Australians who got a tattoo or a body piercing in Bali recently have been advised to have a blood test after a Western Australian traveller was infected with HIV, apparently while getting a tattoo.
“Getting a cut-price holiday tattoo or body piercing can be tempting,” Tonia Buzzolini, Travelvax Australia’s national operations manager, said.

“But, you might be taking home more that you bargained for. If the needles or other equipment are reused without being properly sterilised, the risk of getting a potentially fatal blood-borne infection disease is very real.”

Had ink in Bali? Pencil in a blood test 
WA Health had notified Commonwealth authorities that a returned traveller had tested positive to HIV, with a tattoo obtained in Bali considered the most likely source of the infection. When or where the victim was infected was not revealed, but Indonesian health authorities are investigating the incident.
Meanwhile, Paul Armstrong, director of communicable disease control with WA Health, advised people who had recently had a tattoo or body piercing in Bali to have a blood test.
Ms Buzzolini said sexual health campaigns have made Australians more aware of the risk of HIV and hepatitis from unprotected sex. However, travellers are less likely to associate these potentially deadly diseases with tattoos and body piercings, she said.

If it’s not sterile, it’s not on
“Whenever there is any risk of skin being broken during a procedure, travellers should insist that sterile equipment be used – and make sure it is before going ahead,” she said.
“Not just for tattoos and body piercings, but also the tools used during manicures and pedicures, as well as razors and scissors used in haircuts.
“It also applies if a traveller needs a tetanus shot or sutures in a developing country. That’s the reason we recommend our clients pack a first aid kit containing sterile equipment.”
Ms Buzzolini said a market or street stall is the worst place to get a tattoo, piercing, manicure, or pedicure.
“A lone operator offering a cut-price service would find it virtually impossible to keep equipment sterile,” she said.
“Avoiding an infection would be sheer luck.”
In a tattoo or body piercing parlour, travellers should look to see that an autoclave machine - the gold standard for sterilising medical equipment - is in use.

Bali’s HIV, hepatitis rates are soaring
Almost 653,000 Australians visited Indonesia in 2009-10, based on the latest figures from the Australian Bureau of Statistics. Western Australians especially love Bali: The number of holidaymakers heading to the island from Perth has quadrupled since 1996 – some 385,000 went from WA in 2010-11 financial year, according to government figures.
However, as the island’s popularity has soared, so too has its HIV/AIDS rates. A recent media report quoting health authorities estimate that 1-in-4 of Bali’s prostitutes is HIV-positive, and that in 2010 the number of HIV infections rose by almost 19% on the previous year.
The island is bucking the global trend towards fewer HIV infections. An estimated 2.7 million people acquired HIV infection in 2010 – down from 3.1 million in 2001 – making for a total of 34 million people living with HIV in 2010, according to the WHO.

HIV linked to roadside cafes in Bali
Last month, a senior official warned that Bali’s relatively high rate of HIV/AIDS infection is linked in part to the prevalence of roadside ‘cafes’.
He was echoing concerns voiced by senior politicians, including Ketut Kariyasa Adnyana, of Bali’s House of Representatives (DPRD-Bali), who said cafes and community bars had become a front for prostitution.
“Cafes have spread into remote villages on the island,” he told the Bali Discovery website.
“The condition is worrying because of the high spread of HIV and AIDS. Many of the victims are housewives who got infected from their husbands.”

Hepatitis causing greatest concern in Asia
However, it is hepatitis B and C that are causing greatest concern in Indonesia and among its South and Southeast Asian neighbours, the WHO said. In the last decade, viral hepatitis has killed more people in Asia than malaria, dengue and HIV/AIDS combined.
Thirty times more prevalent than HIV, the blood-borne viruses are among the leading causes of preventable deaths in 11 Asian countries – Indonesia, Bangladesh, Bhutan, Burma, East Timor, India, Maldives, Nepal, North Korea, Sri Lanka, and Thailand. Between them, they have an estimated 130 million sufferers – a quarter of the global burden.
There are effective vaccines for Hepatitis B and A, but none for hepatitis C.
Discuss vaccination at your nearest Travelvax Australia clinic (1300 360 164), or with a GP, at least 6 weeks before departure.
Travelvax Australia and the CDC have more information on the risk of STI’s during travel.