Condom campaign encounters resistance

Condom campaign encounters resistance

JAKARTA (JP): When the government, with the strong support of
non-governmental organizations (NGOs), embarked on a nationwide
campaign to promote the use of condoms to check the spread of the
Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome
(HIV/AIDS), there was optimism that the campaign would be a
success.

But after several years, condom use has not gained in
popularity and its promotion as the best protection against
HIV/AIDS remains controversial.

The use of condoms has been a main theme in the AIDS campaign,
which has received backing from a number of international
organizations, including USAID, KfW of Germany and the World
Bank.

Long before AIDS came to Indonesia, condoms were widely
accepted as a contraceptive. However, a controversy emerged when
condoms began to be promoted as part of the effort to prevent the
spread of HIV. Opposition came from religious groups, which
likened the condom campaign to the tacit promotion of "free sex",
adultery and prostitution.

In February last year, for example, activists from the
Indonesian Family Planning Association became the targets of a
protest by the Catholic community in Belu, East Nusa Tenggara,
when they attempted to distribute free condoms as part of the
AIDS campaign.

The locals accused the association of "promoting
prostitution".

But the strongest opposition to the promotion of condoms in
the AIDS campaign has come from Islamic religious leaders.

This opposition has put the NGOs behind the AIDS campaign,
such as the Indonesian AIDS Society and Gaya Nusantara
Organization, in a difficult position. Nevertheless, the campaign
is forging ahead, albeit in a low-key fashion.

"The promotion of condoms (in the AIDS campaign) is necessary
but it has to be implemented very carefully in view of the local
cultural and religious traditions," says Abdul Manaf, chief of
the directorate for the prevention of communicable diseases at
the health ministry.

"The approach that we use in (dominantly Christian) Irian
Jaya, for example, is totally different from what we do in
(dominantly Muslim) Aceh."

Those who are opposed to the promotion of condoms to prevent
HIV suggest that the AIDS campaign focus on discouraging
promiscuity.

While the controversy remains, HIV/AIDS continues to take its
toll in Indonesia.

According to official statistics, as of the end of February
this year the number of people living with HIV reached 604 and
another 235 people had full-blown AIDS. Since the first AIDS case
was reported in 1987, 113 people with AIDS have died.

Jakarta has the highest number of HIV/AIDS cases with 243,
followed by Irian Jaya with 211 cases and Riau with 107 cases.
Aceh, Lampung, East Nusa Tenggara and East Timor have the fewest
cases with "only" one case each.

New AIDS cases have been steadily on the rise in Indonesia. In
1987, two new cases were reported. Since then, new AIDS cases
have shown an upward trend, reaching 12 in 1991. But the most
dramatic jump was from 34 new cases in 1997 to 74 last year.

No condom, no sex

The sensitivity surrounding the condom promotion has forced
the government to focus their campaign on high risk groups,
particularly prostitutes, homosexuals, fishermen and truck
drivers.

In its latest move, the government has introduced the "100
percent condom use" policy for brothels. The policy was
apparently inspired by a similar tactic in Thailand which has
reportedly been a success. The motto for the policy is "No
Condom, No Sex".

"But since customers' awareness about safe sex is so low, the
policy is doomed to end up a failure," said an AIDS activist.

Manaf said health ministry officials across the country were
told to implement the 100 percent condom use policy "without
causing unrest in their respective areas".

A behavioral surveillance survey conducted in several major
cities across Indonesia showed that the use of condoms among high
risk groups was not very encouraging.

The survey found that 47 percent of prostitutes' customers in
Jakarta in 1997 used condoms, while that number was 30 percent in
Surabaya and 29.5 percent in Manado.

In a 1998 survey the results were just as discouraging. In
Denpasar, close to 70 percent of prostitutes' customers used
condoms, while in Kupang, East Nusa Tenggara, that number was 52
percent and in Ujungpandang only 33 percent of the customers used
condoms.

Manaf said that many people refuse to use a condom simply
because they believe that wearing a condom will make intercourse
less enjoyable, although they are well aware of the risks of
unprotected sex.

There have been suggestions that to provide its AIDS
prevention policies teeth, the government should initiate
legislation similar to that enacted in Thailand.

Manaf cited the need for legislation which, for example, would
require prostitutes to be tested for sexually transmitted
diseases on a regular basis.

However, he said, the problem was that prostitution, which is
illegal in Indonesia, is not always organized in brothels.

"What can we do with streetwalkers who work independently," he
asked?

Prostitution has become an even more complex social and health
problem due to the economic crisis. More sex workers are taking
to the streets as many night spots that once served as
prostitution fronts went bankrupt or were forcibly closed down by
citizens. It is also feared that the economic crisis will force
even larger numbers of women into prostitution. (pan)