KOMPAS/HERU SRI KUMOR
The parade of dozens of people who are members of the Indonesian AIDS Foundation to commemorate International AIDS Day on December 1 in a motorized-free area on Jalan MH Thamrin, Jakarta, Sunday (1/12/2019). They campaign to stay away from free sex, stay away from drugs, and ask the public not to stay away from AIDS sufferers.
The addition of new cases, access to treatment, and discrimination are still challenges in handling HIV/AIDS cases in Indonesia. The formulation of prevention and treatment efforts needs to be strengthened, to achieve the target of eliminating cases of HIV/AIDS infection by 2030.
During the Covid-19 pandemic, HIV infection continues to hit the world. Human Immunodeficiency Virus (HIV) is a virus that causes Acquired Immuno Deficiency Syndrome (AIDS), which threatens the body’s defense capabilities.
Globally, the number of HIV infections in 2020 will increase to around 1.5 million cases, while deaths from AIDS will reach 690 thousand people. In contrast to the graph of the Covid 19 pandemic which has been up and down, the global trend for HIV/AIDS cases is still showing an increase. The same thing happened in Indonesia.
It was noted that during the period 2011 to 2020, national HIV/AIDS cases tended to increase. Data on infection cases have not shown significant signs of decline. The number of new HIV infections in 2020 was almost doubled compared to 2011.
KOMPAS/HERU SRI KUMOR
A poster not to stay away from or give a negative stamp to the founder of HIV AIDS was carried by a teenager who took part in the parade to commemorate International Aids Day on December 1 in a motorized vehicle-free area on Jalan MH Thamrin, Jakarta, Sunday (1/12/2019).
Although there were ups and downs, the trend of adding cases in the last five years (2016-2020), experienced an increase of 93,253 cases compared to the 2011-2015 period. In fact, the percentage of people with AIDS compared to the number of cases of HIV infection in 2020 has increased quite significantly from last year, which was 6.6 percent.
When viewed from the age distribution, people with HIV/AIDS are dominated by the young age group with male sex. However, what is a concern is that the vulnerable group infected with this virus is also very much experienced by housewives (14.40 percent). This number is even higher than that of commercial sex workers (2.79 percent).
The situation of people living with HIV/AIDS is still one of the main health problems in Indonesia. Many people are still taboo to have their condition checked, so they are not aware of infecting others through unsafe sex or sharing needles.
Indonesia itself has a target of eliminating infection cases by 2030. In commemoration of World AIDS Day 2020, the spirit raised was collaboration and solidarity towards the end of AIDS 2030. This joint commitment is a form of seriousness in creating a healthy nation’s life.
The big goal of eliminating HIV/AIDS is certainly not easy for Indonesia. Various problems in handling cases of infection or disease due to the HIV virus have led to significant improvements. One of the latent problems is stigma, which causes a lack of public access to treatment due to feelings of shame and fear of being labeled negatively by society.
In addition to limited access to treatment due to stigma, understanding of therapy or treatment is still minimal. Data in 2020 for HIV infection did fall, but the percentage of people with AIDS increased. This illustrates the delay in therapy or medication to suppress the development of the virus, thus leading to AIDS.
In terms of health facilities, only 24 percent of government and private hospitals have antiretroviral treatment (ARV) services. At the puskesmas level, only 10 percent provide ARV services. Another problem is the unstable distribution of ARV drugs in a number of areas, and there is often a shortage at the end of the year.
The next challenge for the government is how to ensure that people with HIV/AIDS do not drop out of treatment. Notes Compass in 2016 said the dropout rate could reach 27 percent. In 2020, the Ministry of Health said that of the 215,039 people with HIV and AIDS who were undergoing treatment, there were 72,133 people who had dropped out of medication. The effect of stopping treatment is that the virus will be much more resistant, so the type of drug must be replaced with a more expensive one.
COMPASS/NIKSON SINAGA
Children with HIV/AIDS watch cartoons at the parenting shelter at the Batak Protestant Batak Christian House of Love in Nainggolan District, Samosir Regency, North Sumatra, Tuesday (16/7/2019). These children have faced discrimination at school and in the community. They were also rejected in public schools.
Should fast
Efforts to handle cases of HIV/AIDS have long been fought by many countries in the world, including Indonesia. The medical approach through treatment and care has been carried out and has saved many people. In addition to the medical approach, the government strengthens it through stricter regulations.
The complexity of the national HIV/AIDS problem needs to be unraveled and resolved quickly, in line with the government’s efforts to increase awareness of screening people with HIV status (PLHIV). The Government of Indonesia guarantees the care of people with HIV/AIDS in the Regulation of the Minister of Health Number 21 of 2013 concerning the Prevention of HIV/AIDS.
The commitment to handling is described in Article 3, namely reducing to eliminating new HIV infections and deaths due to AIDS, as well as eliminating discrimination against people living with HIV. In addition to these two points, the government has also set targets to be able to improve the quality of life of people living with HIV/AIDS, as well as reduce the socio-economic impact at the individual, family, and community levels.
In terms of treatment and care, several important points to emphasize are that health facilities must not refuse to provide HIV/AIDS treatment and care services, and must provide post-examination counseling. Health facilities must also maintain the confidentiality of patient data.
Not only that, people with HIV/AIDS also get free ARV drugs from the government. ARV drugs need to be consumed for life by patients, because they can suppress the amount of HIV virus in the body to the lowest level.
The HIV virus that is suppressed to very low levels is useful so that the body’s immune system is not attacked and causes AIDS. Controlling the HIV virus in the body certainly makes patients able to move well and be able to improve their quality of life.
While in the context of a pandemic, WHO notes that the risk of people taking ARV treatment is comparable to that of people in general. This means that the occurrence of corona virus infection is entirely dependent on individual compliance with health protocols. Therefore, it is important to ensure that all people with HIV have access to ARV treatment.
Another effort taken by the government is to increase the allocation of funds for handling HIV/AIDS. In the document of the National Action Plan for the Prevention and Control of HIV/AIDS and PIMS in Indonesia 2020-2024, it was recorded that the average increase in funds reached 16.1 percent. The biggest increase occurred from 2020 to 2021, namely 53.18 percent.
The record allocation of funds in 2020 is Rp. 3.1 trillion, then it will increase until 2024 which reaches Rp. 5.3 trillion. The largest portion of funding is located at the district/city level, because it is responsible for handling individuals, communities, and distribution of treatment in hospitals that have HIV/AIDS services.
Strengthen prevention
Transmission of the HIV virus can actually be prevented by taking preventive measures, so that you can protect yourself and others. Preventive measures are certainly much more salvageable than already infected and having to undergo treatment. There are at least five ways to prevent HIV transmission which are regulated in Minister of Health Regulation No. 21 of 2013.
The first way is not to have sex at all, considering that the biggest transmission of the virus is through sexual intercourse. Next, be faithful to your partner, use condoms consistently, and avoid drug abuse or addictive substances. Another way of prevention is to increase education related to HIV/AIDS, including how to treat sexually transmitted infections as early as possible.
one of the latent problems is stigma, which causes a lack of access to treatment for fear of being labeled negatively by society
An important note in HIV/AIDS prevention efforts actually lies in the disclosure of a person’s infection status. People who are sexually active and pregnant/breastfeeding women need to determine whether they are infected with the HIV virus or not. Certainty of the information will save yourself and others.
Other prevention that can be done is through PrEP or treatment Pre-Exposure Prophylaxis. PrEP is a type of treatment for people at high risk of HIV infection with a 99 percent success rate in preventing infection.
There are two types of treatment, namely: locked (sexually active and injection drugs/addictive substances) and descovy (sexually active). The main requirement for using PrEP treatment is that the patient’s HIV status must be negative. The effectiveness to prevent HIV for users of injection drugs/addictive substances is around 74 percent.
Also read: Expansion of HIV Testing Hits Stigma Wall
Prevention efforts are very much determined by the individual’s awareness to protect himself from the HIV virus. On the other hand, central and local governments need to ensure access to treatment and care. Massive education about the risk of HIV infection still needs to be improved, especially for vulnerable groups.
The ultimate goal of both treatment and prevention is to provide a healthy life for the community. Meanwhile, for people with HIV/AIDS, treatment and care are certainly the best option to continue to work and improve the quality of life in the future. (R&D COMPASS)
Also read: Challenges of People with HIV during the Covid-19 Pandemic
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