JP/18/BDNG

JP/18/BDNG

Lack of information hinders HIV/AIDS treatment in W. Java

Yuli Tri Suwarni
The Jakarta Post/Bandung, West Java

Siti Suhyati, a 38-year-old housewife in south Bandung, could
only shudder when her daughter Della, a 12-year-old junior high
school student, asked her about HIV/AIDS.

"Basically, it is an incurable disease. Just pray to God that
we never contract this disease," Siti, who sells snacks to
support her three children, told her daughter.

However brief and incomplete Siti's explanation to her
daughter, it was probably the same basic answer most parents in
West Java would give their children when asked the same question.
If they answered at all, rather than just shaking their heads to
show their complete ignorance about this important subject.

The people of West Java, Indonesia's most populated province,
run the same risks of being infected with HIV as other
Indonesians. This is why it is vital they are educated about
HIV/AIDS.

Take Siti, for example. She does not think her family is at
risk of infection, but her husband, eight years her junior, has
two other wives whom Siti knows nothing about.

According to records from the West Java Health Office, in 2002
about 1.5 million residents of West Java were categorized as
vulnerable to HIV infection.

This figured included some 23,000 injecting drug users, 18,000
commercial sex workers and about 650,000 men who frequented
prostitutes.

This number did not include wives put at risk of HIV infection
by husbands who were injecting drug users or who had unprotected
sex outside the home.

The current state

Rumah Cemara (Casuarina House), a non-profit organization
working with drug users and people living with HIV/AIDS, has seen
many former drug users die without ever agreeing to get tested
for HIV or tuberculosis (TB), putting their wives and children at
risk.

"Many drug users stop taking drugs but refuse to get tested.
Then they get married, have children and die of TB, for example.
We never really know whether they died because they were HIV
positive and their immune system was compromised. We also do not
know what will happen to their children and wives," Ikbal Rahman,
the director of Casuarina House, told The Jakarta Post.

In recent years there has been a significant rise in the
number of officially reported HIV/AIDS cases in West Java, and
many see this as a sign of the authorities' failure to educate
residents about the virus.

In terms of rate of infection, West Java unfortunately finds
itself among the top six provinces, along with Papua, Riau
(Batam), Bali, East Java and Jakarta. Proper information about
HIV/AIDS is needed not only to improve public awareness, but also
to correct some of the misinformation out there that has led
people living with HIV/AIDS to be shunned.

Since the first HIV case was officially detected in the area
of Ciwidey in southern Bandung in 1989 to June 2005, the West
Java Regional AIDS Management Commission (KPAD) has recorded 268
cases of AIDS and 1,042 cases of HIV. However, West Java KPAD
estimates there are closer to 23,385 cases of HIV and 3,367 cases
of AIDS in the province.

Tio Indra Setiadi, secretary of West Java KPAD, said the
commission has collected data in all 25 municipalities and
regencies in the province, except for Banjar. The areas of
Bandung and Bekasi have the largest number of HIV/AIDS cases in
the province, with 561 and 166, respectively.

The commission says 61 percent of HIV cases in West Java are
caused by drug users sharing needles.

The second leading cause is unprotected sex. In terms of age,
over 50 percent of those infected with HIV are between 20 and 29
years old.

"If the HIV/AIDS awareness campaign and the dissemination of
information about HIV/AIDS continues as it is, an explosion of
HIV/AIDS cases in West Java is inevitable," Ikbal said.

Currently, the dissemination of information about HIV/AIDS and
the provision of medical care for people living with HIV/AIDS is
centered only in major cities like Bandung.

Meanwhile, slowly but surely, the number of HIV/AIDS cases in
smaller towns continues to rise. According to Ikbal, awareness
campaigns and concrete action regarding HIV/AIDS have been
conducted only among at-risk groups in major cities.

In addition, support for these campaigns has come only from a
few people living with HIV/AIDS themselves, their families and
non-governmental organizations, with very little help from the
government.

Ikbal cited an experience in the towns of Cianjur and Sukabumi
as a warning. It was estimated there were only 100 injecting drug
users combined in the two towns, but a survey in early 2005 found
this number was much larger.

"We found there were many commercial sex workers who were also
injecting drug users. Even in Bandung and Cianjur, which are
relatively close, the data is wrong and authorities are not
serious about the handling of HIV/AIDS cases, let alone in far-
off Banjar," he said.

Casuarina House has found that about 84 percent of injecting
drug users who are tested are found to be HIV positive.

What to do?

Ikbal said non-governmental organizations had conducted
HIV/AIDS campaigns and taken harm reduction measures only among
at-risk groups because most of the funds donated from abroad
required the money to be spent on these groups. And the 14 non-
governmental organizations in West Java dealing with HIV/AIDS are
not able to reach all of the groups at risk, he said.

KPAD, which was set up in 1995 at the instruction of the
central government, has become the central body in the fight
against HIV/AIDS in the province, helping to direct assistance
and information where it is most needed.

Unfortunately, Tio said, KPAD is still unable to reach
everyone. He said the commission was handicapped by a lack of
funding as well as the stigma still attached to HIV/AIDS, which
inhibits people from being open about the matter.

"The deputy governor (Nu'man Abdul Hakim) has sparked protests
by his promotion of the use of condoms. Many people, for example,
think the distribution of hypodermic needles to drug users, which
is a harm reduction activity, encourages people to use drugs,"
Tio noted.

Therefore, he went on, the awareness campaigns now being
developed simply approach regional administration officials,
members of the regional legislative assemblies, the police and
religious figures, rather than going directly to the public.

In the future, West Java KPAD plans to disseminate information
on HIV/AIDS to housewives active in village family welfare
programs.

As for money, the commission has seen its funding increase
from Rp 600 million in the 2004 provincial budget to Rp 2.5
billion in 2005. About 40 percent of this allocation is for
HIV/AIDS awareness campaigns, with the remaining 60 percent for
surveys and social and coordination activities.

At the end of the day, however, whether information on
HIV/AIDS reaches everyone in West Java will depend on the
political will of the provincial administration.

Will the governor push through the necessary policies to
battle HIV/AIDS before the province experiences an explosion in
the number of cases and more people die unnecessarily?

The governor needs to show the same political will regarding
HIV/AIDS as he showed when ordering all civil servants to wear
batik every Friday. Everyone would agree that HIV/AIDS is a much
more pressing issue than the fashion sense of West Java's civil
servants.