Young slum dwellers dislike using condom

The Jakarta Post, Jakarta | Thu, 04/22/2010 11:24 AM

The lack of information and knowledge about contraceptives has contributed to the common practice of unsafe sex among sexually active youth who live in poverty in Jakarta.

Many people who live in poverty have been said to believe that condom use decreases the experience of sexual activity.

Iqbal, 30, of Kampung Sepatan in Rorotan subdistrict, Cilincing, North Jakarta, said recently that many of the youth in the neighborhood had been in sexual relations and thought condom use could reduce a couple’s intimacy.

Kampung Sepatan is one of the urban slums in Jakarta and home to around 1,400 lower-income residents, many whose livelihood’s depend on trash picking, farming and fishing.

“Using a condom while having sex is not enjoyable,” Iqbal stated.

It was said that while young people there were aware of the dangers of practicing unsafe sex, there was a social propensity among them that championed unsafe sex as a way to cement a relationship.

“My ex-girlfriend insisted that we did not use condoms to hold me responsible if she became preg-nant,” Iqbal’s friend told the The Jakarta Post on condition of anonymity, adding that using condoms in a relationship also symbolized a lack of trust.

Sex education among the youth in the neighborhood appears to lack.

Reportedly many NGOs visiting the area are focused on providing young residents with more assistance with food, clothing and vocational training.

“No NGOs that have visited have provided sex education,” Adi, 20, said.

He said they received sex education from their schools in biology class, which consisted of information about their reproductive organs and function.

Similar to their counterparts in Kampung Sepatan, the young people living along Ciliwung riverbank of Bukit Duri and Kampung Pulo subdistricts, South Jakarta, also agreed that unprotected sex was a strategy to find love.

A young woman said, “I’d rather have sex without using condoms because it’s a symbol of intimacy and trust”.

Unprotected sex is a way in which a woman can ensure her boyfriend remains loyal, she said.

Zaky, 19, told the Post that they had better more informed and became aware of the dangers of unprotected sex after several NGOs recently visited their area to educate them about sex.

However, NGOs did not discuss the importance of using condoms, despite the fact that many young people there were sexually active.

“The NGOs explained the dangers of HIV/AIDS and other sexually transmitted infections [STIs], but not about contraception in detail,” Zaky said.

The Lamp Science Foundation (YPI), a grassroot organization active in promoting the awareness on HIV/AIDS, confirmed that its approaches to young people in lower-income urban areas had been proactive in educating them about reproductive health, STIs and HIV/AIDS prevention.

“We highlighted condom use as one way to reduce the risk of HIV infection,” YPI secretary Srisulistyurini said.

She said that premarital and unsafe sex was prevalent among the youth in shanty areas, and that sex education was the key to curbing the rapid spread of STIs and HIV/AIDS.

The YPI suggested that communities of slum areas in Jakarta should initiate workshops on sex education by requesting NGOs such as the YPI to visit their areas.

“It needs comprehensive participation from society because many NGOs don’t have the resources to map all the slum areas in the city whose young residents need sex education,” Srisulistyurini said.

According to the health agency, 3,863 AIDS cases were reported in 2009, with women and young people being the most prone to infection. (tsy)

Sex education among the youth in the neighborhood appears to lack.

Anti-drug message taken to the streets

Warief Djajanto Basorie, Contributor The Jakarta Post, Bandung

Kapanlagi.com Anti Narkoba (Kapanlagi.com is against drugs) reads a sticker on the dashboard of a yellow angkot (public minibus) in Bandung, 160 kilometers southeast of Jakarta.

Kapanlagi.com (Kapan lagi, if not now, when?) is a website that aims to prevent youth drug abuse.

With support from websites, businesses and civil society groups, Bandung, the capital of West Java, has taken its drug awareness campaign to the streets.

Karaoke clubs in the city's semi-red light district on Jl. Braga also place banners at their entranceways: No drugs. Another banner on the perimeter of the fence of the mayor's office encourages passersby to act against drug abuse and stop the spread of HIV.

There has been a clear connection between the use of injecting drugs -- like heroin -- and HIV/AIDS.

Health Ministry figures up to September 2007 show that 49.5 percent of all AIDS cases in Indonesia are caused by injecting drug use with contaminated needles.

A needle may have been used before or shared within a circle of common users.

Nationally, injecting drug use is now the primary cause of HIV infection, the virus that causes AIDS. Second is unprotected sex among heterosexuals with 42 percent of all cases.

In West Java, 81.2 percent of AIDS cases stem from injecting drug use. This is the highest percentage by province.

Also by province, West Java ranks second in the country after Jakarta in terms of the number of AIDS cases.

Yayasan Masyarakat Sehat (Community Health Foundation, YMS), has a two-story office next to a slaughterhouse on the main road of Banjaran in Bale Endah, an area just outside Bandung's southern limits.

The YMS has an HIV/AIDS prevention program that focuses on behavioral change communication among injecting drug users (IDUs) in the districts of Bandung and Subang.

It has reached out to 450 IDUs in Bandung district and 320 in Subang. The majority of IDUs are in the 20-35 years age group.

"Generally they are not aware of the behavioral hazards of sharing needles," YMS manager Dedi Junaedi Jusuf said.

The YMS, with support from the U.S.-based Family Health International, aims to wean users off their drug habit from two to three injections a day to a full stop in six to seven months. IDUs get free packets of sterile needles to help in the weaning process.

This sterile needles service also concerns harm reduction -- measures taken to address drug problems that are open to outcomes other than cessation of use. Harm reduction is government approved. In a statement last Dec. 7 to mark World AIDS Day, National AIDS Commission chairman Aburizal Bakrie, concurrently the coordinating minister for people's welfare, said Indonesia has 120 sterile needles programs nationwide.

Dedi, 42, however, underscores that sterile needles receivers must adhere to a standard operating procedure. First they must comprehend the YMS' program of behavioral change. Used needles must be handed in for eventual incineration.

"Behavior starts to change after we give information. Counseling, particularly VCT (voluntary counseling and testing of HIV infection) reduces their risk level," Dedi added.

It helps that many of the case managers and the outreach workers YMS employs are former IDUs. Such peer support in weekly meetings strengthens the IDUs' resolve to quit.

Field coordinator Iwan Ahmad Anwari admits relapse is a problem. "Long term users ache to stop. Creative joint activities like designing and printing T-shirts helps to keep their mind off drugs," he continued.

Meanwhile, SMP Negeri 1 Bale Endah -- a local state-run junior high school, a 10-minute drive away -- has introduced drug abuse and HIV/AIDS prevention education. Herdy Luthfiady, 46, the deputy school head, explained the purpose of the awareness activity was to "prevent pupils from falling into it" (into behavior that leads to drug abuse and HIV infection).

Herdy relates a case five years ago when a 13-year-old boy was caught with marijuana in school. His parents pulled him out before the school could expel him. From that incident, the school regularly consults with parents on drug awareness, Herdy said.

Preventive education is also promoted by Gerakan Nasional Anti-Narkotika, (Granat, the National Movement against Narcotics).

Djoni Widjaja Aluwi, 62, the chairman of Granat's West Java chapter, said the primary aim of the community-based organization is prevention. It gives talks on drugs in schools, as well as faith-based and community groups. If you see a negative change in your children's behavior, you should inspect their bedroom for any hidden drugs, Djoni, a practicing lawyer, advises parents.

Drug abuse and AIDS are problems that will not go away soon. The National Narcotics Agency (BNN) estimates Indonesia has four million IDUs. Whatever the number of IDUs, more conscientious former users, more dedicated teachers, more caring parents, and more selfless members of civil society must emerge to curb the drugs scourge.

If not now, when?

Warief Djajanto Basorie is a freelance writer and can be reached at wariefdj@yahoo.com

One out of five Denpasar's teens depressed: Survey

Wasti Atmodjo, The Jakarta Post, Denpasar

A recent study suggests one out of five teenagers in Denpasar has suffered from depression or other serious mental illnesses over the last six months.

The survey, conducted by psychiatrist Lely Setyawati at senior high schools in Denpasar, came about after Lely worked with teenagers at Amerta Youth Center, a clinic for teens at Sanglah Hospital.

She said teenagers coming to the clinic were frustrated with various problems, ranging from conflict with parents, boyfriends or girlfriends to inability to escape bad living environments.

In the survey of 500 teens from Denpasar, said Lely, many teens admitted feeling sad and unhappy much of the time.

Others said they were easily tired, had little spirit, found it hard to concentrate, had no self-confidence and felt useless. Many felt uncertain about their futures.

Lely called these feelings the symptoms of serious depression, and said she was surprised by the findings.

"It turned out that almost 20 percent of respondents were suffering from depression. This was beyond my prediction."

She said she planned to expand her survey to other parts of Bali.

"From the survey we at least know the teenage situation in Denpasar is not much different from that in other big cities. The different is, social control is still high in Bali, such as from members of banjar neighborhood unit, making many teenagers slow to display inappropriate behavior.

"Unfortunately, the same social control makes teenagers reluctant to consult psychologists when they are facing problems," Lely said.

Child psychiatrist Endah Ardjana, the teen center's coordinator, said teens were at the age when a person not be considered neither a child nor a grown-up.

"Teenagers are in the transition period," she said. "They often experience unstable mental conditions."

Currently, the center assists youngsters overcome drug addiction, survive physical and sexual abuse and work through premature sexual relations.

Endah said most teens seeking assistance at the center had serious cases of depression, likely due to their feelings of shame in telling their stories or consulting experts.

Both Lely and Endah regularly visit junior and senior high schools to spread awareness on the need to maintain physical and mental health, and to aware of the consequences of sexual activity.

They also inform teens about the center, which promises confidentiality and offers the services of a team of specialists, including gynecologists and psychiatrists.

Condom campaign doesn't legalize free sex: AIDS council

Mustaqim Adamrah, The Jakarta Post, Jakarta

Chairwoman of the National AIDS Council Nafsiah Mboi has clarified that an aggressive condom-use campaign does not endorse promiscuity.

Speaking at the official launch of National Condom Week in Senayan, Central Jakarta, on Saturday, Nafsiah warned against a common misconception: "National Condom Week doesn't legalize free sex ... we do not approve of this. But if we already have youths who are sexually active, what we're doing now is merely giving them a means of protection," Nafsiah said, adding that the number of HIV infections had recently spiked among the 15 to 24 age group.

She said the weeklong drive, jointly organized by the National Family Planning Board, the AIDS Council, and DKT Foundation, a condom manufacturer, was aimed at educating people on HIV/AIDS and reproductive health, including the proper use of condoms.

"We believe society has the right to receive correct and complete information on HIV/AIDS.

"It's similar to wearing a helmet when riding a motorbike, if you're not riding a bike then you don't need to wear one," said Nafsiah, who is a pediatrician.

According to Nafsiah, as of September this year the number of reported HIV/AIDS cases stood at 16,000.

Nafsiah denied religious organizations were against the campaign. "It's important to remember that condoms are part of the national family planning program which has been endorsed by all religions, including the Catholic Church in Indonesia, since 1972."

UN country coordinator for AIDS programs in Indonesia, Nancy Fee, said raising awareness by talking about condom use in a culturally-sensitive way was very important in AIDS work.

"Previously, the majority of new HIV infections were among injected drug users, but the epidemic is changing ... while the drug problem remains very serious, the majority of new infections are sexually transmitted. Condoms are very important in preventing a larger AIDS epidemic."

Another important element in preventing AIDS, she said, was for parents to talk to their children about the disease when they were still young.

"It's very important for parents to focus on values, good communication, good decision making."

"Because when we inculcate that in children, when they are small, when they become teenagers and their attention is drawn to drugs or sex, they will have core values and be strong -- and that is what will protect them."

Over 400 youths gathered at the Hotel Indonesia traffic circle Saturday to protest the condom campaign.

Coordinator Ivan Ahda said the campaign was intended to promote free sex; Mental Rehabilitation Center Foundation spokesman, Ginanjar, even questioned whether condoms could prevent HIV/AIDS.

"Condoms cannot prevent the spread of HIV/AIDS. Research in the United States has proven HIV viruses, which are 1/250 micron in size, can pass through condom pores that generally are 1/60 micron," said Ginanjar.

Instructions on how to use condoms and how they can prevent pregnancy and sexually transmitted diseases, including HIV, are part of National Condom Week, which runs from Dec. 1 to 8, with activities in cities including Bandung in West Java, Pekanbaru in Riau, Pasuruan in East Java and Manado in North Sulawesi. (amr)

Empowering the young to fight HIV

Joyce and David Djaelani Gordon, Contributors Jakarta Post, Jakarta

With World AIDS Day just a few days away, many of us here are busy organizing programs, walks, shows and media presentations.

There are also countless numbers of people and organizations across the world who are preparing to deliver their HIV/AIDS messages on this day of observation and reflection, and hope.

At this time of year -- approaching the 20th World AIDS Day -- we consider the past, the present and the future. It is a time to spread the good news: the advances in medical research, the development of new strategies and hopes, and the search for effective vaccines. And we share, in retrospect, the failures, shortcomings and hesitancies of the past year too.

We have known for many years that much of the driving force, worldwide, behind the HIV/AIDS pandemic is "sex, drugs and rock 'n' roll". In Indonesia, nationwide statistics show that 56 percent of all cases of HIV/AIDS are among 15-29 year olds.

Among the injecting drug users (IDUs) who are infected with HIV, 1.99 percent are 15-19 years old, and 68.22 percent are between the ages of 20 and 29. Cumulative data shows 72.1 percent of the AIDS cases in the capital city of Jakarta and 81.2 percent of the AIDS cases in West Java are primarily from IDUs. Looking at nationwide statistics by mode of transmission, 49.5 percent of HIV diagnoses are IDUs, and 42 percent were transmitted sexually.

"Drugs, sex and rock 'n' roll" remain a part of the youth scene. Today's youngsters represent a high-risk group for HIV, which also includes sub-groups of ultra-high-risk youth populations.

In fact this is a group of people whom we have had the chance to reach out to since they were preteens and teens. HIV/AIDS and drug use have been around for longer than the teens of today. Another reality is we have had much time and many opportunities to understand the mind-set of preteens and reach out to them.

Young people represent a huge percentage of the driving force behind the epidemic, as well as a huge number of those being infected by the epidemic. It is only natural, therefore, to involve young people in building existing networks and peer support systems and designing action plans.

A great deal of attention has been given to offering young people a voice in the fight against HIV/AIDS. Yet, herein lies the "gap". Why are there not more young educators, advocates, carriers of the message and planners of plans of action?

At YAKITA we have trained hundreds of young people and dozens of youth groups (16-24 years old) and we have some 200-plus young people engaged in outreach work every week.

After training, these young people are supported to do outreach work in their own areas. In their new roles, they automatically begin to provide care, support and treatment for other youngsters.

Yet for us and many others working with HIV/AIDS this only scratches the surface. The difficulties we have encountered here remain virtually the same as encountered across the nation and the globe for some two decades now.

There are many young people doing wonderful and heartfelt work. They band together with other youngsters and are courageously involved in most of the areas regarding HIV/AIDS and correlated issues.

Still, the reality is the number of truly youth-driven initiatives falls short in comparison with the prevalence of HIV in the lives of the nation's young people.

In many countries across Asia, the definition of youth participation is still limited. Hence, often young people are offered token participation rather than full integration in HIV/AIDS work.

How can young people plan or initiate anything if their basic education is limited. Or, if schools and communities working with young people remain shy and discriminatory in talking about HIV/AIDS.

Also young people, as is the way, over the years move into adulthood. Hence, the regeneration and retraining of young people must be done on a continual and evolving basis.

Adult commitment and funding -- which is absolutely necessary for youth to be thoroughly educated, given quality training, and given a place of their own (a facility/center) -- has all too often been lacking or shortsighted. Without adequate funding and support, young people and their services will be marginalized, and their programs destined not to last.

And, learning from past experience, we know that youth-to-youth education and outreach programs often work best. Young people have the energy to reach a great many other young people across the nation. And doing this work may help increase their self-esteem, self worth and life skills.

Youngsters possess a voice that reaches where no other (child, adult or elderly) voice can reach. There needs be a committed resolution to today's youth so that they -- as a collective population -- can kindle the kind of strength needed to challenge, to subdue, and then to minimize the spread of the virus.

It has taken time to be fully aware of the consequences of HIV. As for all of us living and working at the frontlines of the epidemic, we encourage increased investment in our youth in 2008.

So what can you do? Get the facts, and teach the young people around you about HIV/AIDS, about drug use, abuse and addiction.

If young people are not educated now about matters that will affect their lives, we will see more babies with HIV, and far more young people infected with HIV. If this happens more young people, more futures will be lost. The biggest loss of all is if we lose our children to HIV. It is our shared responsibility to turn back the epidemic. If we, as adults, cannot learn, how can we expect young people to learn? How can we expect them to carry the HIV/AIDS message?

Joyce & David Djaelani Gordon are the directors of YAKITA -- Indonesia, a peer-based drug recovery non-governmental organization.

Youth urged to get healthy

The Jakarta Post

JAKARTA (Antara): President Susilo Bambang Yudhoyono on Sunday called on the nation's youth to develop a culture of health and the habit of doing physical exercise to become more globally competitive.

The president made the call at the launch of the Indonesian Healthy Youth Movement as a part of Youth Pledge Day celebrations.

"The youth should keep doing physical exercises, maintaining health, being creative, maintaining harmony among them, avoiding narcotics and violent acts as well as avoiding promiscuity to safeguard the future, make them a leading young generation and develop the nation," he said.

The president said his government would continue to carry out programs to keep Indonesians healthy.