HIV/AIDS the `reality', `the spread', `tomorrow'

HIV/AIDS the `reality', `the spread', `tomorrow'

David and Joyce Jaelani Gordon, Contributors, Bogor, West Java

Greater Jakarta, Bali, Maluku, Bandung, Yogyakarta, Surabaya,
Malang, Manado, Makassar, Papua, Medan -- all are areas where new
cases of HIV and AIDS are increasing.

Many of us who are closely involved with the pandemic expect
an increase of approximately 35,000 new cases of HIV in 2006 in
Indonesia.

That translates to one newly HIV infected person every 15
minutes of every day for the entire year across the nation.
Estimates of those living with HIV/AIDS in Indonesia are between
180,000 and 250,000.

The reality is HIV/AIDS may now be found across the nation,
from Sabang in Banda Aceh to Merauke in Papua. The virus is
fueled, driven, in increasing acceleration, primarily by sexual
activity and drug use, abuse or addiction.

Injecting drug use and unprotected sex while under the
influence of drugs and alcohol have been primary causes of the
past years' increase of HIV cases. It is important to note that
transmission of HIV among injecting drug users in Indonesia has
increased eight-fold since 1998, and most of these injecting drug
users are young people.

"All the elements are here for the rapid spread of HIV, so
it's (up to us) to express concern and to highlight the
opportunities that are there. The opportunities are enormous to
really stop the epidemic, to nip it in the bud," said Peter Piot
from UNAIDS, during his four-day visit to Indonesia to
commemorate World AIDS Day, which fell on Dec. 1.

According to the Ministry of Health, as of July 2005, the
majority of people who are HIV positive in Indonesia are those
aged between 20 and 29. This age group comprises 54.7 percent of
the total number of people living with HIV.

Individuals between the ages of 15 and 19 represent 6.4
percent of the total HIV cases.

So, the majority of those infected by HIV are young people,
most of whom were born into a world where HIV/AIDS was already a
fact of life. While the epidemic is fueled by drug use and sex,
reality exclaims "there is no way to stop people from having sex,
or to stop people from using drugs and alcohol".

The "wars on unsafe sex and drugs" have only shown a modicum
of success, and in many areas across the world both are seen as
having failed.

Regarding the issue of sex, in our close contact with young
people we at YAKITA find that "the beginnings of sexual
experimentation and experience start for many between the ages of
14 and 20 years.

While the subject of sex and sexuality is generally not found
to be openly spoken about at home with parents and family
members, or approached educationally within high schools and
universities, sex is definitely a prime subject often spoken
about between youth, both males and females.

Sex is also exploited by every form of media, from TV to
magazines, from leaflets to billboards, from shoes to
headdresses, from nail polish to hair gel, every single day.

We are bombarded with advertisements with sexual overtones.
Pornographic VCDs are easily found for Rp 10,000 in many areas
across the nation. And the reality is that sex is used to entice
people because sex looks good, sounds good and feels good.

People seek, long for and lust for relationship(s), and sex is
often a large part of what defines relationship. But for some
individuals, the end result of a sexual relationship is a
sexually transmitted disease or HIV/AIDS.

Drug abuse

With drug use, abuse and addiction, the reality shows that
there are more and more people, especially young adults, using
and abusing drugs.

More people are using alcohol and smoking marijuana these
days. More individuals are trying ecstasy.

It is easy to find ecstasy across the nation today in most any
nightspot, mall or place of entertainment, or on or close to
school campuses. More, many more, individuals are abusing and
addicted to shabu-shabu (crystal methamphetamine) and putaw (low-
grade heroin).

Part of the reality of using drugs is that "drugs are fun,
drugs are exciting, the come-on with drugs makes finding and
having sex much easier".

Today, often, using drugs is seen and considered as a ritual
and rite of passage by youth. Some studies have shown that there
are a higher percentage of young people experimenting with drugs
than with sex.

In the mid 1970s, there were hundreds of morphine addicts in
the country. In the late 1980s, there were thousands of drug
abusers/addicts across the nation. Today, there are a few million
drug abusers/addicts.

Another current reality is that within Indonesian culture
there exists a subculture, a youth-movement, which plays to the
proverbial lifestyle of "sex, drugs and rock 'n' roll".

They are video-game-ed, internet-ed, MTV-ed, sinetron-ed,
shopping mall-ed, hip-hugger-ed and cap-ed, fear-factor-ed, fast
food-ed young people looking for, and wanting to be part, of the
next "craze, rave and crave". The reality is that many of these
youth are exposed to the most high-risk populations of people
susceptible to becoming infected with HIV or already infected
with HIV.

Education top strategy

The reality is that there will be more new HIV infections
tomorrow. The spread-rate increases daily. The number one defense
against HIV/AIDS still remains education.

If, and on a national level, there is not a radical shift
concerning the importance of education, and these subjects are
not (respectfully) and directly spoken about and taught, in the
language of facts and reality, beginning at the junior high
school level through the universities, there will be many more
HIV/AIDS cases throughout Indonesia.

Education also must cover the reality of drug use, abuse,
addiction, reproductive health, sex and sexuality.

Today we are at a place and time when we must speak of both
prevention and intervention when discussing HIV and AIDS.

We, as a family-oriented nation, are ill-fated if we wait upon
the resources of government, officials, schools, religion, the
medical profession and medicine, business and organizations to
help with prevention/intervention and assistance with HIV and
AIDS. We all need to put an honest effort into changing the
course of the epidemic.

As in the World AIDS Day theme this year, "Stop AIDS: Keep the
Promise", it is no longer time to just make promises.

Indonesia needs strong leadership, committed and responsible
action, medical agencies and services, and programs that are
specifically designed to aid in the fight against HIV/AIDS.

As Piot explained, while President Susilo Bambang Yudhoyono
has expressed a clear commitment to fighting AIDS, the same level
of commitment is needed from all levels of society

Both prevention and intervention are absolutely necessary to
understand and are related to each other. Both are equally
important. And in the home, even before schools begin educating
students about HIV/AIDS, moms and dads must be the main teachers
in educating their children about HIV/AIDS and protecting them
from the virus.

Meaning that mom and dad must themselves learn about HIV/AIDS
and related issues surrounding the virus. Parents must also be
role models at home.

We, as a nation, are still years away from containment and
then a reduction of HIV/AIDS. Indonesia is no longer considered
in the low-stages of the pandemic; we have now entered the high-
risk category. There is much we can do, and much we must do.

The key to minimizing, containment and reduction of HIV/AIDS
is the word "we". If we work together, as a family, in the
Indonesian sense of gotong royong (mutual work), beginning with
education in the home, then within schools, there is much we can
do, but if not we will surely suffer far greater consequences
than what we are already suffering.

The authors, David Gordon and Joyce Jaelani Gordon, are directors
of the Bogor-based Permata Hati Kita Foundation (YAKITA), a drug
rehabilitation and addiction recovery center.