the infection from their mothers; and two pregnant women are under prevention of mother-to-child transmission (PMTCT) HIV treatment.
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