The HIV/AIDS epidemic continues to mount in Bali with health officials now estimating some 4,000 people have died from the disease on the Island. Each day 2-3 people die of HIV/AIDS adding at least 840 new fatalities to the mounting death toll each year.
Meanwhile, health activists are warning that unless issues connected with the treatments, control and prevention of HIV/AIDS receive their proper due, the illness will, as reported in the Bali Post, sweep across the island like a AIDS tsunami.
This warning was issued by Dr. Nyoman Mangku Karmaya, the Chairman of the Committee for Combating AIDS (KPAD) at a seminar on the control and prevention of HIV/AIDS held in Denpasar on Wednesday, February 27, 2008 where he said: "The threat of drowning in Bali is not only posed by tsunamis composed of sea water, but also by a increasingly growing tsunami of HIV/AIDS sufferers threatening to drown and overwhelm the island."
Among the regencies in Bali worst affected by HIV/AIDS are the capital of Denpasar, Badung, Buleleng and Tabanan. Most alarming to health officials is the rapid rise in infection rates among housewives and babies, groups usually least affected by the disease.
The first major explosion in HIV/AIDS infections in Bali was recorded in 2000 among intravenous drug users, where between 40-60% of known addicts were HIV positive. A subsequent survey conducted in 2006 showed that the rate of new infections among intravenous drug users had been substantially curved through methadone treatment and free needle-exchange-programs (NEP). The latest surge in new infections is linked to the Island's commercial sex workers and the family members of their clients.
In exploring the current explosive increase in new infections emanating from the commercial sex sector, Mangku Karmaya cited four chief causes:
The low level of condom use during commercial sex transactions. Despite an active education campaign, experts estimate that only 30% of commercial sex workers demand that their clients wear prophylactics.
The growing imbalance between the number of sex workers and the number of customers they serve. An estimated 8,000 commercial sex workers in Bali are serving approximately 90,000 clients.
The increasing number of night-time entertainment venues and "kafes" on Bali and their spread to suburban and village locations have increased the number of acts of high-risk sexual contacts in areas where such practice was heretofore rare.
The "double jeopardy" cross-infection between overlapping contact among members of community of commercial sex workers and intravenous drug users.
Beyond the growing opportunity for infection within all levels of Balinese society, Mangku Karmaya also cites community-wide ignorance about HIV/AIDS and the resulting fear and discrimination encountered by those infected with the disease.
The health activist also laid blame for the current situation at the feet of the provincial government who he says are misguided in their approach to the commercial sex industry. Current policies that see sex workers caught in periodic sweeping raids, followed by rapid court trials and the expulsion of sex workers from Bali have only served to chase the illicit sex industry further underground, complicating efforts to address related health issues within the sex industry.
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