It is defined as continous increment of the number of HIV+/AIDS cases in a certain population/region/country after implementation of nation-wide programme in a certain periods of time.
Let's have a look of the data regarding to HIV/AIDS:
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| HIV cases in Asia |
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NO. OF NEW HIV INFECTIONS, AIDS CASES AND AIDS DEATHS BY GENDER PER YEAR REPORTED IN MALAYSIA (From 1986 until December 2008) |
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| HIV cases in Indonesia from 1987 to 2008 |
Supposedly, the rate will be dropped as time goes by bcoz there should be increasing number of humans with higher education level compared to 1990 or years before. don't you agree with this point? government from other countries has been giving the citizens free education frm primary to secondary school, so that more people are educated. with higher education level. People should realise the danger of going for prostitution, the danger of having unsafe sex, how to protect themselves by using condom when having sexual intercourse with sex workers or strangers...etc... but how on earth the prevalence and incidence are still increasing? oh, am i too naive? the reality isn't the same as what i think....
Why would this happen? What do you think?
lets see the possibilities of causing this phenomenon:
1) increasing number of adolescents having sexual intercourse at earlier age?
2) increasing number of rich and horny guys who go for the prostitution, but not using condom bcoz they wana get higher pleasure when having sex?
3) more people having relationships with multipartners and have sex with anyone, including a stranger?
4) more people using narcotic drugs? sharing needles?
5) more girls wana make easy money by providing service to the men? they are willing to lose their self-esteem and dignity and pride?
6) increasing numbers of homosexual or heterosexual? esp the gays who do not use condoms when doing anal sex (i.e MSM)?
7) failure to promote or socialize the HIV prevention programme?
8) failure to treat?
9) failure to support or run the HIV/AIDS and STI prevention programme?
10) a problem of decentralization in Indonesia? The responsibilty of collecting data is devolved to the district level due to decentralization process. So now, there is limited human resources and competing claims on resources sometimes undermine activities such as data-collection, which are seen as NON-ESSENTIAL. A failure to maintain standards and quality in public-health-information systems.
What are the prevention efforts?
1) health promotion
2) strengthen health care system
3) multi departmental program
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| Note: HAART=highly active antiretroviral therapy; PEP=post-exposure prophylaxis; PrEP=pre-exposure prophylaxis; STI=sexually transmitted infection; Bolded items are those that use antiretroviral agents. |
STI patients have a 2-9 times greater risk of being infected with HIV than people who do not have STI. Therefore, effort to test for and treat STI should be put in.
Why can circumcision decrease host susceptibility to HIV infection?
Because after circumcision the glans penis will develop a stronger layer of squamous epithelium.
How to promote condom usage?
It should be done by:
1) free distribution of condoms to sex establishments at the initial stage, and condom social marketing at later stages;
2) encourage the sex workers to consistently have clients use condoms during sexual intercourse.
BUT, how if the clients and sexual workers insist not to use condom?
1) According Prof. Dr. Siswanto, there is an approach of encouraging the sexual worker to help the clients to wear the condom by using a more interesting tactic, so that the clients will not reject to use condom.
2) Enforce the law: Penalties against any sex establishments that do not consistently use condoms.
Besides that, we should attract the attention of executor and senators,by presenting the cases(including showing them the prevalence of HIV infection) to them so that they will give response upon this issue. A sentinel surveillance should be conducted to monitor STD (sexually transmitted disease) and HIV and condom-use compliance.
Harm reduction among the IDU (injecting drug user): PTRM?
Perhaps you ever hear about VCT (voluntary counselling and testing), PMTCT (prevention mother to child transmission). How about PTRM? Here i would like to explain PTRM briefly.
PTRM (Program Terapi Rumatan Methadone) is a therapeutic programme for the IDU (injecting drug user) to substitute the narcotic drugs with methadone. By using this approach, they expect that there will be decrease of numbers of IDU, hence reducing HIV transmission caused by drug injection.
Who are responsible in preventing HIV transmission?
HIV/AIDS prevention is a national issue. It needs to be tackled through a national response. Hence, efforts should be implemented by the community, the government, and NGOs on a partnership basis. The community, together with NGOs (non-government organization), should be the leading agents while the government takes responsibility for steering, guiding and creating a conductive atmosphere to support HIV/AIDS prevention.
In conclusion,
HIV prevention is focused on:
A: Abstinence
B: Be loyal
C: Condom use
D: No drugs
HIV/AIDS should not be treated as a stigma in the community. All of us shall participate in this programme and work hand in hand.
Reference:
1) Dr. Sunardi Radiono. Lecture: HIV/AIDS Disaster and HIV/AIDS in Nature Disaster.
2) Dr. Yanri Wijayanti Subronto. Lecture block 3.6: Screening HIV.
3) Lecture block 3.6: Disease Related to Unsafe Sex and Injecting Drug Use.
4) http://www.ptfmalaysia.org/statistic.htm
5) http://data.unaids.org/publications/irc-pub06/jc978-indonesia_en.pdf
6)http://www.healthpolicyinitiative.com/Publications/Documents/1345_1_Indonesia_HIV_Audit_FINAL.pdf
7)http://www.satuportal.net/content/sebanyak-11-puskesmas-di-jakarta-dilengkapi-prtm-online
8) http://www.thejakartapost.com/news/2010/11/27/national-aids-commission-upbeat-reaching-targets.html
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