High-risk behavior spurs RI's AIDS rate

The Jakarta Post, Jakarta

As the globe commemorates World AIDS Day on Dec. 1, Indonesia's response continues to remain dangerously slow while millions of its people continue to obliviously engage in high risk behavior.

The United Nations' new report on AIDS also revealed that injecting drug use "is the major driver" of the spread of HIV/AIDS here. Meanwhile condom use remains low, despite various campaigns, even in the commercial sex trade, where "it is estimated that fewer than 10 percent of the between 7 million and 10 million Indonesian men who avail of the services of sex workers use condoms consistently," read the UNAIDS report, released ahead of World AIDS Day.

Haikin Rachmat, director of Communicable Diseases Control at the Ministry of Health, said Sunday that according to the ministry's behavior survey, "80 percent of high risk groups know about the transmission mode of HIV but less than 10 percent of them use a condom."

Experts have urged the need to scale up programs to overcome HIV/AIDS in a bid to check the potentially rapid spread of the virus, experts here say.

Zubairi Djoerban, chairman of the Indonesian AIDS Society, said a shortcut measure would be for all stakeholders "to learn success stories from other institutions (in other countries) so that they can scale up existing programs without having to start from scratch."

The experts, along with Amaya Maw-Naing, medical officer at World Health Organization's Representative Office for Indonesia, agreed that government, non-governmental organizations (NGOs), people living with HIV/AIDS (PLWHA), the private sector and donors needed to strengthen and integrate their efforts in tackling the epidemic.

Agence-France Presse on Sunday quoted epidemiologist Elizabeth Pisani as saying that Indonesia has one of the fastest growing epidemics in the world today.

Among female sex workers, she said the rate of HIV infection is low compared to other Asian countries but is growing extremely rapidly. The rate is eight percent in Riau, home to a red light district popular among some Singaporeans, and also eight percent in Merauke in Papua province. Sorong, also in Papua, has the country's highest level of infection at 16 percent according to government data, said Pisani of Aksi Stop AIDS, an AIDS prevention and care group, a project of the above ministry and USAID.

The figures were an increase from zero in the last three or four years, Pisani said.

The Ministry of Health recorded that from 1987 until Sept. 30 this year, there were 3,924 PLWHA across the country. This figure comprises 2,685 HIV cases and 1,239 AIDS cases, while 428 of them have died. However, according to an official estimation from UNAIDS, Indonesia is home to 130,000 PLWHA.

From July to September this year, the ministry recorded 277 new cases, most of them reported from Papua (105 HIV and 62 AIDS), East Java (33 AIDS), Yogyakarta (19 HIV and 5 AIDS), and North Sumatra (2 HIV and 13 AIDS). About 66 AIDS cases are among the 20-29-year-old age group while 46 AIDS cases are in the 30-39 age bracket. Most of the transmission modes involve injecting drug use and sexual encounters.

"All partners need to strengthen their efforts. Prevention, care, treatment and support programs must go together. None is over the other," said Maw-Naing.

Zubairi pointed out that the country still lacked Voluntary, Counseling and Test (VCT) services and only a few pregnant women received information and treatment that could help them avoid transmitting HIV to their children.

"Currently, we only have 10 such centers in the country. We can learn from Africa which has more than 100 VCT centers, or from America, which obliges gynecologists to inform pregnant women about the risk of transmitting the virus to their babies."

Zubairi said that teenagers, especially those who are sexually active, have not received adequate information about the prevention of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome. There are only some schools in Greater Jakarta that pass on such information while the government has yet to insert make any provision for it in school curricula.