Abstract

Masalah HIV/AIDS di Indonesia diyakini bagaikan fenomena gunung es karena laporan resmi jumlah kasus tidak mencerminkan masalah yang sebenarnya. Prediksi besar masalah HIV/AIDS tersebut didasarkan atas jumlah penyalahgunaan narkotika suntik dan prostitusi yang tinggi. Keduanya merupakan faktor utama yang berperan sangat besar dalam penyebaran dan penularan HIV. Berbagai faktor risiko tersebut tidak hanya berkaitan dengan pelayanan keseha-tan tetapi juga dengan masalah sosial ekonomi. Permasalahan tersebut perlu diatasi dengan pendekatan pelayanan kesehatan primer komprehensif yang langsung menyentuh akar permasalahan mencakup masalah sosial ekonomi dan lingkungan kultural. Strategi tersebut dilakukan melalui berbagai langkah yang bersifat menyeluruh, meliputi preventif, promotif, kuratif dan rehabilitatif dengan partisipasi dan kerja sama yang luas yang melibatkan berbagai sektor dan organisasi non pemerintah dan masyarakat. Beberapa langkah yang harus dilakukan meliputi edukasi dan promosi, pelayanan kesehatan yang merata dan terjangkau. Selain itu yang juga tidak kalah pentingnya adalah pengentasan kemiskinan melalui peningkatan lapangan kerja dan kelibatan partisipasi masyarakat.

HIV/AIDS problem in Indonesia is considered as iceberg phenomenon, where the reported cases in the government official record do not represent the real situation. This prediction is based on high number of vulnerable groups such as sexual workers and injecting drug users. These factors are not only related to healthcare services but also social economic structure. Therefore, to address this problem, comprehensive Primary Health Care (PHC) must be imple-mented. The comprehensive PHC concerns on underlying problem which includes socioeconomic issues and environment problems. This strategy is conducted through holistic activities from preventive, promotive, curative and rehabilitative through collaboration with other sectors and community involvement. Based on underlying HIV/AIDS problem in Indonesia, there are several strategies that should be done to address the problem, such as education campaign, addressing poverty issue, equitable health services and community participation.

References

  1. Ministry of Health of Indonesia. National estimates of adult HIV infection, Indonesia 2002. Jakarta: Directorate General of Communicable Diseases of Ministry of Health; 2003.
  2. Linquist J. Organizing AIDS in the borderless world: a case study from Indonesia-Malaysia-Singapore growth triangle. Asia Pacific Viewpoint. 2005; 46(1): 49-63.
  3. USAID (United States Agency for International Development). Health profile Indonesia: HIV/AIDS [edisi 2005, diakses tanggal 1 Juni 2008]. Diunduh dari: http://www.usaid.gov/our_work/global_health/aids /Countries/ane/indonesia_05.pdf.
  4. Simon V, Ho DD & Karim QA. HIV/AIDS epidemiology, pathogenesis, prevention and treatment. The Lancet. 2006; 368: 489-504.
  5. UNAIDS (Joint United Nations Programme on HIV/AIDS). Report on the global AIDS epidemic [edisi 2006, diakses tanggal 5 Juni 2007]. Diunduh dari: http://www.unaids.org/en/HIV_data/2006GlobalReport /default.asp.
  6. Coordinating Minister for People’s Welfare (Menkokesra). National strategy of combating AIDS in Indonesia. Jakarta: Office of the Coordinating minister for People’s Welfare; 1994.
  7. Riono P & Jazant S. The current situation of HIV/AIDS epidemic in Indonesia. AIDS Education & Prevention. 2004; 16(supl. A): 78-90.
  8. WHO (World Health Organization). Indonesia: country profile for HIV/AIDS scale-up [edisi 2005, diakses tanggal 1 Juni 2008]. Diunduh dari: http://www.who.int/hiv/HIVCP_IDN.pdf.
  9. Coordinating Minister for People’s Welfare (Menkokesra). National HIV/AIDS strategy 2003-2007. Jakarta: Office of the Coordinating minister for People’s Welfare - National AIDS commission; 2003 [diakses tanggal 5 Juni 2007]. Diunduh dari: http://www.spiritia.or.id/ eng/StranasEng.php.
  10. Werner D. The challenge to health for all. In Lighten the Burden of Third World Health. Proceeding of International Conference 29-31 January 1997. South Africa: Cape Town; 1997: 7-18.
  11. Baum F. Health for all now, reviving the spirit of Alma Ata in twenty first century: an introduction to Alma Ata Declaration. Social Medicine. 2007; 2(1): 34-41.
  12. Lampstey PR, Johnson JL & Khan M. The global challenge of HIV/AIDS. Population Bulletin. 2006; 61(1): 1-24.
  13. Pisani E. Estimating the number of drug injectors in Indonesia. International Journal of Drug Policy. 2006; 17: 35-40.
  14. Pisani E, Garnett GP, Brown P, Stover P, Grassly NC, Hanskins C, et al. Back to basic in HIV prevention: focus on exposure. British Medical Journal (BMJ). 2003; 326: 1384-7.
  15. UNDP (United Nations for Development Programs). Indonesia at a glance-HIV and AIDS in Indonesia. The HIV Portal for Asia PacificUNDP-UNAIDS; 2006 [edisi 2006, diakses tanggal 5 Juni 2008]. Diunduh dari: http://www.youandaids.org.
  16. Thorpe L, Ford K, Fajans P & Wirawan DN. Correlates of condom use among female prostitutes, tourist clients in Bali Indonesia. AIDS Care. 1997; 9(2): 181-98.
  17. MAP (Monitoring for AIDS Pandemic). The status and the trends of HIV/AIDS/STI epidemic in Asia and the Pacific. Washington, DC: International Program Centre, Population Division, US Centre Bureau; 2001 [edisi 2001, diakses tanggal 1 Juni 2008]. Diunduh dari: http://pdf.usaid.gov/pdf_docs/PNACM798.pdf.
  18. Ford K, Wirawan DN, Reed, BD, Muliawan, P & Sutarga, M. AIDS and STD knowledge, condome use ad HIV/STD infection among female sex workers in Bali Indonesia. AIDS Care. 2000; 12(5): 523-35.
  19. Segall M. District health systems in neoliberal world: a review of five by policy areas. International Journal of Health Policy and Management. 2003; 18: S5-S26.

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