Needle swapping, top HIV/AIDS risk in RI

David and Joyce Djaelani GordonDirectors of Yayasan Harapan Permata Hati Kita Drug Recovery Center and Community Ciawi, Bogor

Only a few years ago Indonesia was passed over by the World Health Organization (WHO) as a high-concern country predicted to have an outbreak of HIV/AIDS.

Today, Indonesia is on the list of countries experiencing a major outbreak of HIV/AIDS. New official reports exclaim, "there are at least (the actual figure is much higher) 120,000 people currently infected with HIV/AIDS".

Out of the estimated 120,000 infected with HIV/AIDS, 43,000 are intravenous drug users.

A few years ago, Indonesia felt there was now risk of a real problem with drug abuse and drug addiction. Now there are an estimated four million drug addicts across the country. Most of the addicts/junkies are aged between 14 and 28 with the highest percentage between 18 and 24 years old.

Today it is easy to buy putaw (heroin), shabu (methamphetamine), ecstasy and marijuana, in addition to various pills (depressants and amphetamines) in most junior high schools, high schools and universities across the country. Parents and teachers are becoming frantic about how to deal with the drug problems found at home and within schools. Putaw remains the favorite drug for the addicts. More and more youths are using and sharing needles while using this drug.

Needle use and sharing is often seen to be a ritual, and a rite of passage. Many youths are coerced by their peers to try this needle ritual for fun and excitement and to enable them to be a part of the group.

Approximately 75 percent of addicts in the Greater Jakarta area are using and sharing needles today, compared to 15 percent back in 1995.

Those young people do not realize that sharing needles is the most effective way of becoming infected and spreading the HIV/AIDS virus. Drug use, drug abuse and drug addiction, needle use and needle sharing are all growing at uncontrollable rates here. And the drug user community is today the number one community being infected and spreading HIV/AIDS, not to mention Hepatitis C. In addition to drug addicts, sex workers -- both male and female -- are now also infected with HIV/AIDS. In recent findings, 3 to 6 percent nationwide, or approximately 8,000 sex workers, are infected with HIV/AIDS.

There are up to 300,000 sex workers in the country, many of whom are under 18-years-old. The number of young men involved in the sex industry is also growing.

A few years ago, Indonesia had no fears of an outbreak of HIV/AIDS within the heterosexual population. But it is different now as more men and women, particularly women, from the general population are testing positive for HIV/AIDS.

Why?

Because boyfriends and husbands are having sexual encounters with sex workers, who are HIV/AIDS positive and then infecting their monogamous female partners back home. It is important to notice that sexual transmission is the second most efficient way to become infected and spread HIV/AIDS. Intravenous drug users and sex workers are two main groups that need direct assistance. Various education campaigns on the risks involved with drugs and sex are also needed immediately. It is too bad that the national program on this issue remains in the planning stage. To this day, there is still not one hospital in the country that specifically administers to people infected with HIV, AIDS, Hepatitis C or Tuberculosis.

Drug Addiction and HIV/AIDS are moving so fast that we cannot possibly curb either epidemic. What we can do is to act. The government, for many reasons, is still bogged down with monumental problems, while we, the community, have lots of things that we can do.

Firstly we must educate ourselves, our families and our children's schools before holding a community or school meeting. Then we are ready to act.