Intervention to curb the HIV/AIDS epidemic in Indonesia should be conducted in a manner that it is low in cost and high in impact, so say authorities in HIV prevention.
This is well understood as resources are severely limited, and yet the epidemic is alive and kicking, and spreading.
It also makes sense as we need to seize the moment, as most of the infections occur within a specific population who are engaged in risky behavior, i.e., sex workers, Men having Sex with Men (MSM), and injecting drug users (IDUs).
In fact, infections among members of this sector contribute more than 75 percent of all reported cases.
It makes a lot of sense also as currently the national aggregate prevalence is still low (0.16 percent), except in West Papua where the epidemic has been generalized (2.4 percent among the population aged 15-49 years old).
The window of opportunity for an effective, low-cost prevention agenda is still wide open.
Having said all of the above, I need to mention the following.
First, the Commission on AIDS in Asia (2008) reminds us that we need to carefully monitor and be concerned about the emerging epidemic among monogamous women who are infected through their husbands (or male partners).
This emerging issue brings serious consequences. When more women are infected it means diminishing support for children and more children will be born from infected mothers, which will in turn increase the likelihood of infant infections.
HIV/AIDS cases reported to the Health Ministry (as of June 2009) do indicate fast growing infection among the population below the age of 19 and school-age individuals.
The number of reported cases increased dramatically from 19 cases in 1996 to 976 cases in 2009.
Those under 14 years old may have been infected through their infected mothers and the older children may be infected through injecting drug use.
There are at least three embedded issues within this emerging epidemic.
First is the fact that, in Indonesia, condom use among men buying sex is still very low. Second, women in marital relationships either have low awareness of their partners' at-risk sexual behavior or they are culturally not equipped or empowered to negotiate condom use with their partners.
Finally, women in marital relationships are not a primary target for the IEC program on HIV prevention.
Second, we need to draw our attention to the strength of formal education. A survey in 2007 clearly suggests that the higher the level of education of the men and women who were in marital relationships, the higher their knowledge of HIV and how it is transmitted and prevented.
Of course, this may mean that better educated people may have a higher need for information. This may also mean, however, that currently information on HIV//AIDS is available in textbooks or on courses in higher levels of education (currently, in high schools and above). The second possibility warrants our serious consideration.
Third, we need to carefully examine how some people are socially constructed as the Most-at-Risk Population (MARP) in the HIV/AIDS epidemic. People are engaged in at-risk behavior for a number of reasons.
Simply put, some people may not know that their behavior risks HIV infection. If they know, they may not know what to do about it for a series of yet different reasons. One is isolation due to discrimination and stigmatization.
Sex workers, MSM and IDUs are groups of people whose behavior is not socially acceptable. They have to fight an uphill battle to get recognition and to preserve their entitlement to basic rights.
Another reason is poverty and, many times, a combination of minority status, "deviant" group status, and poverty. People living in destitution will do anything to survive, including behavior that may compromise their health and safety.
It is also worth noting that many individuals living in poverty are trapped in exploitative and abusive circumstances.
What has this to do with the education sector? There are a few important linkages.
No one is born vulnerable. Vulnerability is socially constructed. Social acceptance or rejection of certain behavior or certain characteristics of individual human beings is commonly preserved in the family or community. We should remember that one of the sectors which are constructed to inform individuals and affect their behavior is the education sector.
Most people, including those labeled as MARP have been, or are currently still, in the formal education system. The problem, however, is that the sector presently does not provide enough and appropriate information and skills to deal with HIV.
It is a great mistake to ignore the role of the education sector in the national strategic planning for HIV prevention. Our children deserve protection from the negative impacts of the epidemic early on.
Although it is acknowledged that changing the education sector to accommodate strategies to prevent HIV infection may be difficult, inevitably the sector should be more responsive, since children and other human resources within the sector are already affected by the epidemic.
by : Irwanto
http://www.thejakartapost.com/news/2009/11/07/the-education-sector-role-hiv-prevention.html
No comments:
Post a Comment