People with HIV need access to ARV
The Jakarta Post, Jakarta
Nine months ago 20-year old former drug user Budiyanto begged his mother to end his life when he was tested HIV positive.
"I was suffering from chronic diarrhea and hepatitis C when the doctors gave me the result," he said. "It made even the medical workers discriminate against me at a time when I was barely able to stand up and needed medication."
His life, however, has substantially improved after he found access to free anti-retroviral (ARV) therapy at another hospital. The combination of drugs he takes twice a day has restored his vitality, allowing him to volunteer as a peer counselor for HIV positive people.
Budiyanto is among the "lucky" ones to have access to the drugs that help prevent the progression of the disease. Out of the 10,000 people living with HIV/AIDS (PLWHA) targeted to receive the medication this year, only 3,000 have access to it, a government report released on Friday said.
The number is a small fraction of the estimated 130,000 people with HIV/AIDS in the country. The government disbursed Rp 24 billion (US$2.53 million) for free antiretroviral drugs for 10,000 people living with HIV/AIDS (PLWHA) last year.
"There has been a mismatch between the hospitals providing ARVs with the patients," National AIDS Commission representative Suharto said late last week.
He explained that fear of discrimination has prevented people from coming out with their illness and asking for medication. "Discrimination is also experienced from medical workers who are reluctant to serve patients with HIV/AIDS."
He added that the fact that the free HIV/AIDS medication did not cover opportunistic infections drove PLWHA further away from receiving ARVs.
Budiyanto admitted that before he was treated with ARV, his lung and liver infections had to first be dealt with. "It was quite expensive and it was not free like the ARV," he said.
Other hindrances, Suharto said, were the limited ARV centers and volunteer consultants to help educate the PLWHA on the importance of medication.
"One of my friends stopped taking ARV drugs once the symptoms were gone," Budiyanto said. "Such behavior makes one resistant to the same drugs, and then the patient will require different and more expensive medication which is not on the list of free drugs."
ARVs are actually available at 25 selected hospitals in 13 provinces across the country, including Cipto Mangunkusumo General Hospital in Central Jakarta, Dharmais Cancer Hospital in West Jakarta, Hasan Sadikin Hospital in Bandung, West Java and Dr. Soetomo Hospital in Surabaya, East Java.
Although it will not cure AIDS, the recommended first-line combination of zidovudine, lamivudine and nevirapine will help increase the low CD4 cell count found among people with HIV/AIDS.
A CD4-cell count equal or below 200 cells per cubic mm is thought to reflect a vulnerability to opportunistic infections. A normal count in a healthy adult can vary but is usually between 500 and 1,500 cells per cubic mm.
CD4 cell is a type of lymphocyte that coordinates the immune system's response to certain microorganisms.(003)