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Education key to preventing HIV/AIDS among housewives
With the Health Ministry’s data showing that housewives are the group most vulnerable to HIV/AIDS in Indonesia, a female reproductive health forum has said that educating women on reproductive health rights and fighting the stigma against people living with HIV/AIDS (PLWHA) are key to prevention
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span>With the Health Ministry’s data showing that housewives are the group most vulnerable to HIV/AIDS in Indonesia, a female reproductive health forum has said that educating women on reproductive health rights and fighting the stigma against people living with HIV/AIDS (PLWHA) are key to prevention.
The ministry’s data shows that 14,721 of the 102,667 PLWHA recorded between 1987 and 2017 were housewives. The figure is higher than the 3,314 sex workers with HIV/AIDS.
Housewives were at risk of HIV transmission from their husbands due to their lack of knowledge in reproductive health rights, said Hartini, an activist of the Indonesian Positive Women Network (IPPI) who is HIV-positive.
Hartini was infected with HIV by her former husband. By the time she was diagnosed in 2008, she was already in clinical stage 4 of HIV, which is defined as the viral infection’s progression to AIDS.
“I was just an ordinary housewife at the time, a little too naive, even. I thought I would never get infected because I was not a sex worker or a drug user,” she said last week at a discussion forum on female reproductive health in South Tangerang, Banten.
“However, I was infected because I failed to notice my former husband’s risky behavior,” said Hartini.
HIV transmission from husbands to wives was common in the country, said Dr. Adiyana Esti of the Angsamerah Foundation that specializes in sexual and reproductive health.
Esti said that while husbands were commonly reluctant to be tested for HIV/AIDS due to the stigma against PLWHA, their wives were often afraid to ask their husbands to use condoms to prevent HIV transmission.
Hartini concurred, adding that from her experience as an HIV/AIDS counselor, husbands tended to take the lead among married couples, which left housewives with the short end of the stick.
Ratri Suksma, who is also HIV-positive, said she was infected by her ex-husband, a former drug user, because he refused to be tested for HIV.
“I asked him to take the HIV test before we got married, but he lied to me and told me that he had already tested negative,” she said.
The Health Ministry’s data shows that 71,502 PLWHA reported in 2017 were infected with HIV through heterosexual intercourse.
Esti, Hartini and Ratri said these cases were “unfortunate”, because heterosexual transmission could be prevented in many ways. However, the lack of awareness and the stigma against PLWHA had resulted in public ignorance of preventive measures.
The ministry’s 2018 Basic Health Research (Riskesdas) shows that 65.2 percent of Indonesians have poor knowledge of HIV/AIDS.
This was evident in recent cases in Samosir, North Sumatra and Surakarta (West Java), in which students living with HIV were expelled from their schools because their parents were afraid that the students could transmit the virus easily.
Advancements in medicine, like the development of antiretroviral (ARV) drugs, have improved the life expectancy of people with HIV/AIDS. The mortality rate of PLWHA in Indonesia has declined from 8.47 percent in 2007 to 1.08 percent in 2017.
Taking preventive measures like using condoms and participating in family planning programs, has also allowed people living with HIV/AIDS to have families without transmitting the virus to their partners or children.
“The most important thing for preventing transmission is to educate women on their sex lives and reproductive health,” said Hartini.
She suggested that relevant ministries run educational programs for women of reproductive age, which could also help reduce cases of perinatal transmission. Records from 2017 show that 3,020 cases were mother-to-child transmission of HIV.
Several local administrations, including the Jakarta administration, are encouraging couples to be tested for HIV/AIDS during their premarital health checks at puskesmas (community health centers) for obtaining marriageability certificates and wedding permits. An HIV/AIDS counselor was available at each puskesmas to assist with the health checks.
Hartini lauded the effort, but expressed concern that such regulations could violate the right to marriage of people living with HIV/AIDS. as the stigma against them could potentially cause their wedding to be cancelled.
“We are worried that the [HIV/AIDS] counselors are not [trained] to provide the couples the correct information to assure them that they can get married without transmitting the virus to their partners or children,” she added.
Ratri said that requiring marriageability certificates could also imply that people living with HIV/AIDS were not eligible for marriage.
“We need to be sure that the premarital test will not separate the couples, but help them seek a solution. [To this end], we still need counselors that do not perpetuate the stigma against people with HIV/AIDS,” said Esti. (ars)
