An uphill battle against AIDS in Indonesia

Thang D. Nguyen, Jakarta

Of all the places in the world that he could be on Dec. 1 this year for World AIDS Day, Peter Piot, the head of UNAIDS, chose to be in Jakarta, Indonesia.

The reason, he said, is that he would like to see more attention paid to Asia, where the level of AIDS infection is increasing at a faster rate than ever before. As Southeast Asia's largest country and the world's fourth-largest population, Indonesia has become "the new frontline of an AIDS epidemic".

"When I look at Indonesia from a global perspective, I would say that there's no doubt that Indonesia is in the early stage of an AIDS epidemic," said Piot earlier this week.

A look at the current rate of HIV/AIDS infection in Indonesia supports this view. As of September this year, the Indonesian Ministry of Health showed that about 8,251 Indonesians are living with AIDS.

According to experts from both Indonesia and abroad, however, the real figure can be from 90,000 to 250,000. Given the size of Indonesia, where public awareness of HIV/AIDS is poor, it is easy to understand why it is difficult to collect data and come up with an accurate number of Indonesians currently infected with HIV/AIDS.

Whatever the real figure is, the Indonesian government has realized that HIV/AIDS is yet another war -- among others like terrorism and poverty -- it has to fight. As part of its national campaign against HIV/AIDS, the government has promoted the use of condoms and sterile needles -- as unsafe sex and needle-sharing are two major ways through which AIDS is transmitted.

This campaign is not so successful, however, for a number of reasons. First, aside from preventing unwanted pregnancy and transmitted diseases (or STDs), condoms play a major role in the protection against HIV/AIDS, but they themselves are not enough a weapon in the fight against this global epidemic.

In other words, the use of condoms must be accompanied by both sex education and public awareness of AIDS. The reason is individuals -- minors and adults alike -- are less likely to use condoms unless, and until, they understand the importance of using them and the consequences of not using them. More importantly, they need to know how to use them.

Unfortunately, many young Indonesians either are not educated about sex or receive sex education late. According to a Durex- sponsored global sex survey this year, Indonesians start to receive sex education at 14.4 years of age, compared to a global average of 13.2 years. The same poll also shows that 40 per cent of Indonesians have unsafe sex without knowing their partners' sexual history.

Second, many Indonesians don't use condoms because their leaders -- religious or otherwise -- advise them not to do so. It sounds unlikely, but there are Indonesians who hold authoritative, senior positions that don't believe in the use of condoms. One of them, for instance, is Adhyaksa Dault, Indonesia's State Minister for Youth and Sports Affairs.

"I don't agree that we should promote condom use as a way of preventing HIV/AIDS. That's not the way. It's more about how to steer our young people away from promiscuity," he was quoted by Antara as saying.

Similarly, during World AIDS Day events in Jakarta in 1996, the wife of the then Minister of Youth and Sports said: "Don't commit adultery or you will make your innocent babies AIDS victims (sic)."

It is obvious that messages like these are counterproductive to Indonesia's campaign against AIDS. If anything, they beget a myth that sex with different partners, or promiscuity, is the root cause of AIDS and that monogamy is the way to prevent AIDS.

What if one of the spouses in a polygamy, which is allowed under Islamic law, happens to be HIV-positive and transmits it to others through unprotected sex? And what happens to people who have safe sex with different partners? Do they all get AIDS?

To be sure, the use of condoms doesn't guarantee absolute protection from AIDS, but they are the most effective, affordable, and user-friendly tool for prevention there is right now.

Third, AIDS victims have been, and still are, stigmatized in Indonesia. The stigmatization of AIDS victims is perhaps the most formidable obstacle in the fight against AIDS in Indonesia -- and the world, for that matter.

Because of this, AIDS victims dare not speak out and contribute to this fight by educating others about AIDS, its causes, and how to protect themselves against it.

If Indonesia is to make progress in its campaign against HIV/AIDS, everyone must be involved. This includes not only medical authorities, international and local non-governmental organizations (NGOs), and the government of Indonesia, but also parents, teachers, religious and community leaders, and AIDS activists, including gays.

In Indonesia, gays and individuals with alternative lifestyles are the most stigmatized group. This is because being a gay, a lesbian, or a bisexual person is a taboo in the world's largest Muslim-majority nation.

Like it or not, this is the way certain individuals are or choose to be. And no one can or should stop it; in fact, it is counterproductive to do so because, given human nature, the more our social institutions or authorities tell us not to do something, the more we want to do it.

But the most important reason to involve the gay community in Indonesia's campaign against HIV/AIDS is that -- you guessed it -- gays are one of the largest groups of AIDS victims.

As there is no cure yet for AIDS, the best cure we have is to prevent it. And Indonesia will do better in its campaign against HIV/AIDS by providing more education on both AIDS and sex; correcting the misperceptions (or myths) by Indonesian leaders and citizens of AIDS; and stopping the stigmatization of its victims.

Otherwise, the campaign will be in vain.

The writer is a Jakarta-based columnist. His writing can be read at www.thangthecolumnist.blogspot.com.