Ds that kill: Denial and discrimination

Tertiani ZB Simanjuntak, The Jakarta Post, Jakarta

HIV-related fear has, ironically, led society to deny the presence of the deadly virus at our doorstep despite the collective risk we are bound to face with the silent spread of the virus due to our rapidly changing lifestyle which exposes us to infection.

Many HIV activists believe that this denial comes from a general lack of knowledge in spite of its accessibility and availability.

Recovering drug addict Decky, who was diagnosed with Human Immunodeficiency Virus (HIV) three years ago said one of his intravenous drug user (IDU) mates strongly rejected the suggestion of an HIV test, rationalizing that he shared needles "only with decent guys".

Decky, who has been a campaigner for HIV prevention for the last two years, described "decent guys" as those who never skip bathing and are always well-groomed.

Another factor is the low level of condom use. HIV activist Andre said most of the customers at Gang Dolly prostitution complex in Surabaya, where he and his friends run the campaign, refused to use any of the free condoms provided.

"They give many reasons. Uncomfortable is the norm. We have learned to be tricky. We taught the female sex workers how to put condoms on without making their customers realize."

Worse still, such indifference in finding out what exactly HIV or the feared Acquired Immune Deficiency Syndrome (AIDS) is all about has created a stigma in the society.

The two most common routes of HIV infection in the country: unsafe sex and IDU are seen as controllable behaviors and therefore avoidable. So, the epidemic is perceived as the bearer's responsibility. Punishment for the immoral.

More over, fear of contagion has made society treat the social groups most affected by the epidemic as vermin and labeled them with the disease.

Pelita Ilmu Foundation (YPI)'s task force recorded many cases of discrimination against the social groups and HIV positive people, such as mandatory testing without counseling prior to or after testing and quarantine.

A 24-year-old man was handcuffed by his family and guarded by a security guard in a room in his own house. Another man was locked up in a room built separate from the family's house. His food was delivered to him under the door.

A teenage sex worker was dispelled from a rehabilitation center by the officials of the social welfare department after the officials announced her HIV status to her rehab mates. A woman was banished from her village for fear she would bring bad luck. Many more are banned from traveling abroad.

Even the dead are not left alone. The family of a male living with AIDS put his body in a plastic bag when he died before burying him. The bed he had slept in was set on fire. In another case of a 15-year-old female, the morgue attendants refused to bathe the body for a proper funeral.

Many hospitals in Jakarta, and more in other big cities in the country, refuse to handle HIV infected people, arguing that they are not ready.

And those are the stories of the 2000s.

What these people have failed to see that it is safe to breathe the air together with the HIV positive and people with AIDS and that the virus can infect anybody no matter how straight their life is.

HIV attacks and eventually destroys white blood cells which are a part of the body's immune system. The virus is spread through the transmission of contaminated body fluids such as semen, vaginal secretions and blood.

The entry occurs through broken skin and mucous membranes -- tissues that line the mouth, vagina, rectum, and urethra.

Any activity where one partner -- heterosexual or homosexual -- penetrates another sexually can spread the illness.

Any cutting into the body with contaminated instruments such as needles used by IDUs, unsterilized medical and dental equipment, as well as blood transfusion, ear piercing, tattooing, and manicure equipment can also expose a person to infection.

When a person is infected, his/her immune system makes antibodies to combat the virus. A person is labeled HIV positive when the antibodies are found in his/her blood.

There are therapies and medication to slow down the development of HIV but there is no cure or vaccination to prevent the virus, which is eventually fatal.

However, the HIV positive may remain healthy for many, many years before they suffer AIDS which is the last stage of HIV infection where various malignancies occur and lead to death.

Due to the stigma of HIV/AIDS, the social groups at risk are deterred from undergoing tests or seeking information and assistance for risk reduction while those who live with the virus or the disease must face hostility from society when they need help and support.

At a rough estimate, the virus had infected 80,000 to 120,000 Indonesians. Official data from the Ministry of Health collected from 1987 to June 2002 shows only 2,900 people. Learning from the rising number of IDUs and HIV prevalence which, in developing Southeast Asian countries, is up to 0.6 percent, the data is likely to be just the tip of the iceberg.

Both HIV positive and HIV negative campaigners are now struggling against stigma and discrimination -- the focus of the World AIDS Day this year, which falls on Sunday.

The denial of potential risk and the hostile attitude that keeps HIV positive people behind closed doors will not do anything to slow down, or prevent, the epidemic. It is time to stop burying our head in the sand.