U=U in Indonesia, Situations, and Challenges

U=U has been advocated in Indonesia since 2018 when a non-profit organization called Jaringan Equals Indonesia (#Equals_id)  joined Prevention Access Campaign as community partner.

Equals_id (founded by Aan S. Rianto) has been writing lots of articles regarding U=U with embedded original references in many local HIV communities using hashtag #equals_id.

Even though U=U bring enlightenment to most people living with HIV to breakdown stigma and acknowledged and endorsed by WHO and other international health organisations, it was not easily accepted in Indonesia.

People think I was halucinating when presenting the results of Partner Study I and II, HTPN 052  and also Opposite Attract to mention some studies.

Some even bullied with bad comments inside the communities and sent threatening messages to stop further advocating U=U.

When I replied back with all of the original references then I found out that language is the main barriers....they wouldn't read any articles longer than a paragraph, and if it's not in local language they wouldn't even look.

I tried to translate most articles in Bahasa Indonesia but still it's not considered important while they themselves can't read English......

Even the communities reacted negatively to the facts that U=U should free any PLHIV from stigma and shame being HIV positive.

Most old timer activists (even medical practitioners) believe that U=U is a mere movement of PLHIV claiming their rights to do condomless sex, even in every articles written about U=U there always a foot note mentioning  condom is to be used to prevent other STI's and unwanted pregnancy. Thus this movement was considered dangerous in increasing the STI's case.

Why wouldn't they educate STI properly if they concerned about STI's?

They do understand the ESSE (Exit, Sufficient, Survive, Enter) principal for HIV transmission, they know that a women living with HIV can breastfeed her baby but wouldn't take a word that a PLHIV is no more infectious of transmitting HIV to others through sex when they're Undetectable. They believe viral load Undetectable is not or never be stabil so condom is a must for PLHIV to prevent hiv transmissions to their sexual partners.

I myself understand what is it like to live with HIV, the worries of acquiring AIDS, the nightmares of transmitting HIV to partners....those thoughts will keep haunting for the rest of the live and creating unhealthy mental condition.

Understanding U=U is like bringing a light into what was darkness , that PLHIV can live worry free for not transmitting HIV to their partner once reaching and keeping their Viral Load suppressed.

Sadly, those old timer activists and paramedics prefer to keep their patient and client live a worry-full live, isolating them from accessing newer information and references regarding HIV treatment and studies.

They only educate that Viral Load is only a measurement of successful of ARV therapy so PLHIV can live healthy. They don't educate that being Undetectable by staying on good adherence will prevent them from transmitting HIV to their partners. 

This (infact) leads into ARV interruption when people think they have to take ART for the rest of their live but still living in worry of transmitting HIV. Some even being forbidden to get married with people without HIV, and to make things worse, some still believe that PLHIV should not conceive a baby.

Ever since joining as community partner to Prevention Access Campaign, Equals_id writes persistently and consistently to influent newer generation regarding U=U.

 Slowly people start opening up their mind and talk about U=U, in someway they "believe" that being Undetectable is equals to transmittable but they still insist condomized sex to prevent hiv even though their Viral Load is Undetectable. 

This is insane, they allow a mother with HIV to breastfeed their baby as long as the viral load is Undetectable but they still believe that HIV still can be transmitted through sex even though Viral Load is well suppressed.

They still believe that U=U movement is  still considered as free sex movement.

Even though many articles have been written that U=U prevents HIV transmission 100% they still educating that using condom is still safer to prevent HIV transmission while latest reference mentioned that condom can only give 80% protection due to condom failure usage.

Many later webinars talk about being Undetectable=Untransmittable but they still mentioned all the time that U=U is never guaranteed 100% preventing HIV transmission.

 Latest data shows that only 3.8% people living with HIV in Indonesia got their Viral Load suppressed.