An uphill battle against AIDS in Indonesia

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.