HIV/AIDS Cases Increasingly Troubling

The spread of HIV/AIDS cases in Indonesia is increasingly troubling. The latest news is that a 12-year-old girl has been infected with HIV/AIDS from a person who had sexual intercourse with her.

The case is currently being handled by the police. It is a saddening fact that if this girl is positive, it means that she puts her future sexual partners at greater risk of being infected.

The teenager is currently healthy but she could transmit the virus in her future sexual partners. My observations of the media in several regencies show that there new cases of HIV/AIDS in Cianjur regency in July had doubled from the previous year.

One month ago we were informed that hundreds of teenagers in Bandung were detected to have HIV.

In early September, the Gunung Kidul Health office reported that dozens of children in Gunung Kidul were infected with HIV/AIDS from their parents. The Indonesian Red Cross (PMI) Surabaya City Blood Donor Unit reported that between January and June as many as 514 bags of blood out of 66,274 had to be discarded because they were detected to contain infectious viral infections, including HIV/AIDS and syphilis.

The spread of HIV/AIDS is like an iceberg phenomenon. Cases that do not come to the surface are bigger than those that do.

Of that number, 3.3 percent were children below the age of 14.

Nia Kurniati, a lecturer at the Faculty of Medicine in University of Indonesia who researches HIV in children, during her doctoral promotion in July estimated that in 2020 there were 540,000 cases of HIV/AIDS in Indonesia. Of that number, 3.3 percent were children below the age of 14.

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Nia revealed that UNAIDS in 2020 globally targeted 90 percent of people with HIV/AIDS to be aware that they have HIV/AIDS, but in fact in Indonesia it reached 66 percent. They also targeted 90 percent of patients who know they have HIV to receive antiviral drugs, but this reached 26 percent. In her research, Nia also discovered that the later the cases were handled, the higher the rate of treatment failure. This is a lot of homework for all of us.

HIV risk factors

The Human Immunodeficiency Virus (HIV) infection is caused by an RNA virus. This is a disease that is mainly transmitted through sexual contact, either through same-sex or opposite-sex relationships. HIV attacks the immune system that can kill the patient if not treated. Patients who have HIV in the course of their illness can develop into the condition of Acquired Immunodeficiency Syndrome (AIDS).

Promiscuity, both with the same sex and opposite sex, which is common in big cities, means it can be predicted that HIV cases in adolescents will be found in other big cities in Indonesia.

Transmission in young people is mainly through vaginal or anal intercourse. Having multiple partners carries a risk of contracting HIV infection. Patients with other sexually transmitted infections, such as syphilis, herpes or gonorrhea, are also at risk of HIV infection because they generally have open sores on their genitals or anus.

The use of drugs through needles is also a risk of transmission, even though the use of syringes has decreased as currently drugs are consumed by drinking, smoking or inhalation.

This means that those undetected cases will have an impact on the community if they unknowingly spread transmission through sexual contact.

The main problem in tackling HIV/AIDS in Indonesia is the low detection of new cases. A press release from the Health Ministry in early August stated that out of the targeted 97,000 known cases, only 13,000 were detected. This means that those undetected cases will have an impact on the community if they unknowingly spread transmission through sexual contact.

To be honest, as an academic and a clinician handling HIV cases related to gastrointestinal symptoms, the findings of hundreds of infected teenagers are quite disturbing. Education of the illness must be a continuous process. Ignorance about the mode of transmission carries a possible risk of HIV infection, of which the treatment is lifelong. People with HIV are usually asymptomatic, showing chronic symptoms after they enter the AIDS period.

When a patient visits the doctor, their doctor is usually not aware of an HIV diagnosis. Therefore, patients need to be honest when visiting a doctor, conveying that he or she is perhaps at risk of being infected with HIV.

So far I have noticed that the age of HIV patients also varies; from only 25 years old to 65 years old. Their profession also varies, ranging from sex workers to housewives. In fact, recent media discoveries have found that HIV occurs in both adolescents and children. So, you could say that HIV infects anyone, from all walks of life.

Symptoms of HIV/AIDS

The symptoms of HIV can vary. There are patients who were diagnosed with HIV after an endoscopy found fungi in their esophagus. A white tongue due to fungus accompanied by weight loss should also be suspected as HIV symptoms. Pulmonary tuberculosis should be evaluated for the possibility of being infected with HIV.

Patients with HIV can also experience abnormalities in the skin in the form of black spots. They can experience convulsions when HIV has invaded the brain.

If a patient between the ages of 20 and 30 has chronic diarrhea, doctors must suspect HIV as a cause. It is difficult to detect the presence of HIV early in patients as it must always be remembered that patients with HIV can be like any other healthy person. The obvious signs that he or she has developed AIDS are various clinical symptoms, such as a chronic cough, diarrhea, lumps in the neck or dark spots on their skin.

With the increasing number of HIV cases in the community, the doctors’ ability to detect them should also be enhanced. The sooner patients get treated, the sooner complications can be prevented. Currently, my patients who are in treatment and taking medication for life—free medication from the government—can live a normal life without any complaints and their weight has even returned to what it was before the illness. I always remind people to be careful during sexual intercourse because this infection can be transmitted to other people through sexual contact.

The frightening stigma that people living with HIV should be ostracized is unnecessary.

Casual sex is a major risk factor for how the virus is passed from one person to another. A husband or wife who has HIV will pass it on to his wife or husband. HIV-infected mothers can transmit it to their unborn children. People in the same household or office or schoolmates with HIV will not be infected by chatting or working in a team, eating together, swimming together or sitting in the same room. The frightening stigma that people living with HIV should be ostracized is unnecessary.

Patients should also not have to be sad about their future because by taking antiretroviral (ARV) drugs, regularly and uninterruptedly, the quality of their life will be no different from people without HIV.

Cases of HIV/AIDS can be prevented and incidences can be reduced if all of us are serious about controlling the number of cases from increasing. Anyone at risk should check their HIV status. The sooner it is detected and the sooner it is treated, the lower the risk of infecting others.

KOMPAS/PRAYOGI DWI SULISTYO

Ari Fahrial Syam

Ari Fahrial Syam, Professor of Internal Medicine at FKUI, Dean of FKUI

(This article was translated by Kurniawan Siswo)