As safe-sex campaigns fail, HIV spreads beyond high-risk groups
Elly Burhaini Faizal
The Jakarta Post
Nine years ago housewife Mirza “Vivi” Revilia gave birth to a girl. She was a young mother who had no idea what HIV was or how it would affect her life.
She suspected that something was wrong when Putri, her newborn, suffered from severe diarrhea, mouth ulcers and the flu. How could such illnesses occur in an infant aged only 40 days? The first thing that popped into her head was that her husband, an intravenous drug user, might have caused the problem.
Vivi said it was the most difficult part of her life when she and her baby were diagnosed with HIV. “I was not a drug user. I didn’t even know a thing about the disease at that time,” Vivi told The Jakarta Post.
The 33-year-old is currently an activist with the Yayasan Partisipasi Kemanusiaan (Partisan), an NGO led by Jim Aditya for housewives infected with HIV by their husbands.
Many women with HIV from low-risk groups have been infected by husbands who were not aware of or did not reveal their status until they married.
“Just as happened to me, many women are unaware that their partners are HIV-positive until they married,” Vivi said.
The number of new HIV cases in Indonesia continues to climb. According to the Health Ministry, there were 21,591 HIV cases in Indonesia in 2010, up from 14,427 cases in the previous year, while AIDS cases reached 4,917 in 2010, up from 3,863 in 2009.
Unlike previous years, women who are married or are in long-term relationships are at greater risk from heterosexual transmission of HIV compared to commercial sex workers or injecting drug users.
Studies show that about 90 percent of women living with HIV in Asia are infected by their husbands or long-term partners.
According to the Health Ministry’s subdirectorate for AIDS and sexually-transmitted disease control, the number of people who contracted HIV through sex with intravenous drug users comprised 34 percent of new cases in 2010, down from 53 percent in 2005. However, the number of people contracting the disease from heterosexual sex was 55 percent in 2010, up from 37 percent in 2005.
The phenomenon shows that anyone can be affected by the disease.
“Most ‘high-risk men’ including injecting drug users and cheating husbands may not only suffer from the disease but also infect their own wives. HIV-infected spouses in turn will pass the virus to their unborn children. It’s an appalling ping-pong phenomenon,” Tony Wendra, the Health Ministry’s HIV control director, said.
As most HIV infections are transmitted through sexual intercourse, condom use must still be part of HIV prevention programs.
With condom use, risks of unsafe sex can be reduced by 70 percent, according to a report.
Thailand is one country that achieved a sustained reduction in HIV infections by promoting consistent condom use by commercial sex workers.
In Indonesia, condom use campaigns aimed at halting the spread of HIV have not reached their targets.
The rate of condom use by men in high-risk groups was only 16 percent, and 32 percent for women, as of 2010 — short of the 70 percent rate needed to stop transmission.
Traditional and religious leaders, however, have been reluctant to promote a 100 percent condom use campaign.
“People in high-risk groups generally are somewhat reluctant to use condoms as it is still seen as a taboo. Without condoms, heterosexual transmission will continue to soar,” Tony said.
The closing of red-light districts such as Kramat Tunggak in North Jakarta have made fighting HIV transmission more difficult as commercial sex workers now meet with clients in various locations.
Nafsiah Mboi, the National AIDS Prevention Commission (KPA) secretary-general, said a more integrated program including HIV prevention, care, support, treatment and anti-stigmatization measures, was need to halt HIV.
“Preventing social stigma against HIV victims will be important as well since it may prohibit people from seeking treatments needed to halt the spread of the disease,” said Nafsiah.
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