HIV\/AIDS threat gets more worrying with every passing day<\/p>\n
David and Joyce Djaelani Gordon, Contributors, Bogor, West Java<\/p>\n
HIV\/AIDS is spreading across Indonesia faster than we can
\nidentify and verify, and many who were considered at low risk
\njust a few years ago are now thought to be vulnerable or exposed
\nto higher risks.<\/p>\n
Often, conversations with lay people, unfortunately, confirm
\nthat they believe Indonesia is still viewed as low-risk for HIV
\ntransmission.<\/p>\n
This unjustly conceals the reality that tens of thousands are
\nalready infected -- and many millions more individuals are now
\nvulnerable and now at high risk as the HIV\/AIDS virus flash-
\nspreads across Indonesia, from Aceh to Papua, in uncontrolled
\nfashion.<\/p>\n
Indonesia is still in the First Phase of escalation with the
\nHIV\/AIDS pandemic, not the newly-quoted Second Wave which is at
\npresent aggressively striking many parts of the world.<\/p>\n
The Second Wave -- in places, nations and areas where new
\ninfection rates had leveled off and stayed fairly constant for a
\nperiod of time -- are currently experiencing a rise in rates of
\nnew infections. This is now being called, and justifiably so, the
\nSecond Wave.<\/p>\n
Indonesia, just a few years ago, was looked upon as a "low-
\nprevalence" nation, with concentrated pockets of high infection
\nrates among some focused high-risk-groups.<\/p>\n
High-risk groups<\/p>\n
Much has changed; at present, high-risk groups include sex
\nworkers (both male and female) drug abusers and addicts,
\nespecially injecting drug users (IDUs), and now common drug
\nusers, individuals that are not injecting users but are sexually
\nactive yet without practicing safe sex.<\/p>\n
Also included are men who have sex with men, because of unsafe
\nsex practices; males and females in prisons, because of the
\n(extremely) high rate of unsafe drug use, especially needle-
\nsharing when inmates manage (often) to get drugs into prisons,
\nunsafe sexual practices and prison tattooing.<\/p>\n
Migrant workers are also perceived to be at high risk, because
\ntheir work takes them away from their home areas, and some often
\nseek out the services of sex workers, indulging in unsafe sex
\nbecause of very rare condom usage; many are also known to drink
\n(which if done to excess can result in loss of self-control) and
\nuse drugs.<\/p>\n
Truck, becak and taxi drivers are at risk due to unsafe sex,
\nwhile the risk of greatest concern today is young people. Why
\nyoung people? Simply because young people, with their curiosity,
\nsearch for fun and excitement, naivete and desire to conform with
\ntheir peers, are open to all the above risks.<\/p>\n
It is no wonder that young people, in the 15 to 30 age group
\nrepresent the largest percentage on the HIV infection charts
\nacross the nation.<\/p>\n
Within these groups of young people, in general, women are
\nespecially at risk. Even if they are not involved in drug use or
\nabuse themselves, they are often involved with men who use drugs
\nand\/or inject drugs, or have habits\/patterns of other high-risk
\nbehavior.<\/p>\n
Since women are physically more vulnerable to sexual
\ninfections compared to men, more are becoming infected with
\nHIV\/AIDS in ever-increasing quantities. Also, as with women, we
\nare beginning to see an increase in newborn babies with HIV,
\nbabies that have to begin antiretroviral therapies shortly after
\nthey are born.<\/p>\n
Now, a factual and alarming realization: Since 2002, Indonesia
\nhas been using estimates that there could be some 90,000 to
\n130,000 infected with HIV\/AIDS. These numbers are now over three
\nyears old, and thus obsolete by most mathematical standards.<\/p>\n
Specialists estimate that the rate of new infections during
\nthe years 2002, 2003, 2004 and half way through this year is
\nabout 30,000 to 40,000 new infections per year.<\/p>\n
Projecting these approximations to the present, halfway
\nthrough 2005, on the low side about 180,000 would be infected
\nwith HIV\/AIDS, and on the high side over 250,000 are infected.
\nThose figures would seem to be much more realistic.<\/p>\n
By 2010, approximately 16 percent to 20 percent of the
\nnation's population, of approximately 230 million people could
\nor will be "at possible risk" of infection from HIV\/AIDS.<\/p>\n
That means approximately 38.8 million on the low side and 46
\nmillion on the high side, "could" be vulnerable or at risk of
\ncontracting the virus. This does not necessarily mean they will
\nbe infected by the virus.<\/p>\n
Young especially at risk<\/p>\n
It does mean, though, that they could be vulnerable or at
\nrisk, of becoming infected a more aggressive campaign and large-
\nscale intervention is done to prevent HIV from spreading.
\nHowever, if there are only limited amounts of services, programs,
\nand funds available, then as a nation we must put more effort
\ninto common sense approaches and increase work in two areas of
\nprevention; curbing unsafe sex and curbing needle-sharing.<\/p>\n
Yet, curbing unsafe sex could be problematic, if findings from
\na study done by UNICEF about young people are an indicator of
\nwhat we can expect. In the study done by UNICEF with 1,034
\nrespondents aged 14 to 17, 84 percent responded that they did not
\nknow much about HIV\/AIDS, and a whopping 73 percent could not
\neven explain what a condom is.<\/p>\n
In 2003, the Indonesian Ministry of Health estimated that
\nthere were some 124,000 to 196,000 IDUs throughout the nation,
\nalthough some experts said, "the actual numbers could be as high
\nas a million IDUs".<\/p>\n
Most of the drug users\/abusers are young people, and hence it
\nis not alarming to find that the majority of new cases of
\nHIV\/AIDS infection in Indonesia are people in their twenties, and
\ntwo-thirds of them are sexually active. Another study done in
\nJakarta and Bali by Yayasan Harapan Permata Hati Kita (YAKITA)
\nand the Ford Foundation (2003) found that 27 percent of HIV-
\npositive addicts in recovery at YAKITA were aged 16 to 20, 47
\npercent 21 to 25, and 22 percent 26 to 30, compared with 2
\npercent for those aged 31 and above. The same study also found
\nthat most young addicts had lost their virginity by the time they
\nwere 16 years old, while 83 percent reported that they rarely or
\nnever used condoms.<\/p>\n
So young males and females between the ages of 16 and 28 are
\nthe ones who are and will be infected most. The youth are the
\nmost sexually active and the ones that use and abuse drugs the
\nmost.<\/p>\n
Fast track<\/p>\n
Indonesia has decided to fast-track its approach to a number
\nof problems: from politics to the economy, from health and
\nwelfare to natural resources, from corruption to poverty, from
\neducation to employment, and from transportation to pollution.<\/p>\n
Although we do not need additional problems, we have to face
\nthe fact that we are plagued by a virus so complex, so elusive,
\nso debilitating and deadly, which has already taken the lives of
\nthousands, and which is at present infecting and devastating the
\nlives of several hundred thousand-plus individuals, and which
\nwill, without doubt, infect a million more individuals in the
\ncoming decade.<\/p>\n
We are confronted and humbled by the reality, the truth that
\nthe world quest for a vaccine still remains elusive, and as a
\nnation we remain virtually unprepared to meet the challenges
\nnecessary to prevent escalation of the HIV and AIDS crisis.<\/p>\n
Each day, the numbers of those who become infected with HIV
\nincreases, not diminishes. Let us update the figures, now, to be
\nmore accurate about the rising numbers of people who are
\ninfected, and what increase we can expect to see each and every
\nday.<\/p>\n
If we accept the low estimates, there were 90,000 to 130,000
\npeople infected with HIV or AIDS in 2002. With a spread rate of
\napproximately one person becoming infected with HIV every 15
\nminutes from 2003 to 2005 we must add, at least, 105,000 people
\nto those figures.<\/p>\n
So, using the low estimate of 90,000 plus 105,000, that would
\nput the low figure of those infected with HIV\/AIDS at 195,000.
\nThis would be the lowest possible number of people infected at
\npresent.<\/p>\n
Indonesia is still in the First Phase of the HIV\/AIDS
\npandemic. Today, just this one day, approximately 96 people
\nacross the nation will become infected with the HIV virus.
\nTomorrow is another day. If it had been a bombing or a series of
\nbombings, then these 96 people, or more, would be seen as victims
\n-- with updates on the front page of all newspapers and on
\ntelevision around the clock.<\/p>\n
The media would pick up on the injustice of it all. With
\nHIV\/AIDS it has almost been always viewed as a silent disaster,
\nand this should not be so. The virus still kills daily, and does
\nso silently.<\/p>\n
This is the reality, no less! Unless we see these figures as
\nreality, and put forth the effort needed to defend ourselves and
\nour families, as well as the nation against HIV and AIDS, these
\nnumbers cannot lessen but only increase.<\/p>\n
One of these numbers may mean YOU or your loved ones. Your
\nchildren may end up being one of the fatalities. The future
\nbegins now, and changes in our response, also, must begin now.<\/p>\n
in box:<\/p>\n
The authors can be contacted at
\nJl. Ashari Jaya II\/40, RT 04\/RW 04
\nSindangsari, Tajur, Bogor, West Java
\ntel. (0251) 244375
\nhttp:\/\/www.angelfire.com\/hi\/joydave<\/p>\n
Yayasan Harapan Permata Hati Kita
\nVilla Pandawa YAKITA
\nJl. Ciasin No. 21, Desa Bendungan
\nCiawi, Bogor, West Java
\n(PO Box 126, Bogor )
\ntel. (0251) 243069\/243077
\nwisma_srikandi@hotmail.com
\nhttp:\/\/www.yakita.or.id<\/p>",
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