Stigmatization Persists for People Living with AIDS
Indonesia is facing a huge challenge in achieving its HIV mitigation targets, including the reduction of new infections, the end of HIV-related deaths and the end of discrimination against people living with AIDS in 2030. Even today, stigmatization persists for people living with AIDS.
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ANTARA FOTO/RAISAN AL FARISI
Students from various campuses conduct an antidiscrimination campaign in the Car Free Day area in Dago, Bandung, West Java, on Sunday (2/12/2018). Held in commemoration of World AIDS Day, the antidiscrimination campaign encouraged the public to shed the social stigma against people with HIV/AIDS.
JAKARTA, KOMPAS — Indonesia is facing a huge challenge in achieving its HIV mitigation targets, including the reduction of new infections, the end of HIV-related deaths and the end of discrimination against people living with AIDS in 2030. Even today, stigmatization persists for people living with AIDS.
The Health Ministry’s HIV and sexually transmitted diseases subdirectorate head, Endang Budi Hastuti, told a World AIDS Day press conference in Jakarta on Monday (3/12/2018) that the government should improve its efforts to achieve the targets. Attending the press conference were Indonesian country director Tina Boonto of the Joint United Nations Program on HIV/AIDS (UNAIDS) and people living with AIDS rights organization Positive Indonesia Network research and advocacy manager Verdy Tee.
Widespread stigmatization for people living with AIDS in Indonesia has led to the reluctance of many from being open about their health status. “Acceptance of people living with AIDS remains low. When the environment is not ready, people living with AIDS are often discriminated against,” said director Aditia Taslim of advocacy organization Rumah Cemara in Bandung on Monday.
In providing counseling to children with HIV/AIDS, the organization often does not inform the children’s schools regarding their health status. This is based on the consideration that the child may be shunned by his or her friends and teachers.
Bandung resident Iva, 35, who wished to use an alias for this story, said her status as a person living with AIDS resulted in her child being excluded in school. “I have explained my status to other parents. My child is HIV negative. Ever since I was pregnant and after I gave birth, I carefully follow the correct procedures to prevent transmitting the disease to my child,” she said.
Aditia said information dissemination on HIV/AIDS should be improved significantly so that the public at large understands its modes of transmission and do not unnecessarily stigmatize people living with AIDS. Multiple approaches must be included in promoting HIV/AIDS-related health topics to ensure that the general public has comprehensive knowledge of the disease. “HIV is not the only issue here. Public access to medical treatment should also be discussed,” he said.
Advocacy organization Mahameru Foundation director Farid Hafifi said in Surabaya on Monday that people living with AIDS should fully accept their health status in order to obtain comprehensive knowledge on their own disease. This will be the start of improving their quality of life as persons with HIV.
Verdy said there were many obstacles in successful therapy for people living with AIDS, including low understanding on HIV, poor antiretroviral (ARV) therapy, the presence of anti-ARV groups, therapy’s side effects, public stigmas and discrimination. Many people living with AIDS refuse to reveal their HIV-positive status even to the people closest to them.
When taking medicine, many people living with AIDS are not educated properly, leading to poor knowledge on their disease and lack of knowledge with regard to the importance of therapy. Many people living with AIDS do not know that ARV drugs are covered by the National Health Insurance-Indonesia Health Card (JKN-KIS) scheme.
Check health status
Endang said there were around 49,000 new cases of HIV infections and 39,000 HIV-related deaths in Indonesia. Of the estimated 630,000 persons with HIV-positive status in 2017, only 48 percent were aware of their personal health status and 15 percent had undergone ARV therapy. Furthermore, 0.64 percent of people living with AIDS in Indonesia have undetectable viral loads.
In the 90-90-90 target-achieving acceleration, it is aimed that 90 percent of people living with AIDS become aware of their health status, 90 percent of them become aware of their health status and undergo ARV therapy and 90 percent of them undergo therapy and have undetectable viral loads. “Without the acceleration, there will be no significant case reductions in 2030. We want to reduce the number of new infections, increase the number of people living with AIDS who are aware of their status and undergoing therapy and reduce the number of HIV-related deaths,” Endang explained.
Furthermore, the high prevalence of coinfection of HIV and tuberculosis (TB) and pregnant mothers infecting their fetuses remain huge challenges. In 2016, an estimated 1 million people living with AIDS contracted TB and died from it.
The number of healthcare facilities capable of TB treatment far outnumbers those providing HIV care. However, not all of the TB-capable healthcare facilities also provide HIV care, thereby limiting service coverage for people with both HIV and TB.
Globally, Tina said, there remained gaps between the 90-90-90 target and achievement. Only 75 percent of people are aware of their status, 79 percent of them aware of their status are undergoing ARV therapy and 47 percent of them undergoing therapy have undetectable viral loads. There are still 1.4 million people living with AIDS globally with detectable viral loads. “The world is still far from achieving the target,” she siad.
In Asia-Pacific, Indonesia is on par with India (31 percent) and China (22 percent) in the top three of countries with the largest new cases of HIV infections.
