'Prevention is key' to fight against AIDS

'Prevention is key' to fight against AIDS

By Wirasti Wiryono

YOGYAKARTA (JP): Doctors must continue enforcing the proper
diagnosis of sexually transmitted diseases and maintain patients'
confidentiality, including those infected with HIV/AIDS, a
medical expert said recently.

Director of the AIDS counseling and testing center Pelita Ilmu
Foundation, Dr. Samsuridjal Djauzi, told 20 print journalists at
a recent workshop on media training about AIDS here that a person
can carry the syndrome for five to seven years before showing any
sign of it, a prevalent situation among HIV/AIDS carriers.

Samsuridjal called for an increased awareness of HIV, the
virus that causes AIDS, and said health care professionals should
practice universal precautions, diagnosing and treating sexually
transmitted diseases frequently found in Indonesia. He said the
lack of HIV counselors meant doctors had to understand the basics
of AIDS counseling to be able to help their patients.

He said that anonymous HIV testing and proper monitoring need
to be increased nationwide.

Ninety percent of HIV/AIDS cases in Indonesia is from sexual
intercourse and prevention is the key to promoting public
awareness about the syndrome because treatment for AIDS is
costly, he said.

The costs of treating an HIV/AIDS carrier are staggering, with
basic treatment reaching as much as Rp 144 million (US$58,872)
over three years for medication and one year of blood tests worth
Rp 9.6 million, he said.

The medications available on the market include AZT, DDI, DDC
and Zidovudine.

In a book titled Sebelas Langkah Memahami AIDS (Eleven ways to
understand AIDS) published by the Yogyakarta Institute of
Education, Research and Publishing (LP3Y), the use of water-
based, not oil-based lubricants with condoms is promoted in the
prevention of HIV/AIDS. This is to avoid tears in the latex
condoms. Female condoms can also be used if a person develops
allergies to latex condoms.

Differing views

Samsuridjal expressed his concern about the differing figures
on HIV/AIDS cases in Indonesia. Neighboring Malaysia reported
20,000 HIV cases as of December 1996 while Thailand reported
800,000.

According to official figures released by the Ministry of
Health, there are currently 545 HIV/AIDS carriers in 21
provinces.

"HIV/AIDS carriers need tremendous public acceptance and
support, not 'quarantine'," he said. "The best treatment that the
public can afford currently to fight AIDS includes a healthy
diet, use of medications available at public health centers and
for the more affluent, a combination -- known as cocktail -- of
AIDS medications."

HIV enters the human body through unprotected sexual contact,
blood transfusions and can also be transmitted from a HIV
positive pregnant woman to her baby. The virus attacks white
blood cells known as CD-4, which helps to maintain the body's
immunity levels.

The US-based Center for Disease Control and Prevention (CDC)
defines a person infected with AIDS as having CD-4 count of
200/mm3 (per cubic millimeter). A healthy person maintains a CD-
4 count of 1,200 per cubic millimeter. The low CD-4 count makes
the AIDS carrier vulnerable to other diseases including
hepatitis, tuberculosis, pneumonia and even a cold.

A member of the LP3Y, Rondang Pasaribu, said that HIV thrives
inside the human body, blood, sperm and vaginal fluids but cannot
survive in the open air, perspiration, tears, saliva and urine,
despite the public's continued perceptions of infection ranging
from shaking hands, hugging, kissing and swimming in pools.

Rondang said there is a "window period" of three to six
months, in which HIV infects someone but the test results could
be negative, a "false negative".

In Indonesia, HIV testing is done through the popular Elisa
and Western blot methods. Elisa tests for HIV antibodies while
Western blot confirms the positive detections, Samsuridjal said.
Testing for HIV antigens is used for cases where tests for
antibodies are difficult to detect, he said.

Samsuridjal said that testing must be voluntary, maintain
confidentiality, and include informed consent and counseling. He
acknowledged that violations of these procedures persist, causing
a person with HIV undue anxiety, seclusion or worse, feelings of
suicide.

Pretest and posttest counseling help a person who could test
positive or negative for HIV accept the situation and prepare
ways to cope with the carrier's problems more constructively, he
said.

Minister of Health Sujudi warned on June 15 that the spread of
AIDS would affect one to 2.5 million Indonesians by the year
2000, Antara reported. The figures were estimated from the
ministry and epidemiologists.

During his three-day official visit to West Sumatra, Sujudi
said that by 2000, there would be 30 to 40 million people
infected with HIV/AIDS worldwide, with 80 percent of them in
Asia.