HIV/AIDS threat gets more worrying with every passing day
HIV/AIDS threat gets more worrying with every passing day
David and Joyce Djaelani Gordon, Contributors, Bogor, West Java
HIV/AIDS is spreading across Indonesia faster than we can
identify and verify, and many who were considered at low risk
just a few years ago are now thought to be vulnerable or exposed
to higher risks.
Often, conversations with lay people, unfortunately, confirm
that they believe Indonesia is still viewed as low-risk for HIV
transmission.
This unjustly conceals the reality that tens of thousands are
already infected -- and many millions more individuals are now
vulnerable and now at high risk as the HIV/AIDS virus flash-
spreads across Indonesia, from Aceh to Papua, in uncontrolled
fashion.
Indonesia is still in the First Phase of escalation with the
HIV/AIDS pandemic, not the newly-quoted Second Wave which is at
present aggressively striking many parts of the world.
The Second Wave -- in places, nations and areas where new
infection rates had leveled off and stayed fairly constant for a
period of time -- are currently experiencing a rise in rates of
new infections. This is now being called, and justifiably so, the
Second Wave.
Indonesia, just a few years ago, was looked upon as a "low-
prevalence" nation, with concentrated pockets of high infection
rates among some focused high-risk-groups.
High-risk groups
Much has changed; at present, high-risk groups include sex
workers (both male and female) drug abusers and addicts,
especially injecting drug users (IDUs), and now common drug
users, individuals that are not injecting users but are sexually
active yet without practicing safe sex.
Also included are men who have sex with men, because of unsafe
sex practices; males and females in prisons, because of the
(extremely) high rate of unsafe drug use, especially needle-
sharing when inmates manage (often) to get drugs into prisons,
unsafe sexual practices and prison tattooing.
Migrant workers are also perceived to be at high risk, because
their work takes them away from their home areas, and some often
seek out the services of sex workers, indulging in unsafe sex
because of very rare condom usage; many are also known to drink
(which if done to excess can result in loss of self-control) and
use drugs.
Truck, becak and taxi drivers are at risk due to unsafe sex,
while the risk of greatest concern today is young people. Why
young people? Simply because young people, with their curiosity,
search for fun and excitement, naivete and desire to conform with
their peers, are open to all the above risks.
It is no wonder that young people, in the 15 to 30 age group
represent the largest percentage on the HIV infection charts
across the nation.
Within these groups of young people, in general, women are
especially at risk. Even if they are not involved in drug use or
abuse themselves, they are often involved with men who use drugs
and/or inject drugs, or have habits/patterns of other high-risk
behavior.
Since women are physically more vulnerable to sexual
infections compared to men, more are becoming infected with
HIV/AIDS in ever-increasing quantities. Also, as with women, we
are beginning to see an increase in newborn babies with HIV,
babies that have to begin antiretroviral therapies shortly after
they are born.
Now, a factual and alarming realization: Since 2002, Indonesia
has been using estimates that there could be some 90,000 to
130,000 infected with HIV/AIDS. These numbers are now over three
years old, and thus obsolete by most mathematical standards.
Specialists estimate that the rate of new infections during
the years 2002, 2003, 2004 and half way through this year is
about 30,000 to 40,000 new infections per year.
Projecting these approximations to the present, halfway
through 2005, on the low side about 180,000 would be infected
with HIV/AIDS, and on the high side over 250,000 are infected.
Those figures would seem to be much more realistic.
By 2010, approximately 16 percent to 20 percent of the
nation's population, of approximately 230 million people could
or will be "at possible risk" of infection from HIV/AIDS.
That means approximately 38.8 million on the low side and 46
million on the high side, "could" be vulnerable or at risk of
contracting the virus. This does not necessarily mean they will
be infected by the virus.
Young especially at risk
It does mean, though, that they could be vulnerable or at
risk, of becoming infected a more aggressive campaign and large-
scale intervention is done to prevent HIV from spreading.
However, if there are only limited amounts of services, programs,
and funds available, then as a nation we must put more effort
into common sense approaches and increase work in two areas of
prevention; curbing unsafe sex and curbing needle-sharing.
Yet, curbing unsafe sex could be problematic, if findings from
a study done by UNICEF about young people are an indicator of
what we can expect. In the study done by UNICEF with 1,034
respondents aged 14 to 17, 84 percent responded that they did not
know much about HIV/AIDS, and a whopping 73 percent could not
even explain what a condom is.
In 2003, the Indonesian Ministry of Health estimated that
there were some 124,000 to 196,000 IDUs throughout the nation,
although some experts said, "the actual numbers could be as high
as a million IDUs".
Most of the drug users/abusers are young people, and hence it
is not alarming to find that the majority of new cases of
HIV/AIDS infection in Indonesia are people in their twenties, and
two-thirds of them are sexually active. Another study done in
Jakarta and Bali by Yayasan Harapan Permata Hati Kita (YAKITA)
and the Ford Foundation (2003) found that 27 percent of HIV-
positive addicts in recovery at YAKITA were aged 16 to 20, 47
percent 21 to 25, and 22 percent 26 to 30, compared with 2
percent for those aged 31 and above. The same study also found
that most young addicts had lost their virginity by the time they
were 16 years old, while 83 percent reported that they rarely or
never used condoms.
So young males and females between the ages of 16 and 28 are
the ones who are and will be infected most. The youth are the
most sexually active and the ones that use and abuse drugs the
most.
Fast track
Indonesia has decided to fast-track its approach to a number
of problems: from politics to the economy, from health and
welfare to natural resources, from corruption to poverty, from
education to employment, and from transportation to pollution.
Although we do not need additional problems, we have to face
the fact that we are plagued by a virus so complex, so elusive,
so debilitating and deadly, which has already taken the lives of
thousands, and which is at present infecting and devastating the
lives of several hundred thousand-plus individuals, and which
will, without doubt, infect a million more individuals in the
coming decade.
We are confronted and humbled by the reality, the truth that
the world quest for a vaccine still remains elusive, and as a
nation we remain virtually unprepared to meet the challenges
necessary to prevent escalation of the HIV and AIDS crisis.
Each day, the numbers of those who become infected with HIV
increases, not diminishes. Let us update the figures, now, to be
more accurate about the rising numbers of people who are
infected, and what increase we can expect to see each and every
day.
If we accept the low estimates, there were 90,000 to 130,000
people infected with HIV or AIDS in 2002. With a spread rate of
approximately one person becoming infected with HIV every 15
minutes from 2003 to 2005 we must add, at least, 105,000 people
to those figures.
So, using the low estimate of 90,000 plus 105,000, that would
put the low figure of those infected with HIV/AIDS at 195,000.
This would be the lowest possible number of people infected at
present.
Indonesia is still in the First Phase of the HIV/AIDS
pandemic. Today, just this one day, approximately 96 people
across the nation will become infected with the HIV virus.
Tomorrow is another day. If it had been a bombing or a series of
bombings, then these 96 people, or more, would be seen as victims
-- with updates on the front page of all newspapers and on
television around the clock.
The media would pick up on the injustice of it all. With
HIV/AIDS it has almost been always viewed as a silent disaster,
and this should not be so. The virus still kills daily, and does
so silently.
This is the reality, no less! Unless we see these figures as
reality, and put forth the effort needed to defend ourselves and
our families, as well as the nation against HIV and AIDS, these
numbers cannot lessen but only increase.
One of these numbers may mean YOU or your loved ones. Your
children may end up being one of the fatalities. The future
begins now, and changes in our response, also, must begin now.
in box:
The authors can be contacted at
Jl. Ashari Jaya II/40, RT 04/RW 04
Sindangsari, Tajur, Bogor, West Java
tel. (0251) 244375
http://www.angelfire.com/hi/joydave
Yayasan Harapan Permata Hati Kita
Villa Pandawa YAKITA
Jl. Ciasin No. 21, Desa Bendungan
Ciawi, Bogor, West Java
(PO Box 126, Bogor )
tel. (0251) 243069/243077
wisma_srikandi@hotmail.com
http://www.yakita.or.id