Women with HIV/AIDS need 'greater care'

Hera Diani, The Jakarta Post, Jakarta

Frika Iskandar says it took her over a year to accept that she was HIV positive. Of course, she was only 18 when she learned she had the virus.

Six years later, much more assured and confident, the 24-year- old student has accepted that she is HIV positive, but what she cannot accept is that women living with HIV/AIDS in Indonesia have a much tougher time than men infected with the virus.

"Access to health services, particularly women's reproductive health services, is very limited. It is difficult even to get a Pap smear. The staff at hospitals and clinics often do not want to do it because we are HIV positive. And if they do, we have to pay more," she told The Jakarta Post on the sidelines of a discussion on women living with HIV/AIDS last Thursday.

The types of antiretroviral (ARV) drugs available here are also limited, while the ones that are available, such as Efavirenz, can affect fertility and damage fetuses.

"Limited access to health services and drugs are very serious because the number of opportunistic infections for women is higher (than for men). Yet there is very little information about it," Frika said.

The patriarchal society in the country creates a double stigma for women living with HIV/AIDS, who are often assumed to be drug addicts or sex workers.

Also, the generally weaker position women occupy in the family and society, a lack of education and skills, as well as economic dependency on men, mean women living with HIV/AIDS are often on their own in dealing with the disease.

"Despite their ailment, women still have to serve their families. They also often lose custody of their children once they are infected with HIV," said Frika, who has actively been involved in local campaigns to fight HIV/AIDS.

Because of this many women are reluctant to talk about their situation, which has led to the underreporting of the number of cases of women living with HIV/AIDS.

Women's activist Debra Yatim compared the double stigma and discrimination faced by women living with HIV/AIDS with men and women who were homosexuals.

"When a man comes out of the closet and tell people he is gay, somehow people are more tolerant. But it is different with women who say they are lesbian," she said during the discussion on Thursday.

The situation has prompted organizations dealing with HIV/AIDS to launch the Indonesian Positive Women's Agreement (IPPI) aimed to shine a light on the unique problems and needs of women living with HIV/AIDS.

"Women with HIV/AIDS have their own specific problems that need special handling, but they have never been accommodated by any support groups in Indonesia," Frika said.

She said IPPI was a network that helped members meet the needs of women living with HIV/AIDS.

"Aside from exchanging information, we also ask for greater involvement from every party, not just people living with HIV/AIDS," Frika said.

She voiced concern over women's organizations, which she said seemed detached from HIV/AIDS issues.

"It is different in Thailand, where the women's organizations are united. Here, despite the same goals, it is tough to get them united.

"HIV is a very complicated issue, particularly for women. It takes networking and a collective effort to help women feel more confident and supported," Frika said.