Prof.dr. Tjandra Yoga Aditama. SPP (K), MARS, DTM & H, DTCE, "..ARVs
( antiretroviral treatmentare ) not only beneficial for those who are already treated but also reduce the burden of the epidemic in the community with appropriate cut HIV transmission,..."
Prof.dr. Tjandra Yoga Aditama. SPP (K), MARS, DTM & H, DTCE
ARV treatment to control the spread of HIV / AIDS
Based on the study, HIV positive who receive antiretroviral treatment (ARV) have a very small likelihood of transmitting HIV than those who were not treated.
ARVs are not only beneficial for those who are already treated but also reduce the burden of the epidemic in the community with appropriate cut HIV transmission, said Director General of Disease Control and Environmental Health (P2PL), Prof.. dr. Tjandra Yoga Aditama. SPP (K), MARS, DTM & H, DTCE at the meeting of Monitoring and Evaluation Referral Hospital Antiretroviral (ARV) Western Regional recently in Jakarta.
On that occasion also requested that the Director General P2PL further enhanced implementation strategy for the coverage of HIV testing and ARV initiation as early as possible and how to normalize HIV testing in the community, so that HIV testing in parallel with other laboratory tests and to reduce stigma and discrimination.
In efforts to expand HIV testing was offered and performed on all people with STIs disease, pregnant women, pairs of HIV positive patients with TB-HIV co-infection, patients with hepatitis B and C. It is expected that in 2014 could reach 4 million people tested for HIV.
To increase the coverage of antiretroviral therapy, and retention, the provision of ARVs to provide convenience and comfort of people living with HIV / AIDS (PLWHA).
According to Tjandra, starting in 2013 will be available fixed combinations which form the Triple Fixed Dose Combination (FDC) which consists of a combination of Tenofovir, Emtricitabine, and Evafirens. Uses 3 triple FDC has the advantage of convenience of use, low side effects and prevention of resistance.
The Ministry of Health supports the presence of antiretroviral drugs through good logistics management. Currently there are reports that certain types undergo ARV stock outs, therefore, appealed to the Director General P2PL each officer in order to monitor the availability of ARVs careful attention to the rest of the available drugs, including taking into account the shipping cycle, availability of personnel, and financing the provision of various resources.
This will be very important especially when ARVs will be decentralized to local government through the Provincial Health Office and District / City of discretion MOH one gate policy related to medication management. It was proved that Indonesia can realize Getting to Three Zeros, explained Prof. Thandra.
HIV / AIDS is the biggest challenge in achieving the target of the MDGs (Millennium Development Goals). Transmission of new HIV infections still occur and people with AIDS are still found, in this case the prevention and early detection of HIV should continue to be encouraged.
As of December 2012 cumulatively totaled 98 390 people living with HIV and AIDS people carrying amount to 42 887 people.
Data transmission of HIV to December 2012 shows transmission through heterosex-risk relationship of 58.7%, 17.5% injecting drug use and perinatal transmission of 2.7%.
From the results of the modeling in 2012 known trend of increasing new HIV infections occur in the next 3 main groups, namely men sex with men (MSM), among housewives and high-risk men (male sex buyers), while the increase in new infections in key populations such as (Female Sexual workers, IDU, and trans gender) does not happen too significant improvement.
These challenges require quick response to take immediate measures to be carried from upstream to downstream so that the epidemic is not developed to the side that is not good.
Efforts in the upstream can be done by giving sufficient briefing to the nation about the moral education, religious education, reproductive health education and knowledge about the dangers of drug use, because of the things that is the entrance of the growing epidemic of HIV / AIDS and prevention at the population still undertake risky behavior.
Other efforts, among others, by taking into account transmission lines such as sexual transmission, transmission through needle on drug users, and the transmission through the transmission from mother to unborn child.
Prevention of Sexual Transmission Through (PMTs) conducted with consistent condom use and treatment of sexually transmitted infections (STIs). To reduce the risk of transmission of infection through needle done with the program LASS (Sterile Syringe Services) and methadone maintenance therapy.
In 2012 launched the Comprehensive Continuous Service activities (LKB), a service at all health care facilities, up to the primary health care facilities, providing HIV and AIDS services in accordance with the referral mechanism, so it can be easily affordable to the public.
Community involvement, the initiator of the group, and Peer Support Group (KBS) in health care is a very important element. In addition, the role of the National AIDS Commission is the main motor driving the relationship between services and communities as well as other related sectors are expected to further increase the coverage of LKB.
Based on the study, HIV positive who receive antiretroviral treatment (ARV) have a very small likelihood of transmitting HIV than those who were not treated.
ARVs are not only beneficial for those who are already treated but also reduce the burden of the epidemic in the community with appropriate cut HIV transmission, said Director General of Disease Control and Environmental Health (P2PL), Prof.. dr. Tjandra Yoga Aditama. SPP (K), MARS, DTM & H, DTCE at the meeting of Monitoring and Evaluation Referral Hospital Antiretroviral (ARV) Western Regional recently in Jakarta.
On that occasion also requested that the Director General P2PL further enhanced implementation strategy for the coverage of HIV testing and ARV initiation as early as possible and how to normalize HIV testing in the community, so that HIV testing in parallel with other laboratory tests and to reduce stigma and discrimination.
In efforts to expand HIV testing was offered and performed on all people with STIs disease, pregnant women, pairs of HIV positive patients with TB-HIV co-infection, patients with hepatitis B and C. It is expected that in 2014 could reach 4 million people tested for HIV.
To increase the coverage of antiretroviral therapy, and retention, the provision of ARVs to provide convenience and comfort of people living with HIV / AIDS (PLWHA).
According to Tjandra, starting in 2013 will be available fixed combinations which form the Triple Fixed Dose Combination (FDC) which consists of a combination of Tenofovir, Emtricitabine, and Evafirens. Uses 3 triple FDC has the advantage of convenience of use, low side effects and prevention of resistance.
The Ministry of Health supports the presence of antiretroviral drugs through good logistics management. Currently there are reports that certain types undergo ARV stock outs, therefore, appealed to the Director General P2PL each officer in order to monitor the availability of ARVs careful attention to the rest of the available drugs, including taking into account the shipping cycle, availability of personnel, and financing the provision of various resources.
This will be very important especially when ARVs will be decentralized to local government through the Provincial Health Office and District / City of discretion MOH one gate policy related to medication management. It was proved that Indonesia can realize Getting to Three Zeros, explained Prof. Thandra.
HIV / AIDS is the biggest challenge in achieving the target of the MDGs (Millennium Development Goals). Transmission of new HIV infections still occur and people with AIDS are still found, in this case the prevention and early detection of HIV should continue to be encouraged.
As of December 2012 cumulatively totaled 98 390 people living with HIV and AIDS people carrying amount to 42 887 people.
Data transmission of HIV to December 2012 shows transmission through heterosex-risk relationship of 58.7%, 17.5% injecting drug use and perinatal transmission of 2.7%.
From the results of the modeling in 2012 known trend of increasing new HIV infections occur in the next 3 main groups, namely men sex with men (MSM), among housewives and high-risk men (male sex buyers), while the increase in new infections in key populations such as (Female Sexual workers, IDU, and trans gender) does not happen too significant improvement.
These challenges require quick response to take immediate measures to be carried from upstream to downstream so that the epidemic is not developed to the side that is not good.
Efforts in the upstream can be done by giving sufficient briefing to the nation about the moral education, religious education, reproductive health education and knowledge about the dangers of drug use, because of the things that is the entrance of the growing epidemic of HIV / AIDS and prevention at the population still undertake risky behavior.
Other efforts, among others, by taking into account transmission lines such as sexual transmission, transmission through needle on drug users, and the transmission through the transmission from mother to unborn child.
Prevention of Sexual Transmission Through (PMTs) conducted with consistent condom use and treatment of sexually transmitted infections (STIs). To reduce the risk of transmission of infection through needle done with the program LASS (Sterile Syringe Services) and methadone maintenance therapy.
In 2012 launched the Comprehensive Continuous Service activities (LKB), a service at all health care facilities, up to the primary health care facilities, providing HIV and AIDS services in accordance with the referral mechanism, so it can be easily affordable to the public.
Community involvement, the initiator of the group, and Peer Support Group (KBS) in health care is a very important element. In addition, the role of the National AIDS Commission is the main motor driving the relationship between services and communities as well as other related sectors are expected to further increase the coverage of LKB.
Pengobatan ARV kendalikan penyebaran HIV/AIDS
Berdasarkan penelitian, pengidap HIV positif yang mendapatkan pengobatan antiretroviral (ARV) memiliki kemungkinan sangat kecil menularkan HIV dibanding mereka yang tidak diobati.
ARV tidak hanya menguntungkan bagi orang yang sudah diobati tapi juga menurunkan beban epidemi pada masyarakat dengan memutus penularan HIV secara tepat, kata Direktur Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan (P2PL), Prof. dr. Tjandra Yoga Aditama. SpP(K), MARS, DTM&H, DTCE pada acara Pertemuan Monitoring dan Evaluasi RS Rujukan Antiretroviral (ARV) Regional Barat belum lama ini di Jakarta.
Pada kesempatan itu pula Dirjen P2PL meminta agar strategi implementasi lebih ditingkatkan untuk cakupan tes HIV dan inisiasi ARV sedini mungkin dan cara melakukan normalisasi tes HIV pada masyarakat, agar tes HIV sejajar dengan tes laboratorium lainnya dan dapat mengurangi stigma dan diskriminasi.
Dalam upaya perluasan tes HIV telah ditawarkan dan dilakukan pada semua orang dengan penyakit IMS, Ibu hamil, pasangan dari HIV positif, penderita koinfeksi TB-HIV, penderita hepatitis B dan C. Diharapkan pada tahun 2014 bisa mencapai 4 juta orang yang melakukan tes HIV.
Untuk meningkatkan cakupan terapi ARV dan retensi, penyediaan ARV memberikan kemudahan dan kenyamanan Orang Dengan HIV/AIDS (ODHA).
Menurut Tjandra, mulai tahun 2013 akan tersedia bentuk kombinasi tetap yaitu Triple Fixed Dose Combination (FDC) yang terdiri atas kombinasi Tenofovir, Emtricitabine, dan Evafirens. Penggunaan Triple FDC memiliki 3 keunggulan yaitu kenyamanan penggunaan, rendahnya efek samping dan pencegahan terjadinya resistensi.
Kementerian Kesehatan mendukung adanya ARV melalui pengelolaan logistik yang baik. Saat ini masih ada laporan bahwa ARV jenis tertentu mengalami stock out, oleh karena itu, Dirjen P2PL mengimbau petugas agar dapat saling memonitor ketersediaan ARV memperhatikan secara cermat sisa obat yang tersedia termasuk memperhitungkan siklus pengiriman, ketersediaan tenaga, dan pembiayaan penyediaan berbagai sumber daya.
Hal ini akan menjadi sangat penting terlebih pada saat ARV akan didesentralisasikan ke pemerintah daerah melalui Dinas Kesehatan Propinsi dan Kabupaten/Kota sesuai kebijakan Kemkes terkait one gate policy untuk pengelolaan obat. Hal itu membuktikan bahwa Indonesia dapat mewujudkan Getting to Three Zeros, jelas Prof Thandra.
HIV/AIDS merupakan tantangan terbesar dalam mencapai target MDGs (Millenium Development Goals). Penularan infeksi baru HIV masih terjadi dan pengidap AIDS masih ditemukan, dalam hal ini upaya pencegahan dan deteksi dini HIV harus terus digalakkan.
Sampai Desember 2012 secara kumulatif penderita pengidap HIV berjumlah 98.390 orang dan AIDS tercatat berjumlah 42.887 orang.
Data penularan HIV sampai Desember 2012 menunjukkan penularan melalui hubungan heterosex yang berisiko sebesar 58,7%, penggunaan napza suntik 17,5% dan penularan masa perinatal 2,7%.
Dari hasil modeling tahun 2012 diketahui tren peningkatan infeksi baru HIV kedepan terjadi pada 3 kelompok utama yaitu lelaki seks dengan lelaki (LSL), kalangan ibu rumah tangga dan lelaki beresiko tinggi (lelaki pembeli seks), sedangkan peningkatan infeksi baru pada populasi kunci seperti (Wanita Pekerja Seksual, Penasun, dan trans gender) tidak terjadi peningkatan yang terlalu signifikan.
Tantangan tersebut menuntut respon cepat untuk dapat segera melakukan upaya agar dapat dilakukan dari hulu sampai hilir agar epidemi ini tidak berkembang kearah yang tidak baik.
Upaya di hulu dapat dilakukan dengan memberi pembekalan yang cukup kepada bangsa mengenai pendidikan moral, pendidikan agama, pendidikan mengenai kesehatan reproduksi serta pengetahuan bahaya penggunaan Napza, karena hal-hal inilah yang menjadi pintu masuk dari pertumbuhan epidemi HIV/AIDS serta pencegahan pada populasi yang masih melakukan perilaku berisiko.
Upaya lainnya antara lain dengan memperhatikan jalur transmisi seperti transmisi seksual, transmisi melalui jarum suntik pada pengguna napza, dan transmisi melalui penularan dari Ibu ke anak yang dikandung.
Pencegahan Melalui Transmisi Seksual (PMTS) dilakukan dengan penggunaan kondom secara konsisten serta pengobatan penyakit infeksi menular seksual (IMS). Guna mengurangi risiko transmisi penularan melalui jarum suntik dilakukan dengan program LASS (Layanan Alat Suntik Steril) dan terapi rumatan metadon.
Tahun 2012 diluncurkan kegiatan Layanan Komprehensif Berkesinambungan (LKB) yaitu layanan pada semua fasilitas layanan kesehatan, sampai pada fasilitas layanan kesehatan primer, memberikan layanan HIV-AIDS sesuai dengan mekanisme rujukan, sehingga dapat terjangkau masyarakat dengan mudah.
Keterlibatan komunitas, kelompok penggagas, dan Kelompok Dukungan Sebaya (KBS) didalam layanan kesehatan merupakan suatu elemen yang sangat penting. Selain itu, peran Komisi Penanggulangan AIDS merupakan motor utama penggerak dalam hubungan antara layanan dan komunitas serta sektor lain yang terkait yang diharapkan dapat semakin meningkatkan cakupan LKB
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