Ds that kill: Denial and discrimination

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.