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HIV/AIDS: ASPEK
EPIDEMIOLOGI & STRATEGI
PENANGGULANGAN NASIONAL
Joko Mulyanto
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OUTLINE
Pendahuluan
Situasi HIV/AIDS Global dan Nasional
Strategi Nasional Penanggulangan HIV/AIDS


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SEJARAH
AIDS: Acquired Immunodeficiency Syndrome;
Kumpulan gejala dan tanda akibat berkurangnya
sistem imun tubuh.
Kasus klinis diidentifikasi pertama kali di AS
tahun 1981.
Agen Penyebab adalah Human
Immunodeficiency Virus (HIV), diidentifikasi
tahun 1983.
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ASPEK EPIDEMIOLOGIS
Penularan: Parenteral (kontak seksual, jarum suntik,
transfusi, transplasental).
Masa inkubasi panjang.
Fatalitas tinggi.
Treatement: ARV (mahal), vaksin belum tersedia
Populasi tertentu berisiko tinggi
Konsekuensi: sosial, psikologis, ekonomis, demografis.
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KLASIFIKASI EPIDEMI HIV
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HIV / AIDS
SITUASI GLOBAL & NASIONAL
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Global summary of the AIDS epidemic, December 2007

Total 33 million [30 36 million]
Adults 30.8 million [28.2 34.0 million]
Women 15.5 million [14.2 16.9 million]
Children under 15 years 2.0 million [1.9 2.3 million]
Total 2.7 million [2.2 3.2 million]
Adults 2.3 million [1.9 2.8 million]
Children under 15 years 370 000 [330 000 410 000]
Total 2.0 million [1.8 2.3 million]
Adults 1.8 million [1.6 2.1 million]
Children under 15 years 270 000 [250 000 290 000]
Number of people living
with HIV in 2007
People newly infected
with HIV in 2007
AIDS deaths
in 2007
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Global estimates for adults and children, 2007
People living with HIV 33 million [30 36 million]
New HIV infections in 2007 2.7 million [2.2 3.2 million]
Deaths due to AIDS in 2007 2.0 million [1.8 2.3 million]
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Over 7400 new HIV infections a day in 2007
More than 96% are in low and middle income countries
About 1000 are in children under 15 years of age
About 6300 are in adults aged 15 years and older
of whom:
almost 50% are among women
about 45% are among young people (15-24)
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KASUS HIV/AIDS INDONESIA
(2007)
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2007 : 11.141 kasus AIDS, 6.066 HIV positif (10
%, fenomena gunung es).
Prevalensi nasional 0,16 %; Papua 2,4 %
PSK 9,4 %
LSL (MSM) 5,2 %
IDU 52.4%
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Modeling Epidemiologi HIV/AIDS
(2020)
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Sebaran Geografis HIV/AIDS
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HIV/AIDS
STRATEGI PENANGGULANGAN NASIONAL
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ASPEK LEGAL
Komitmen Sentani 19 Januari 2004
Peraturan Presiden No.75 tahun 2006 tentang
Komisi Penanggulangan AIDS
Permenko Kesra No.7 tahun tentang Strategi
Nasional Penanggulangan AIDS 2007 - 2010
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LATAR BELAKANG
Perkembangan kasus yang sangat pesat
menuju ke epidemi.
Dampak demografi, pelayananan kesehatan,
ekonomi, tatanan sosial.
Respon terdahulu yang belum mencukupi.
Isu strategis: IDUs, perilaku seksual berisiko,
mobilitas penduduk.
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TUJUAN
Mencegah dan mengurangi penularan HIV
Meningkatkan kualitas hidup ODHA.
Mengurangi dampak sosial ekonomi akibat HIV
dan AIDS pada individu, keluarga, dan
masyarakat.

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PRINSIP DASAR
Memperhatikan nilai agama dan norma budaya
masyarakat.
Gerakan nasional, semua komponen masyarakat.
Fokus pada kelompok berisiko tinggi.
Menghormati harkat dan martabat manusia dan prinsip
kesetaraan gender.
Pencegahan efektif dan harm reduction
Informed consent, konseling, konfidensialitas.
Non diskriminatif.
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AREA PRIORITAS
Pencegahan HIV dan AIDS
Perawatan, pengobatan, dukungan kepada
ODHA.
Surveilans HIV/AIDS dan IMS.
Penelitian dan riset operasional
Lingkungan kondusif.
Koordinasi dan harmonisasi multipihak.
Kesinambungan penanggulangan.
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PENCEGAHAN HIV & AIDS
Infected people, high-risk people, vulnerable
people, general population.
Tujuan: tidak tertular dan tidak menularkan.
Program:
- VCT - Produk darah yang aman
- Kondom - Universal precaution.
- Harm reduction
- PMTCT
- Penanggulangan IMS

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PERAWATAN, PENGOBATAN,
DUKUNGAN ODHA
Universal access
Mengurangi penderitaan, meningkatkan kualitas
hidup.
Program :
- Distribusi, ketersediaan obat dan sarana
diagnostik.
- Peningkatan penjangkauan dan dukungan
ODHA.
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SURVEILANS HIV,AIDS, & IMS
Memperoleh data yang akurat mengenai
besaran, kecenderungan ,distribusi HIV/AIDS
dan faktor yang mempengaruhi.
Program:
- Surveilans HIV AIDS, sub populasi dan umum
- Surveilans perilaku
- Surveilans IMS
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AREA PENELITIAN DAN RISET
OPERASIONAL
Evidence-based health policy and medicine.
Program:
- Riset evaluasi
- Riset resistensi obat ARV
- Riset obat tradisional
- Riset dampak sosial ekonomi HIV/AIDS
- Riset epidemiologi dan perilaku.
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LINGKUNGAN KONDUSIF
Peraturan perundangan yang kondusif bagi
upaya pencegahan dan penanggulangan
HIV/AIDS.
Program
- Advokasi
- Capacity building
- Pemberdayaan LSM
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HARMONISASI & KOORDINASI
MULTIPIHAK
Menselaraskan dan mengkoordinasikan
program penanggulan HIV/AIDS yang
diselenggarakan oleh pemerintah, LSM, mitra
internasional agar mencapai tujuan.
Program:
- Peningkatan kelembagaan
- Jaringan informasi dan komunikasi
- Kerjasama internasional
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KESINAMBUNGAN
PENANGGULANGAN
Menjamin kelangsungan upaya pencegahan
dan penanggulangan HIV/AIDS.
Program:
- Peningkatan SDM
- Peningkatan sarana prasarana
- Advokasi.
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National indicators for the implementation of the
Declaration of Commitment on HIV/AIDS
National Indicators National Indicators
National Commitment and Action
1 Domestic and international AIDS spending by categories and financing sources
2 National Composite Policy Index (Areas covered: gender, workplace programmes, stigma and discrimination,
prevention, care and support, human rights, civil society involvement, and monitoring and evaluation)

National Programmes (Blood safety, antiretroviral therapy coverage, prevention of mother-to-child
transmission, co-management of TB and HIV treatment, HIV testing, prevention programmes, services for
orphans and vulnerable children, and education)
3 Percentage of donated blood units screened for HIV in a quality assured manner
4 Percentage of adults and children with advanced HIV infection receiving antiretroviral therapy
5 Percentage of HIV-positive pregnant women who received antiretrovirals to reduce the risk of mother-to-child
transmission
6 Percentage of estimated HIV-positive incident TB cases that received treatment for TB and HIV
7 Percentage of women and men aged 15-49 who received an HIV test in the last 12 months and who know their results
8 Percentage of most-at-risk populations that have received an HIV test in the last 12 months and who know their results
9 Percentage of most-at-risk populations reached with HIV prevention programmes
10 Percentage of orphaned and vulnerable children aged 017 whose households received free basic external support in
caring for the child
11 Percentage of schools that provided life skills-based HIV education in the last academic year
FIRST OF
2 PARTS:
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National indicators for the implementation of the
Declaration of Commitment on HIV/AIDS
b
National Indicators National Indicators
Knowledge and Behaviour
12 Current school attendance among orphans and among non-orphans aged 1014*
13 Percentage of young women and men aged 1524 who both correctly identify ways of preventing the sexual
transmission of HIV and who reject major misconceptions about HIV transmission*
14 Percentage of most-at-risk populations who both correctly identify ways of preventing the sexual transmission
of HIV and who reject major misconceptions about HIV transmission
15 Percentage of young women and men aged 1524 who have had sexual intercourse before the age of 15
16 Percentage of women and men aged 1549 who have had sexual intercourse with more than one partner in the last
12 months
17 Percentage of women and men aged 1549 who had more than one sexual partner in the past 12 months reporting
the use of a condom during their last sexual intercourse*
18 Percentage of female and male sex workers reporting the use of a condom with their most recent client
19 Percentage of men reporting the use of a condom the last time they had anal sex with a male partner
20 Percentage of injecting drug users reporting the use of a condom the last time they had sexual intercourse
21 Percentage of injecting drug users reporting the use of sterile injecting equipment the last time they injected

Impact
22 Percentage of young women and men aged 1524 who are HIV infected*
23 Percentage of most-at-risk populations who are HIV infected
24 Percentage of adults and children with HIV known to be on treatment 12 months after initiation of antiretroviral
therapy
25 Percentage of infants born to HIV-infected mothers who are infected
* Millennium Development Goals indicator
LAST OF
2 PARTS:
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TERIMA KASIH
djokomoeljanto2009