Sex, Bali and HIV/AIDS
So what are all the free condoms and HIV signs all about? I left the incredible night at the Arma museum with a substantial collection of lollipop condoms (lemon flavored condoms on a stick to be precise). Meanwhile Fiesta fans and HIV info is scattered all around the Dharma fair. So again – what is it all about? Why has the Bali Spirit Festival partnered with Spirit Paramacitta Foundation, Kerti Praja Foundation, and dan KISARA Foundation, a dynamic collaboration of organizations who are focused on HIV/AIDS issues in Bali?
According to the UNDP, “Indonesia faces the looming threat of a major HIV epidemic.” UNAIDS has in recent years termed Indonesia’s incidence of HIV as a ‘concentrated’ epidemic, indicating high risk populations where infection rates are over five percent. Currently there are an estimated 5 million sufferers in Indonesia, but even this figure is tricky to pinpoint due to the many cases which go unrecorded. According to Antra, only 5-10% of HIV/AIDS suffers actually get diagnosed and treated.
And what about Bali? According to Bali’s Commission of AIDS Prevention, the number of Balinese infected with AIDS will double in 2011 to over 7,300 cases, raising the next question of why? The answers are not clear cut, but point towards the rapid population expansion, the increase in intravenous drug users (IDUs) and most significantly the growing number of sex workers. Ultimately, on an island which has remained isolated from some of the more restrictive Islamic and cultural codes of conduct, HIV/AIDS has become concentrated in Bali when compared to other parts of Indonesia and the finger is being pointed at sex.
To put this ‘concentrated’ epidemic into figures, the prevalence of HIV/AIDS cases in sexual workers in the island doubled to 2 percent from 1 percent in 1999. In 2005, the number of cases increased to 12 percent, and further rose to 23 percent in 2009. The National Commission on HIV/AIDS Treatment (KPAN) and the Health Ministry estimates that the number of people living with HIV/AIDS in Bali reached 7,317 in 2010 and out of this the majority were sex workers. Moreover, 3,017 patients contracted HIV/AIDS from sex workers and were feared to have transmitted the deadly infection to their partners and children, with the estimated number of this group reaching 668. About 23 percent (or 730) were infected through drug injections, showing that sex rather than just drug use is where the focus of HIV/AIDS prevention needs to go. The most vulnerable section of the population is youth and young adults. Males represent the vast majority of those infected, and those most at risk are reported to be men and women of reproductive age (15-29 years old).
So what is AYO! Kita Bicara and the rest of the team going to do about it? AYO! Kita Bicara HIV/AIDS (Let’s Talk about HIV/AIDS) is an ongoing educational Outreach Program created by The BaliSpirit Festival, to engage the local community – specifically the Balinese youth, in conversations and education about HIV/AIDS at the grassroots level, promoting teenagers as an Agent of Change within Indonesia.
Education is key. The more people are talking about HIV/AIDS the easier it is to break the stigma about it, and pave the way for survivors to seek treatment and advice. Education is also the key to prevention. Sex tourism in Bali is on the rise. Just doing a Google search for ‘Prostitution in Bali’ brings addresses of hotels, bungalows, bars, clubs and massage parlors who can provide sex workers with the price for one night beginning from as little as 1,500,000 rupiah. So it goes to follow that targeting schools before girls start working may be one way to persuade young women towards another trade, or at least enable them to take adequate protection.
According to Dr. Dewa Nyoman Wirawan, a public health professor at Udayana University, just 20-30 percent of clients consistently use condoms when visiting a sex worker, he said. Wirawan stated that “Sex workers need the money so badly that if a client refuses to use condoms, they will take the risk anyway,” said Rita, a former prostitute. “If prostitutes ask the client to use a condom, they usually will. But some women have many clients in one night, maybe 10 or 15, and using a condom makes the sex more painful and it lasts longer.” If the clients are more aware of the risks and the sex workers have access to free condoms then perhaps both parties will think twice before engaging in unprotected sex. Likewise, if young people are given honest and open sex education advice which once again includes access to contraception and primarily condoms then they will be better prepared to make informed choices and of course better equipped to have safe sex.
So a big ‘Hurrah’ for AYO! Kita Bicara and let’s keep on moving and grooving here at the Bali Spirit Fest to keep those condoms (on a lollipop stick) flowing, education growing and HIV prevalence rates slowing.
photos by Ulrike Reinhold