Does a flood of AIDS

Does a flood of AIDS
await as flood recedes?

Christopher Purdy
Director, DKT Indonesia
Jakarta

In case you had not noticed, AIDS is here in Indonesia. In the
last 12 months, the Ministry of Health released data indicating
that 80,000 to 120,000 Indonesians were infected with HIV. The
government stated that transmission rates of HIV among "high-
risk" groups such as sex workers, transvestites, and intravenous
drug users are higher (in some cases, much higher) than 5
percent.

This technically re-classified the AIDS epidemic in Indonesia
from a "low" to a "concentrated" prevalence rate, repeating an
all-too-familiar pattern of the epidemic's evolution to larger
populations and communities -- primarily in urban areas.

This new information was important because it marked the
government's decision to bravely address "uncomfortable" issues
such as sex and intravenous drug use. By confirming that HIV
rates were much higher than previously reported, the government
significantly created political space to find solutions to these
problems and increase prevention efforts. This is a welcome
development but is accompanied by a new kind of challenge.

In Indonesia, talking about sexual behavior poses problems.
While Indonesia struggles with self-identity and cultural shifts
associated with modernization and globalization, a generation of
young Indonesians are exploring their sexuality (and getting
pregnant!). Commercial sex establishments are tolerated and, by
all reports, continue to run a brisk business. Since the economic
crisis, an increasing number of young women have been forced into
commercial sex, moving among brothels, massage parlors, and bars.
Sales of energy drinks and traditional herbs (jamu), widely
considered to contain aphrodisiacal qualities (mostly caffeine)
that improve sexual performance, are reportedly strong.

However, talking about sex or disease prevention remains a
taboo subject, liable to send most Indonesians running or
laughing. While many young Indonesians are indeed conservative,
most are simply terribly embarrassed by the subject of sex. While
they publicly shy away from discussions about sex, they privately
yearn for knowledge. Because there is no publicly accepted forum
for discussion, many young Indonesians turn to the internet,
VCDs, and their friends for information about sex.

How then, will Indonesia combat an issue like HIV/AIDS?
Without straightforward dialog about disease prevention and
sexual behavior, this remains a serious challenge. Condom
advertisements, for example, cannot be aired before 9 p.m. for
fear that young people might see them. However, if youngsters do
not see such advertisements, when will they be exposed to issues
regarding personal safety? How will they know how to prevent
disease? Who will tell them?

If the recent flooding in Jakarta is any metaphor, careful
planning and preparation are critical to prevent an overflow of
HIV transmissions in the future. However, Indonesians must not
look only to their government bodies to address and solve this
problem. Individuals and communities must open up the floodgates
of education and clear a pathway for fresh thinking and behavior.

Frank and open discussions about HIV, including the promotion
and use of condoms, are required (if you have never counseled
your adolescent children about HIV and condoms, do so today!).
Public dialog about HIV prevention from pop culture icons (such
as movie stars, singers, and athletes) and community, business,
and cultural leaders will make discussing HIV/AIDS and condoms
more acceptable and less embarrassing.

However, this must be done aggressively and continually.
Unlike the waters spilling across the Jakarta streets, a flood of
HIV will not be so easily controlled and will not recede.

DKT Indonesia is a part of the Washington-based international
organization focusing on HIV prevention and family planning.