HIV\/AIDS the `reality', `the spread', `tomorrow'<\/p>\n
David and Joyce Jaelani Gordon, Contributors, Bogor, West Java<\/p>\n
Greater Jakarta, Bali, Maluku, Bandung, Yogyakarta, Surabaya,
\nMalang, Manado, Makassar, Papua, Medan -- all are areas where new
\ncases of HIV and AIDS are increasing.<\/p>\n
Many of us who are closely involved with the pandemic expect
\nan increase of approximately 35,000 new cases of HIV in 2006 in
\nIndonesia.<\/p>\n
That translates to one newly HIV infected person every 15
\nminutes of every day for the entire year across the nation.
\nEstimates of those living with HIV\/AIDS in Indonesia are between
\n180,000 and 250,000.<\/p>\n
The reality is HIV\/AIDS may now be found across the nation,
\nfrom Sabang in Banda Aceh to Merauke in Papua. The virus is
\nfueled, driven, in increasing acceleration, primarily by sexual
\nactivity and drug use, abuse or addiction.<\/p>\n
Injecting drug use and unprotected sex while under the
\ninfluence of drugs and alcohol have been primary causes of the
\npast years' increase of HIV cases. It is important to note that
\ntransmission of HIV among injecting drug users in Indonesia has
\nincreased eight-fold since 1998, and most of these injecting drug
\nusers are young people.<\/p>\n
\"All the elements are here for the rapid spread of HIV, so
\nit's (up to us) to express concern and to highlight the
\nopportunities that are there. The opportunities are enormous to
\nreally stop the epidemic, to nip it in the bud,\" said Peter Piot
\nfrom UNAIDS, during his four-day visit to Indonesia to
\ncommemorate World AIDS Day, which fell on Dec. 1.<\/p>\n
According to the Ministry of Health, as of July 2005, the
\nmajority of people who are HIV positive in Indonesia are those
\naged between 20 and 29. This age group comprises 54.7 percent of
\nthe total number of people living with HIV.<\/p>\n
Individuals between the ages of 15 and 19 represent 6.4
\npercent of the total HIV cases.<\/p>\n
So, the majority of those infected by HIV are young people,
\nmost of whom were born into a world where HIV\/AIDS was already a
\nfact of life. While the epidemic is fueled by drug use and sex,
\nreality exclaims \"there is no way to stop people from having sex,
\nor to stop people from using drugs and alcohol\".<\/p>\n
The \"wars on unsafe sex and drugs\" have only shown a modicum
\nof success, and in many areas across the world both are seen as
\nhaving failed.<\/p>\n
Regarding the issue of sex, in our close contact with young
\npeople we at YAKITA find that \"the beginnings of sexual
\nexperimentation and experience start for many between the ages of
\n14 and 20 years.<\/p>\n
While the subject of sex and sexuality is generally not found
\nto be openly spoken about at home with parents and family
\nmembers, or approached educationally within high schools and
\nuniversities, sex is definitely a prime subject often spoken
\nabout between youth, both males and females.<\/p>\n
Sex is also exploited by every form of media, from TV to
\nmagazines, from leaflets to billboards, from shoes to
\nheaddresses, from nail polish to hair gel, every single day.<\/p>\n
We are bombarded with advertisements with sexual overtones.
\nPornographic VCDs are easily found for Rp 10,000 in many areas
\nacross the nation. And the reality is that sex is used to entice
\npeople because sex looks good, sounds good and feels good.<\/p>\n
People seek, long for and lust for relationship(s), and sex is
\noften a large part of what defines relationship. But for some
\nindividuals, the end result of a sexual relationship is a
\nsexually transmitted disease or HIV\/AIDS.<\/p>\n
Drug abuse<\/p>\n
With drug use, abuse and addiction, the reality shows that
\nthere are more and more people, especially young adults, using
\nand abusing drugs.<\/p>\n
More people are using alcohol and smoking marijuana these
\ndays. More individuals are trying ecstasy.<\/p>\n
It is easy to find ecstasy across the nation today in most any
\nnightspot, mall or place of entertainment, or on or close to
\nschool campuses. More, many more, individuals are abusing and
\naddicted to shabu-shabu (crystal methamphetamine) and putaw (low-
\ngrade heroin).<\/p>\n
Part of the reality of using drugs is that \"drugs are fun,
\ndrugs are exciting, the come-on with drugs makes finding and
\nhaving sex much easier\".<\/p>\n
Today, often, using drugs is seen and considered as a ritual
\nand rite of passage by youth. Some studies have shown that there
\nare a higher percentage of young people experimenting with drugs
\nthan with sex.<\/p>\n
In the mid 1970s, there were hundreds of morphine addicts in
\nthe country. In the late 1980s, there were thousands of drug
\nabusers\/addicts across the nation. Today, there are a few million
\ndrug abusers\/addicts.<\/p>\n
Another current reality is that within Indonesian culture
\nthere exists a subculture, a youth-movement, which plays to the
\nproverbial lifestyle of \"sex, drugs and rock 'n' roll\".<\/p>\n
They are video-game-ed, internet-ed, MTV-ed, sinetron-ed,
\nshopping mall-ed, hip-hugger-ed and cap-ed, fear-factor-ed, fast
\nfood-ed young people looking for, and wanting to be part, of the
\nnext \"craze, rave and crave\". The reality is that many of these
\nyouth are exposed to the most high-risk populations of people
\nsusceptible to becoming infected with HIV or already infected
\nwith HIV.<\/p>\n
Education top strategy<\/p>\n
The reality is that there will be more new HIV infections
\ntomorrow. The spread-rate increases daily. The number one defense
\nagainst HIV\/AIDS still remains education.<\/p>\n
If, and on a national level, there is not a radical shift
\nconcerning the importance of education, and these subjects are
\nnot (respectfully) and directly spoken about and taught, in the
\nlanguage of facts and reality, beginning at the junior high
\nschool level through the universities, there will be many more
\nHIV\/AIDS cases throughout Indonesia.<\/p>\n
Education also must cover the reality of drug use, abuse,
\naddiction, reproductive health, sex and sexuality.<\/p>\n
Today we are at a place and time when we must speak of both
\nprevention and intervention when discussing HIV and AIDS.<\/p>\n
We, as a family-oriented nation, are ill-fated if we wait upon
\nthe resources of government, officials, schools, religion, the
\nmedical profession and medicine, business and organizations to
\nhelp with prevention\/intervention and assistance with HIV and
\nAIDS. We all need to put an honest effort into changing the
\ncourse of the epidemic.<\/p>\n
As in the World AIDS Day theme this year, \"Stop AIDS: Keep the
\nPromise\", it is no longer time to just make promises.<\/p>\n
Indonesia needs strong leadership, committed and responsible
\naction, medical agencies and services, and programs that are
\nspecifically designed to aid in the fight against HIV\/AIDS.<\/p>\n
As Piot explained, while President Susilo Bambang Yudhoyono
\nhas expressed a clear commitment to fighting AIDS, the same level
\nof commitment is needed from all levels of society<\/p>\n
Both prevention and intervention are absolutely necessary to
\nunderstand and are related to each other. Both are equally
\nimportant. And in the home, even before schools begin educating
\nstudents about HIV\/AIDS, moms and dads must be the main teachers
\nin educating their children about HIV\/AIDS and protecting them
\nfrom the virus.<\/p>\n
Meaning that mom and dad must themselves learn about HIV\/AIDS
\nand related issues surrounding the virus. Parents must also be
\nrole models at home.<\/p>\n
We, as a nation, are still years away from containment and
\nthen a reduction of HIV\/AIDS. Indonesia is no longer considered
\nin the low-stages of the pandemic; we have now entered the high-
\nrisk category. There is much we can do, and much we must do.<\/p>\n
The key to minimizing, containment and reduction of HIV\/AIDS
\nis the word \"we\". If we work together, as a family, in the
\nIndonesian sense of gotong royong (mutual work), beginning with
\neducation in the home, then within schools, there is much we can
\ndo, but if not we will surely suffer far greater consequences
\nthan what we are already suffering.<\/p>\n
The authors, David Gordon and Joyce Jaelani Gordon, are directors
\nof the Bogor-based Permata Hati Kita Foundation (YAKITA), a drug
\nrehabilitation and addiction recovery center.<\/p>",
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