Authors: Rabiyatul Adawiyah, Eki Marlia, Novi Pratiwi Lestari dan Lukman Hapsaro

Reviewer: Farid Al-Firdaus, Nadia Faradiba, Alfi Nabila, Dwi Martutiningrum, Yuni Asnidar and Nur Zahroh Hamidah

  1. Why should we care for HIV?

In achieving the Indonesian golden age 2045, the Vision for Indonesia 2045 is arranged with four pillars, one of a kind and foremost is human resources, whose intelligence outperforms other nations worldwide. Health factors are critical for better human resources. Reducing Human Immunodeficiency Virus (HIV) cases will contribute to this pillar.  It is one of the incurable and preventable diseases spread worldwide by weakening the immune system, specifically the white blood cells (CD4 cells) which are important against any viruses, infections and cancers. 

The most dangerous stage is Acquired Immunodeficiency Syndrome (AIDS) that causes severe long-term diseases. The transmissions through anal/vaginal sex or sharing other drug injection equipment and even to their babies from the unaware pregnant women who suffer from HIV. For those people who are living with HIV (PLHV), Antiretroviral Therapy (ART) is crucial to achieve viral suppression or undetectable viral load. This state is necessary to prevent the mortality rate and sexual transmissions to their partners (CDC, 2023).

In Indonesia, Roughly, there are 640,000 PLHIV; 400,000 are men, and 220,000 are women, with the remaining children. Since 2010, the number of AIDS-related deaths in Indonesia has climbed by over 60%. The new HIV infections from January to March 2022 were around 1907 people (SIHA, 2022). Particular communities such as Direct and indirect female sex workers (FSW), men having sex with men (MSM), transgenders, people who inject drugs (PWIDs), and high-risk men are these essential populations.

The number of HIV cases reported was 7,000 in 2006, which reached 48,000 cases in 2017. In contrast, AIDS cases dropped from over 12,000 in 2013 to just over 9,000 in 2017. The increasing accessibility of ART and its efficient application contributed to this achievement, though it is still below the WHO objectives (Thompson, 2019).

There are approximately 340,000 people are aware of their status (53%), 17% are on ART, and only 1% have suppressed viral levels (Figure 1). Concern exists regarding ART’s accessibility across Indonesia with its 3,000 miles long and 17,000 islands. Sufficient evidence supports the claim that stigma and discrimination have slowed down Indonesia’s HIV response (Yuvraj, 2020).

Figure 1: national surveillance data for Indonesia for 2018. ARV + antiretroviral therapy. VL = Viral load. 

Source: HIV in Indonesia and in neighbouring countries and its social impact, Rhino et. al (2020)

Meanwhile, in the Asia-Pacific region, approximately 4 million PLHIV, representing nearly 15% of the world total. The prevalence varies from the global average of 0.22% of the population and is above this average in Cambodia, Indonesia, Myanmar, and Papua New Guinea as well as Thailand (UNAIDS, 2019a). There are marked differences in the region as to trends of infection (Table 1). 

Table 1: People living with HIV/AIDS Asia-Pacific region in 2019

Source: HIV in Indonesia and in neighbouring countries and its social impact, Rhino et. al (2020)

  1. How could online communities increase HIV awareness? 

By 2050, over three-quarters of the world’s population living in cities will face health problems. To reduce this risk, it is important to provide people with in-depth health knowledge through digitalization and health literacy, besides health literacy is also used as cities’ and communities’ resources (Kristine, 2018). It will be damaging if health literacy is not maximized, especially for PLHIV. For instance, less understanding of ART could lead to HIV transmission through risky behaviors (Sanders, 2021). 

In 2013, Jadin claimed that research on knowledge sharing primarily focused on online communities and virtual teams. Online communities have a shared goal, are governed by informal policies, and computer technologies support their interactions. Promoting continued education is essential to stop HIV transmissions and improve the well-being of PLHIV. We want to investigate how the communities will play their educator roles, specifically online communities.

Because of its large archipelagic traits, Indonesians behave like outgoing marine people, accustomed to helping those in need and collaborating harmoniously, leading to group gatherings. This character is amplified with the emergence of the internet through building online communities and bringing new human connectivity (Pontoh, 2012).

Online communities have provided ubiquitous benefits, such as:

  1. Accessible – People with mobility problems, speech and hearing difficulties, or caregiving responsibilities can easily participate. 
  2. Openness – PLHIV also found that online communities are welcoming places to disclose their problems since it is anonymous so that they feel safe when discussing a taboo topic leading to the possibility of honesty (White, 2001). However, the online stigma related to HIV was prevalent. People searching for HIV information might correlate with being HIV-positive (Paython, 2016).
  3. HIV-related transmission updates – Provide information about HIV transmision
  4. Activeness – Encourage people and PLHIV as the most contributing member in society in amplifying HIV awareness and concern
  5. Strategic amplifiers – The community should involve and cooperate with several parties:
  1. Scholars and teachers to amplify HIV education while being aware of the challenges these platforms presents (Henry, 2021). 
  2. Government to provide the HIV treatment programs, act as a bridge between PLHIV and nearby health center and regulate the social media amplification strategy based on international best practices with local modification (Strekalova & Krieger, 2017). 
  3. Doctors as an agent to present facts and counseling.
  4. Online community members to disseminate the HIV awareness to those who have limited access.
  1. Conclusion 

Regarding our concerns, studies and collaborative actions must examine how online communities meet these strategies. Based on that, we proposed online communities, regardless of their interest, to normalize HIV education. This action will strongly correlate with the Permenkes 21/2013 concerning HIV and AIDS Management stating that increasing community empowerment is one of the strategies for carrying out HIV and AIDS prevention activities. 

The online community will act as a powerful tool for massively educating and spreading HIV awareness to the public by collaborating with professional experts in their respective fields. Importantly, online communities can act as important agents for disseminating HIV-related knowledge to those who lack access to information.

In the long term, if part of society becomes aware of HIV, they could apply prevention actions, increase supportive attitudes toward PLHIV. Suppose the online communities maximize their members to raise HIV awareness. It will help Indonesia decrease the case of HIV/AIDS and achieve SDGs #3.

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