CHAPTER IPRELIMINARY 1.1 BackgroundHIV is the abbreviation from Human Immuno Deficienci Virus. This virusattacks the human immune system, so that someone who suffers the disease will geta high decrease in the ability to defend the body from opportunistic infectionsand various disease attacks.
This virus was commonly infected in body fluidssuch as blood, semen, vagina fluid, and breast.When HIV virus has reached an advanced stage, 5-12 years from thebeginning of the attack, HIV virus will cause AIDS (Acquired Immuno DeficiencySyndrome). In industrialized countries, an HIV-infected adult will become AIDSwithin a period of 12 years. Meanwhile in developing countries, the time periodwill be shorter specifically 7 years. (Liswidyawati, 2010).HIV / AIDS is transformed into one of the most feared diseases oftoday’s world society.
Despite many studies and research on this disease, thereis no effective drug in solving or destroying the HIV virus in the human body.Nowadays, the sufferers could only consume ARVs that only inhibit the growth,not to kill all of the virus. Since discovered in 1981 in America and Europe,the disease continues to spread throughout the world. Until the end of 2015,research says, there were 35 million cumulative deaths from AIDS-relatedillnesses since the start of the epidemic, and there are still 36.7 millionpeople globally living with HIV.
Thus, this disease has become one of the mostdeadly epidemics in human history.Seeing this condition, the world society does not want to be silent.Through the United Nations (UN), the world society has committed to reducingthe spread of this epidemic. In the year 2015, they completed the MDGs program,but it the program still remains unfinished. So, the UN established SDGs(Sustainable Development Goals) as a form of global commitment in an effort tosolve the world’s problems.
Including HIV / AIDS. The epidemic is targeted ingoal number 3 in SDGs. There is “Good Health and Well Being”. Thereare several targets in SDGs number 3 related to HIV / AIDS: 1) By 2030, end theepidemics of AIDS, tuberculosis, malaria and neglected tropical diseases andcombat hepatitis, water-borne diseases and other communicable diseases, 2)Strengthen the prevention and treatment of substance abuse, including narcoticdrug abuse and harmful use of alcohol, 3) By 2030, ensure universal access to sexual andreproductive health-care services, including for family planning, informationand education, and the integration of reproductive health into nationalstrategies and programmes 4) Support the research and development of vaccinesand medicines for the communicable and non-communicable diseases that primarilyaffect developing countries. As one of the UN member, Indonesia must become actively involved in theprogram. In its application inside the country, Indonesia has summarized theSDGs in the existing laws and regulations in Indonesia. Indonesia has created astrong legal foundation as an effort to solve global problems that occur insidethe country. Likewise the problematic of HIV / AIDS, Indonesia has made astrong legal foundation in Indonesia.
As we know, the basis of the formation ofthis legislation is of course the basis of our State of Pancasila which is describedin the constitutional form in the UUD 1945 and other Indonesian legislationPancasila as the Ideal Foundation and the nation’s view of life hasstrong values in it. Bakry quoted in the MKWU’s book, Pancasila’s Education forHigher Education said that Pancasila said to be the nation’s life view is meaningthe values of divinity, humanity, unity, democracy, justice and believed in thegoodness, the beauty, and the usefulness by Indonesian nation serve as aguideline for the society and national life and gives a strong determination topractice it in real life.Pancasila and the UUD 1945 in Indonesia became the nation’s benchmark insolving the problem. HIV / AIDS as one of the nation’s problems, should be seenfrom Pancasila and the UUD 1945 point of view.
Therefore, it is necessary todeepen the Pancasila and the UUD 1945 against the HIV / AIDS epidemic.1.2 Problem Formulation2. What is thedefinition, causes and danger of HIV/AIDS ?3. How does thePancasila view to HIV/AIDS ?4. How does thegovernment strategies and programs to overcome the HIV/AIDS epidemic accordingto the existing of laws and regulation in Indonesia?CHAPTER IIDISCUSSION 2.
1 Definition, Causes and Dangers of HIV / AIDSAccording to Permenkes RINo. 21 Year 2013, Human Immunodeficiency Virus (HIV) is a virus that resultAIDS. While Acquired Immuno Deficiency Syndrome (AIDS) is a collection ofsymptoms that reduced self-defense capabilities caused by the entry of HIVvirus in a human’s body. Thus, HIV / AIDS is one of the types of dangerousdiseases caused by HIV virus that attack the human immune system.The Existing of HIV virus atsomeone body will continue destroy immune.
As a consequence, viruses, bacteriums,mushrooms that usually is not dangerous become breakneck because its immunesystem body. (Pipih Sopiah, 2011, hlm. 9). Until now, there is no drug thatcompletely eliminates the HIV virus. Currently, people with HIV / AIDS diseasecan only rely on antiretroviral drugs that inhibit the HIV virus to develops inthe body.
The HIV virus can be foundin the human body, commonly found in blood, semen, and vaginal liquid. Thisvirus can also be found in other bodies, such as breast milk, but in fewerlevels. Therefore, HIV virus is widely spread through sex, the use ofcontaminated syringes, and through contaminated blood transfusion. DG of Communicable DiseaseControl & Environmental Health Ministry in the fourth quarter of December2016 released HIV / AIDS statistic data in Indonesia.Graph 2.1. Number of HIV PatientsBased on ProvinceGraph 2.
2. Number of AIDSPatients Based on Province Based on graph 2.2, the report of DG of Disease Control Health Ministry in RI, HIV sufferers in Jakarta reach 45,355people. This indicates that the province of DKI Jakarta is the province inIndonesia with the most people with HIV, followed by East Java as many as31,429 patients. While in the AIDS, the most amount of patient is in theProvince of East Java as many as 16,911 patients. Followed by Papua with a totalof 13,398 patient.
2.2 Pancasila As A Moral SystemThe fourth paragraph in the Preamble of the UUD 1945states the phrase:”…maka disusunlah kemerdekaan kebangsaan Indonesia itu dalam suatuUndang-Undang Dasar negara Indonesia, yang terbentuk dalam suatu susunan negaraRepublik Indonesia yang berkedaulatan rakyat dengan berdasar kepada : KetuhananYang Maha Esa, kemanusiaan yang adil dan beradab, persatuan Indonesia, dan kerakyatanyang dipimpin oleh hikmat kebijaksanaan dalam permusyawaratan/perwakilan, sertadengan mewujudkan suatu keadilan sosial bagi seluruh rakyat Indonesia.” The sentence is preceded by the function and purposeexplanation of the Republic of Indonesia. The paragraph shows that is veryfundamental for Pancasila as the foundation toward the ideals of the nation.
Thus, citizens of Indonesia are obligedto do Pancasila’s values in all aspects of life including in the ethical systemPancasila as an ethics system is a moral guidancefor the citizen of Indonesia that can be implemented in the real behavior ofour daily life. In the ethics of Pancasila, there are values of divinity,humanity, unity, democracy, and justice.These five values forming Indonesian human behaviorin all life aspects. The first “Sila”, divinity, contains spiritual values thatcan be realized in bringing the human person closer to the Creator. The secondprinciple, humanist value, means to make humans more humane that can beimplemented by improve the quality of humanity in the inter-communalrelationship. The value of unity contains solidarity, a sense of togetherness(mitsein), love the homeland. Democracy contain the value of respect each other,appreciate every opinions of others, and not to force our desire to others. Thelast value, justice, deliver value of caring and helping each other.
2.3 The Pancasila Perspective to HIV PatientsIn daily life, the values ofPancasila reach many aspects, and one of them is health aspect. Pancasila as anethical system in relation to the health aspects will interpreting many things.Analysed from cases of epidemic HIV / AIDS, when it’s infected because of free sexthat is not suit according to the norm. Surely, he has violated the values ofPancasila.
Violations of the firstprecepts are made by HIV-infected persons who infected by having free sex orwho are experiencing with the type of same because in the whole religion thatexists in Indonesia does not agree to free and homosexual (Lukman Hakim, 2017).In addition, the patients surely violate the second precepts. In humanitiesvalue, we make humans more human.
If the person has sex with the same sex orfreely, then the human will be fade.However, when viewed fromanother perspective, about how people views another who living with HIV / AIDS,they must be well-regarded. The first principle, religion, teach to be good to another.Then, the implementation is to provide support for people living with HIV.
Thesecond precept is aimed at not subjecting the eye to the sufferers. Viewed fromthe third precepts, mandate all the people of Indonesia to support and assistthe patients. And the fifth precept dictates how justice is taught in thesocial environment. There should be no difference between sufferers andnon-suffered either from social treatment and other rights. 2.4 HIV / AIDS Handling ActivitiesIn Permenkes No.
21 Year 2013, there are fivecountermeasures against HIV / AIDS conducted by the government:: 1. HealthPromotionAscontained in article 10 clause 1 and 2, health promotion is aimed at promotingcorrect and comprehensive knowledge on prevention of HIV transmission andeliminating bad stigma in society. Promotion is given in the form of advocacy,development of atmosphere, empowerment, partnership and community participationfit in socio-cultural conditions and supported by public policy.Inpractice, officials from the government will emphasize the benefits andtreatment of HIV test, condom use, and antiretroviral treatment. The deliverymethod used to be match with the culture, language, and habits of the local society.Withthis health promotion, is expected to be the beginning of awareness andknowledge of the community about HIV / AIDS.
Pipih Sopiah, (2013), explainsthere are four stages of forming people’s understanding of HIV / AIDS:2.4.1 KnowledgeThe first stage after gaining knowledge and counselling. At this stage,the public will know the beginning of HIV/AIDS and way its infection andspreading, danger, and its prevention way.
2.4.2 Confidence(beliefs)This effort started to wake up the society about the danger of HIV/AIDSvirus. But in fact, until now many people who know about HIV / AIDS but stilldoubt it. They do not believe that until now HIV / AIDS has no cure.
2.4.3 Awareness/founding/confidence(conviction)After they are getting knowledge and belief, they expect they will beaware, so the danger of free sex and prostitution activity that influence theinfection and spreading HIV/AIDS. 2.4.4 Domination(mastery)After getting theknowledge, hopefully they can be able to realize and motivated, and people willtry to implement the knowledge they already have in their daily world. 2.
Preventionof HIV Transmission Graph 2.3. Number of HIV Patients by Factor(Source: Report of DG of Disease Control& Environmental Health Ministry)Based on graphic 2.
3 the report of DG of DiseaseControl & Environmental Health Ministry in RI until December 2016, the spread of HIV virus are mostlyoccurred due to hetero sex factor with a total of 83,037 people. Followed by otherfactor, 42,544 people, then LSL / MSM (homosexual) with the number 27.509people, and injecting drug users as many as 14,749 people. The total number ofpeople with HIV virus including the unknown cause is 204.
095 people.Moreover, from the graph there is also a considerableincrease from year to year. The largest enhancement is found in 2015 to 2016 asmany as 15,002 people whereas the infection from the previous year’s growth wasonly about 2000-4000 people.Forthe reason, the Indonesian Government are trying to inhibit HIV deployment.
Prevention of HIV transmission in Indonesia in Permenkes No. 21 Year 2013Number 12. Rules on prevention of HIV transmission can be achieved effectivelyby applying a safe and non-risk lifestyle. There are three prevention types whichconducted by the government: a. Preventionof HIV transmission through sexual intercoursePreventionof HIV transmission through sexual intercourse is an effort to prevent someoneinfected with HIV and / or other sexual infectious disease. Prevention of HIVtransmission through sexual intercourse is focused on high-potential place inspreading of the risky sexual HIV virus.
Prevention of HIV transmission throughsexual intercourse is conducted with four integrated activities including:a) Enhancingthe role of stake holdersb) Behaviorchange interventionc) Managementof preventive health supplyd) Managementof sexual infectious disease Furthermore,in article 14 states that prevention of HIV through sexual intercourse isconducted through efforts to:a) Nothaving sexual intercourse (Abstinensia) for unmarried;b) Beingfaithful with a spouse, means only having sex with not HIV-infected;c) Condomused) Avoidthe misuse of drugs / other addictive substances e) Improvingprevention capabilities through education as early as possible f) Doother prevention, including through circumcision b. Preventionof HIV Transmission through Non-Sexual RelationsInarticle 15, prevention of HIV transmission through non-sexual relations aimedat preventing the transmission of HIV through the blood, including blood donortest, prevention of HIV infection on medical and non-medical measures that injurethe body, and decrease an adverse effects of injecting drug users c. Preventionof mother-to-child HIV transmission Preventionof mother-to-child HIV transmission is carried out through 4 (four) activitieswhich include:a) Preventionof HIV transmission in reproductive age womenb) Unplannedpregnancy prevention in women with HIVc) Preventionof HIV transmission from pregnant women with HIV to their babiesd) Givea psychological, social and care support to mothers with HIV and theirfamilies. Theessence of that activity is point c, the prevention of HIV transmission inpregnant women who have been infected with HIV to their children. Acomprehensive maternal and child health services includes the followingactivities:1) IntegratedANC services including HIV testing;2) HIVDiagnosis 3) Antiretroviraltherapy given4) Safechildbirth 5) Feedingmanagement for infants and children;6) Delayand regulate pregnancy;7) Antiretroviralprophylaxis and cotrimoxazole given in children;8) Diagnosticinspection of HIV in children 3. HIVDiagnostic InspectionNowadays,many people are not aware that he/she was infected by HIV. HIV / AIDS patientsare likened to the iceberg philosophy, which is reported in the governmentdata, it’s only a fraction number of unknown patients. Thus, the HIV screeningprogram was set up in Article 21 stated that an HIV diagnostic inspection wasconducted to prevent early transmission or increased incidence of HIVinfection.
This inspection is based on the principle of confidentiality (theresults of the examination should be kept confidential except for certainpersons), approval, counseling, recording, reporting and referral.Inarticle 22, there are two kinds of procedures for carrying out an HIVdiagnostic inspection:a. VoluntaryTesting.This test is only for someone who approves it in paper writing. Thereare three steps in performing this test: Pre-test counselling; HIV testing; andpost-test Counselling.b. HIVTesting On Health Staff Initiation This test is for someone who does not make a written rejection.
Usually,the test becomes a suggestion in doing this following action:a. Whena person comes to a health care facility with symptoms or medical conditionsthat bring throught the person to become infected with HIV,b. Antenatalcare in pregnant women and maternity mothers,c. Babiesborn from HIV-infected mothers,d. Childrenwith abnormal growth in large epidemic areas, or malnourished children who arenot working with malnourished druge. Adultmen who request a circumcision as a prevention against HIV.Thereis little difference in the HIVTesting on Health Staff Initiation implementation steps.Unlike with voluntary testing, this test is not preceded by pre-testcounseling.
There are four steps in doing the test: giving information aboutHIV / AIDS, test execution, delivering of results, and followed by counseling 4. Treatment,care, and supportUntilnow, there is no drug that fully destroys or eliminates the HIV virus.Therefore, the Indonesian government seeks the treatment, care and supportprovided for in Article 30, it is said that every health care facility isprohibited from refusing treatment and care for people living with HIV. And ifthe facility is not sufficient for HIV prevention, the facility must refer itto the ARV referral hospital.UnderArticle 33, HIV and AIDS treatment is performed by the following treatment:a. TherapeuticTherapeutics means all things that related to therapy. In the context ofHIV / AIDS, therapeutic (therapy) is associated with antiretroviral treatment,STI treatment, and treatment of opportunistic infections.
b. ProphylaxisAccording to KBBI, the meaning of prophylaxis is health care and diseaseprevention. Prophylactic treatment in HIV treatment includes post-exposure antiretroviraltherapy and co-trimoxazole for therapy.
c. SupportSupportive treatment in this context is adjuvant supportive treatment,and improved nutrition. 5. RehabilitationRehabilitationmeans carried out on every transmission pattern of HIV to the key populationsspecifically sex workers and injecting drug users (IDUs) in the form ofimproving work skills and self-efficacy that can be done by the social sector,both government and society. Rehabilitation of HIV and AIDS activities isexpected to restore the quality of life to be productive economically andsocially. CHAPTER IIICLOSING 3.
1 ConclutionPancasila as the legalideology in Indonesia obliges its people to practice their good values.Pancasila has many points of view. In his view as an ethical system, Pancasilateaches its people to respect each other and live the norms that are inherentin society. Pancasila is implemented in a constitutional foundation in the formof the UUD 1945. Furthermore, Pancasila and the UUD 1945 cover many aspects.Among the important aspectscovered by the UUD 1945, there is aspects of health. One of the focus of healthaspects is the growing HIV / AIDS epidemic worldwide.
HIV / AIDS is one of themost feared epidemic diseases in the world today. In addition there is no drugthat kills the virus intact, HIV / AIDS increasingly spread throughout theworld, especially in developing countries. Therefore, Indonesia implements acountermeasures system based on the values of Pancasila and the UUD 1945.
In its application, Indonesiathrough the Ministry of Health established Permenkes RI No. 21 Year 2013 whichbecame the main foundation in understanding HIV / AIDS disease in Indonesia. Init, there are definition, purpose, and how to overcome it as has been widelymentioned. 3.2 SuggestionThe authors suggest thatpeople deepen their knowledge of HIV / AIDS.
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