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Plague in Paradise? AIDS and Condoms “Misunderstood”

by Susi, 18 May 2011

Bali HIV AIDS situation, low condom use, high prostitution

Well, now we’ve gone and done it. HIV/AIDS thrives on ignorance and denial, and it’s thriving in Bali. A decade ago it was almost unheard of here; now it’s the stuff of headlines in the local Indonesian language newspaper almost every day. Today’s headline story, set off from the other news on page two of the Bali Post is “Condom Use Low in Bali”. Apparently this situation is the result of a “misunderstanding.” The story reads as follows.

Heterosexual contact is now the highest risk factor in HIV/AIDS transmission here. It is estimated that in 2010 there were appoximately 4,000 customers of sex workers here infected with the virus, with the potential of passing it on to their families, not only to their wives but to their children as well.

Ironically, the level of condom use among customers of sex workers in Bali is still very low; only around 26 percent. It should, however, be at the 80 to 90 percent level. “In Thailand, condom use is in the 80 to 90 percent range, and their HIV infection rates have dropped sharply,” stated the head of the Public Health Department of Bali, Dr. Nyoman Sutedja on Tuesday (17 May).

To reduce transmission of HIV/AIDS through heterosexual factors, the socialisation of condom use represents one effective means, particularly in prostitution areas. However, condom use is still consider a “tabu” subject by the people of Bali. Condoms are disapproved of, and seen as an endorsement of free sex, even at a time when unwanted pregnancies among school children are on the increase, along with HIV infection rates that are rising every year.

According toe Sutedja, Bali actually does have one public condom dispenser, located in Kuta. While it was installed as a means to reduce HIV/AIDS infection levels through heterosexual contact, local society opposed it regarding its presence as sanctioning free sex. Now, according to Sutedja, this condom dispenser no longer works because it is broken.

It is impossible not to comment on the article. Bear in mind that prostitution in various forms is commonplace in Bali, and is by no means limited in any way to tourism areas, such as Kuta. Simple, cheaply built brothels, known in local parlance as Kafe Remang, have sprouted like mushrooms all over the countryside and on the margins of  towns and villages. Numerous resident foreigners here who know what they look like, have complained about how many there are in the vicinity of The Green School, a high quality international school with the environment and social responsibility as key themes in its curriculum. Can you imagine driving a carpool future world leaders to and from school every day, passing a slew of cinderblock and tin brothel-bars on the way? I’m  certainly not pointing a finger at The Green School, and I’ll bet if there’s anything they can do to address the situation, they probably are doing it. I’m simply showing how the sublime and the tragic often rub elbows here in Bali. Strange bedfellows, so to speak.

Now consider that the HIV infection rate among sex workers in Bali today is variously estimated to be somewhere between 25 and 50 percent, depending on which study by which agency or NGO forms the basis of the report. A recent study of women giving birth in the main public hospital in the city of Singaraja revealed that an alarmingly high percentage are HIV positive. The same report also mentioned that numerous families in North Bali are 100% HIV positive; father, mother, and all of their children. Some households have become “extinct,” which poses problems for Balinese Hindus as it is not really feasible to “decommission” their family temples even if the entire family has passed away. And it’s essentially impossible to sell or buy a Balinese adat home or the land it sits on, even if it’s abandoned.

Finally, I’m laughing through tears here. How can it be worth mentioning that Bali has one public condom dispenser? Is that really something we can consider an “effort” to address the current AIDS epidemic on the island?

Also tragic, and ironic, is this article from a little over three years go, warning of an incoming tsunami of AIDS in Bali. And this one, from over five years ago, announcing how the local government would be installing lots of public condom dispensers. And, irony of ironies, Bali hosted the International Conference on AIDS in Asia and the Pacific, less than two years ago. It’s time for positive action. Click these links for starters: Yayasan AIDS Indonesia, Indonesia AIDS Community (in English) , Kerti Praja Foundation

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    • Bali777
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    • May 19, 2011

    Hi Susi, I like to point out a few things that your readers that do not know Bali well might want to know. Indeed, HIV is growing fast in Bali. Most of it is spread by prostitutes and their customers. However, these prostitutes, are on the very bottom of their profession In general, foreign men would never meet them.. The vast majority of the working girls in Kuta or the plus plus massage places do not have HIV. A friend of mine (yes I have a few unsavory friends), tests the girls when they start working for his place and then every six months. Never a positive. He has tested hundreds of girls this way over the last 4 years. In any case, Guys wear a hat. Regards, Peter

      • Susi
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      • May 19, 2011

      I think what Peter says is probably at least partially accurate. (Thanks, Peter for weighing in with your thoughts and opinions. Much appreciated.) The rapid spread of HIV among "regular folks" in Bali is related to the commercial sex industry here, especially the "lower-market" part of that industry. That's true. But I don't think it can possibly be correct to think there is a clear line between the "lower-market" (primarily patronised by local Indonesian people) and "the working girls in Kuta or the plus plus massage places". HIV infects all kinds of people, including nice, honest, kind, wealthy, educated, professional people, and all other kinds. All nationalities. The problem isn't the commercial sex industry itself. The problem is unsafe sex. It only happens because of lack of awareness about HIV, and lack of accurate understanding of how great the risks are of unprotected sex. They are great. Even if statistically small. The consequences of infection are tremendous. Wearing a "hat" or some call it a "raincoat" is not optional, it's necessary. No matter where or how expensive one's commercial sex provider is. Or non-commercial, if not scientifically certain that they are HIV-free. We should be very careful about suggesting to foreign men that they can feel safe having unprotected sex with commercial sex workers "in Kuta or the plus plus massage places". That's simply wrong. I don't want to sound snide, but I wonder if your friend tests the girls AFTER they've been working for a while, or just when they start working for him? And I wonder if he requires that the girls and the customers at his place practice safe sex, as they should. Always. You can't tell if someone has HIV by looking at their clothes, their car, their face, their friends, their house, their bank account, their nationality, or their place of work. It's not bad or wrong to have HIV. It is, however wrong to be unaware, careless, not know whether or not one has HIV, or practice unsafe sex. Full stop.

    • Bali777
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    • May 20, 2011

    Hi Susi, I could not agree more with you on condom use. To have sex with anyone, including pros, anywhere in the world, at the start of a relationship, is madness. The possible penalty is simply to high. I am definitely not suggesting that it safe to have unprotected sex with with girls in Bali. While they may not be infected with HIV, they may very well have all kind of other STDs. The line between pros and non-pros is very blurry in Bali, as in most developing countries. Best to presume that if a visiting man picks up a girl in a bar, she is not exactly going with him because of his great looks. My friend has them tested before they see any customer. Yes, the rule is condoms only. If he finds out that none were used, the girl is banned. Supposedly rarely happens, but then again, how can he really know? Peter

      • Susi
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      • May 21, 2011

      Thanks, Peter! Great comments. One great point that you make here is "the line between pros and non-pros is very blurry". Also, you and I, and most realistic thinkers recognise that the commercial sex industry has been thriving since the dawn of humanity and will continue to thrive. Whether people like it or not, they need to recognise this simple fact, and give some attention to it in order to prevent or at least mitigate negative effects that can occur in relation to commercial sex.

    • mo
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    • April 15, 2015

    Girl workers? What about the male workers in Bali! Tons of them out for a bule, and a bit of cash. Male massage services in Bali go beyond the western norm of relaxation.

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