Around 500 pregnant mothers in Indonesia's Bali HIV positive

With Bali's one per cent prevalence of HIV positive pregnant mothers among the some 50,000 pregnancies recorded annually, it is estimated that around 500 mothers are thought to have HIV/AIDS yearly, said an expert recently.

Head of the planning, monitoring and evaluation working group on Bali HIV/AIDS Commission I, Dewa Nyoman Wirawan, cautioned that once the promiscuous husbands infected their wives with HIV, the potential was very high for the infected pregnant mothers to transfer the infection to their babies.

"From around 500 pregnant mothers who are estimated to be HIV positive, about half of them, or 250 mothers, would have HIV positive newborns," said the epidemiologist at the medicine faculty of Udayana University.

"The HIV infection can only be detected when the baby reaches the age of between four and six," Wirawan said, stating that it was currently still difficult to diagnose whether a newborn was HIV positive due to the absence of determining symptoms.

Common symptoms that might indicate an HIV positive baby include constant malnourishment and prolonged diarrhoea. “Sometimes the baby experiences continual illness, like diarrhoea or coughing. If the doctor is knowledgeable about HIV, he would test the baby for it,” he said.

Among the numerous and complex challenges to prevent the spread of HIV, Wirawan acknowledged that there were doctors who were still reluctant to recommend their patients be tested for HIV. Access to health institutions that could do the tests was also still very limited, thus, it remained an uphill battle to curb the spread of HIV.

"Currently health services for patients with HIV/AIDS are still limited, only being available at Sanglah hospital in Denpasar. We have to develop the services at other hospitals in Singaraja, Bangli and Karangasem regencies. The public health centres, or puskesmas, in the villages and local districts [kecamatan] must also provide healthcare for HIV positive patients," said Wirawan.

Wirawan pointed out the urgency for early detection of HIV/AIDS so that patients could start taking ARV medication. "Patients will be able to suppress the chance of infecting others by up to 90 per cent by taking the ARV continuously and routinely," said Wirawan. The challenge to give ARV medication to HIV positive children still remains.

"I'm glad liquid ARV medicine for HIV positive children has recently become available. It's easier that way for the children to take the right dosage of the drugs," said Wirawan.

As the place where the country’s first HIV/AIDS case was discovered back in 1987, Bali has regulated HIV/AIDS mitigation through bylaw No. 3/2006. However, Bali administration spokesperson Ketut Teneng acknowledged that until today, the administration still found it hard to implement the regulation, which included raising awareness among high-risk groups of the importance of health examinations and wearing condoms during sex.

"We keep promoting safe sex to them, but raising awareness and changing behaviour are still difficult," said Teneng.

As of June, Bali health agency had recorded over 6,200 cases of HIV/AIDS on the island. Most of the HIV infections (74.4 per cent) arise through heterosexual activity. Around 12.79 per cent of infections come through the use of injected drugs, 3.9 per cent from homosexual activity and 0.03 per cent from tattoo making.

Most, about 40 per cent, of the infected patients are aged between 20 to 29 years old, with 35.76 per cent aged 30 to 39 years old.

About 2.64 per cent of the HIV positive are toddlers of the age 1 to 4, while babies below one year old accounted for 0.7 per cent. To date, most HIV/AIDS cases have been discovered in Denpasar (40.3 per cent) and Buleleng (19.91 per cent).-Asia News Network (August 30, 2012)