CHAPTER 5-12 years from the beginning of the





HIV is the abbreviation from Human Immuno Deficienci Virus. This virus
attacks the human immune system, so that someone who suffers the disease will get
a high decrease in the ability to defend the body from opportunistic infections
and various disease attacks. This virus was commonly infected in body fluids
such as blood, semen, vagina fluid, and breast.

When HIV virus has reached an advanced stage, 5-12 years from the
beginning of the attack, HIV virus will cause AIDS (Acquired Immuno Deficiency
Syndrome). In industrialized countries, an HIV-infected adult will become AIDS
within a period of 12 years. Meanwhile in developing countries, the time period
will be shorter specifically 7 years. (Liswidyawati, 2010).

HIV / AIDS is transformed into one of the most feared diseases of
today’s world society. Despite many studies and research on this disease, there
is 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-related
illnesses since the start of the epidemic, and there are still 36.7 million
people globally living with HIV. Thus, this disease has become one of the most
deadly 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 reducing
the 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 to
solve the world’s problems. Including HIV / AIDS. The epidemic is targeted in
goal number 3 in SDGs. There is “Good Health and Well Being”. There
are several targets in SDGs number 3 related to HIV / AIDS: 1) By 2030, end the
epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and
combat hepatitis, water-borne diseases and other communicable diseases, 2)
Strengthen the prevention and treatment of substance abuse, including narcotic
drug abuse and harmful use of alcohol, 3) By 2030, ensure universal access to sexual and
reproductive health-care services, including for family planning, information
and education, and the integration of reproductive health into national
strategies and programmes 4) Support the research and development of vaccines
and medicines for the communicable and non-communicable diseases that primarily
affect developing countries.

As one of the UN member, Indonesia must become actively involved in the
program. In its application inside the country, Indonesia has summarized the
SDGs in the existing laws and regulations in Indonesia. Indonesia has created a
strong legal foundation as an effort to solve global problems that occur inside
the country. Likewise the problematic of HIV / AIDS, Indonesia has made a
strong legal foundation in Indonesia. As we know, the basis of the formation of
this legislation is of course the basis of our State of Pancasila which is described
in the constitutional form in the UUD 1945 and other Indonesian legislation

Pancasila as the Ideal Foundation and the nation’s view of life has
strong values in it. Bakry quoted in the MKWU’s book, Pancasila’s Education for
Higher Education said that Pancasila said to be the nation’s life view is meaning
the values of divinity, humanity, unity, democracy, justice and believed in the
goodness, the beauty, and the usefulness by Indonesian nation serve as a
guideline for the society and national life and gives a strong determination to
practice it in real life.

Pancasila and the UUD 1945 in Indonesia became the nation’s benchmark in
solving the problem. HIV / AIDS as one of the nation’s problems, should be seen
from Pancasila and the UUD 1945 point of view. Therefore, it is necessary to
deepen the Pancasila and the UUD 1945 against the HIV / AIDS epidemic.

1.2  Problem Formulation

2.      What is the
definition, causes and danger of HIV/AIDS ?

3.      How does the
Pancasila view to HIV/AIDS ?

4.      How does the
government strategies and programs to overcome the HIV/AIDS epidemic according
to the existing of laws and regulation in Indonesia?




2.1  Definition, Causes and Dangers of HIV / AIDS

According to Permenkes RI
No. 21 Year 2013, Human Immunodeficiency Virus (HIV) is a virus that result
AIDS. While Acquired Immuno Deficiency Syndrome (AIDS) is a collection of
symptoms that reduced self-defense capabilities caused by the entry of HIV
virus in a human’s body. Thus, HIV / AIDS is one of the types of dangerous
diseases caused by HIV virus that attack the human immune system.

The Existing of HIV virus at
someone body will continue destroy immune. As a consequence, viruses, bacteriums,
mushrooms that usually is not dangerous become breakneck because its immune
system body. (Pipih Sopiah, 2011, hlm. 9). Until now, there is no drug that
completely eliminates the HIV virus. Currently, people with HIV / AIDS disease
can only rely on antiretroviral drugs that inhibit the HIV virus to develops in
the body.

The HIV virus can be found
in the human body, commonly found in blood, semen, and vaginal liquid. This
virus can also be found in other bodies, such as breast milk, but in fewer
levels. Therefore, HIV virus is widely spread through sex, the use of
contaminated syringes, and through contaminated blood transfusion.

DG of Communicable Disease
Control & Environmental Health Ministry in the fourth quarter of December
2016 released HIV / AIDS statistic data in Indonesia.

Graph 2.1. Number of HIV Patients
Based on Province

Graph 2.2. Number of AIDS
Patients Based on Province


Based on graph 2.2, the report of DG of Disease Control &
Environmental Health Ministry in RI, HIV sufferers in Jakarta reach 45,355
people. This indicates that the province of DKI Jakarta is the province in
Indonesia with the most people with HIV, followed by East Java as many as
31,429 patients. While in the AIDS, the most amount of patient is in the
Province of East Java as many as 16,911 patients. Followed by Papua with a total
of 13,398 patient.

2.2  Pancasila As A Moral System

The fourth paragraph in the Preamble of the UUD 1945
states the phrase:

“…maka disusunlah kemerdekaan kebangsaan Indonesia itu dalam suatu
Undang-Undang Dasar negara Indonesia, yang terbentuk dalam suatu susunan negara
Republik Indonesia yang berkedaulatan rakyat dengan berdasar kepada : Ketuhanan
Yang Maha Esa, kemanusiaan yang adil dan beradab, persatuan Indonesia, dan kerakyatan
yang dipimpin oleh hikmat kebijaksanaan dalam permusyawaratan/perwakilan, serta
dengan mewujudkan suatu keadilan sosial bagi seluruh rakyat Indonesia.”


The sentence is preceded by the function and purpose
explanation of the Republic of Indonesia. The paragraph shows that is very
fundamental for Pancasila as the foundation toward the ideals of the nation.
Thus, citizens of Indonesia are obliged
to do Pancasila’s values in all aspects of life including in the ethical system

Pancasila as an ethics system is a moral guidance
for the citizen of Indonesia that can be implemented in the real behavior of
our daily life. In the ethics of Pancasila, there are values of divinity,
humanity, unity, democracy, and justice.

These five values forming Indonesian human behavior
in all life aspects. The first “Sila”, divinity, contains spiritual values that
can be realized in bringing the human person closer to the Creator. The second
principle, humanist value, means to make humans more humane that can be
implemented by improve the quality of humanity in the inter-communal
relationship. 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. The
last value, justice, deliver value of caring and helping each other.


2.3  The Pancasila Perspective to HIV Patients

In daily life, the values of
Pancasila reach many aspects, and one of them is health aspect. Pancasila as an
ethical 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 sex
that is not suit according to the norm. Surely, he has violated the values of

Violations of the first
precepts are made by HIV-infected persons who infected by having free sex or
who are experiencing with the type of same because in the whole religion that
exists in Indonesia does not agree to free and homosexual (Lukman Hakim, 2017).
In addition, the patients surely violate the second precepts. In humanities
value, we make humans more human. If the person has sex with the same sex or
freely, then the human will be fade.

However, when viewed from
another 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. The
second precept is aimed at not subjecting the eye to the sufferers. Viewed from
the third precepts, mandate all the people of Indonesia to support and assist
the patients. And the fifth precept dictates how justice is taught in the
social environment. There should be no difference between sufferers and
non-suffered either from social treatment and other rights.


2.4  HIV / AIDS Handling Activities

In Permenkes No. 21 Year 2013, there are five
countermeasures against HIV / AIDS conducted by the government::



contained in article 10 clause 1 and 2, health promotion is aimed at promoting
correct and comprehensive knowledge on prevention of HIV transmission and
eliminating bad stigma in society. Promotion is given in the form of advocacy,
development of atmosphere, empowerment, partnership and community participation
fit in socio-cultural conditions and supported by public policy.

practice, officials from the government will emphasize the benefits and
treatment of HIV test, condom use, and antiretroviral treatment. The delivery
method used to be match with the culture, language, and habits of the local society.

this health promotion, is expected to be the beginning of awareness and
knowledge of the community about HIV / AIDS. Pipih Sopiah, (2013), explains
there are four stages of forming people’s understanding of HIV / AIDS:


The first stage after gaining knowledge and counselling. At this stage,
the public will know the beginning of HIV/AIDS and way its infection and
spreading, danger, and its prevention way.


This effort started to wake up the society about the danger of HIV/AIDS
virus. But in fact, until now many people who know about HIV / AIDS but still
doubt it. They do not believe that until now HIV / AIDS has no cure.


After they are getting knowledge and belief, they expect they will be
aware, so the danger of free sex and prostitution activity that influence the
infection and spreading HIV/AIDS.


After getting the
knowledge, hopefully they can be able to realize and motivated, and people will
try to implement the knowledge they already have in their daily world.


of 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 Disease
Control & Environmental Health Ministry in RI until December 2016, the spread of HIV virus are mostly
occurred due to hetero sex factor with a total of 83,037 people. Followed by other
factor, 42,544 people, then LSL / MSM (homosexual) with the number 27.509
people, and injecting drug users as many as 14,749 people. The total number of
people with HIV virus including the unknown cause is 204.095 people.

Moreover, from the graph there is also a considerable
increase from year to year. The largest enhancement is found in 2015 to 2016 as
many as 15,002 people whereas the infection from the previous year’s growth was
only about 2000-4000 people.

the reason, the Indonesian Government are trying to inhibit HIV deployment.
Prevention of HIV transmission in Indonesia in Permenkes No. 21 Year 2013
Number 12. Rules on prevention of HIV transmission can be achieved effectively
by applying a safe and non-risk lifestyle. There are three prevention types which
conducted by the government:


a.       Prevention
of HIV transmission through sexual intercourse

of HIV transmission through sexual intercourse is an effort to prevent someone
infected with HIV and / or other sexual infectious disease. Prevention of HIV
transmission through sexual intercourse is focused on high-potential place in
spreading of the risky sexual HIV virus. Prevention of HIV transmission through
sexual intercourse is conducted with four integrated activities including:

a)      Enhancing
the role of stake holders

b)      Behavior
change intervention

c)      Management
of preventive health supply

d)     Management
of sexual infectious disease


in article 14 states that prevention of HIV through sexual intercourse is
conducted through efforts to:

a)      Not
having sexual intercourse (Abstinensia) for unmarried;

b)      Being
faithful with a spouse, means only having sex with not HIV-infected;

c)      Condom

d)     Avoid
the misuse of drugs / other addictive substances  

e)      Improving
prevention capabilities through education as early as possible

f)       Do
other prevention, including through circumcision


of HIV Transmission through Non-Sexual Relations

article 15, prevention of HIV transmission through non-sexual relations aimed
at preventing the transmission of HIV through the blood, including blood donor
test, prevention of HIV infection on medical and non-medical measures that injure
the body, and decrease an adverse effects of injecting drug users


of mother-to-child HIV transmission

of mother-to-child HIV transmission is carried out through 4 (four) activities
which include:

a)      Prevention
of HIV transmission in reproductive age women

b)      Unplanned
pregnancy prevention in women with HIV

c)      Prevention
of HIV transmission from pregnant women with HIV to their babies

d)     Give
a psychological, social and care support to mothers with HIV and their


essence of that activity is point c, the prevention of HIV transmission in
pregnant women who have been infected with HIV to their children. A
comprehensive maternal and child health services includes the following

1)      Integrated
ANC services including HIV testing;

2)      HIV

3)      Antiretroviral
therapy given

4)      Safe

5)      Feeding
management for infants and children;

6)      Delay
and regulate pregnancy;

7)      Antiretroviral
prophylaxis and cotrimoxazole given in children;

8)      Diagnostic
inspection of HIV in children


Diagnostic Inspection

many people are not aware that he/she was infected by HIV. HIV / AIDS patients
are likened to the iceberg philosophy, which is reported in the government
data, it’s only a fraction number of unknown patients. Thus, the HIV screening
program was set up in Article 21 stated that an HIV diagnostic inspection was
conducted to prevent early transmission or increased incidence of HIV
infection. This inspection is based on the principle of confidentiality (the
results of the examination should be kept confidential except for certain
persons), approval, counseling, recording, reporting and referral.

article 22, there are two kinds of procedures for carrying out an HIV
diagnostic inspection:


This test is only for someone who approves it in paper writing. There
are three steps in performing this test: Pre-test counselling; HIV testing; and
post-test Counselling.

Testing 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.       When
a person comes to a health care facility with symptoms or medical conditions
that bring throught the person to become infected with HIV,

b.      Antenatal
care in pregnant women and maternity mothers,

c.       Babies
born from HIV-infected mothers,

d.      Children
with abnormal growth in large epidemic areas, or malnourished children who are
not working with malnourished drug

e.       Adult
men who request a circumcision as a prevention against HIV.

is little difference in the HIV
Testing on Health Staff Initiation implementation steps.
Unlike with voluntary testing, this test is not preceded by pre-test
counseling. There are four steps in doing the test: giving information about
HIV / AIDS, test execution, delivering of results, and followed by counseling


care, and support

now, there is no drug that fully destroys or eliminates the HIV virus.
Therefore, the Indonesian government seeks the treatment, care and support
provided for in Article 30, it is said that every health care facility is
prohibited from refusing treatment and care for people living with HIV. And if
the facility is not sufficient for HIV prevention, the facility must refer it
to the ARV referral hospital.

Article 33, HIV and AIDS treatment is performed by the following treatment:


Therapeutics means all things that related to therapy. In the context of
HIV / AIDS, therapeutic (therapy) is associated with antiretroviral treatment,
STI treatment, and treatment of opportunistic infections.


According to KBBI, the meaning of prophylaxis is health care and disease
prevention. Prophylactic treatment in HIV treatment includes post-exposure antiretroviral
therapy and co-trimoxazole for therapy.


Supportive treatment in this context is adjuvant supportive treatment,
and improved nutrition.



means carried out on every transmission pattern of HIV to the key populations
specifically sex workers and injecting drug users (IDUs) in the form of
improving work skills and self-efficacy that can be done by the social sector,
both government and society. Rehabilitation of HIV and AIDS activities is
expected to restore the quality of life to be productive economically and





3.1  Conclution

Pancasila as the legal
ideology in Indonesia obliges its people to practice their good values.
Pancasila has many points of view. In his view as an ethical system, Pancasila
teaches its people to respect each other and live the norms that are inherent
in society. Pancasila is implemented in a constitutional foundation in the form
of the UUD 1945. Furthermore, Pancasila and the UUD 1945 cover many aspects.

Among the important aspects
covered by the UUD 1945, there is aspects of health. One of the focus of health
aspects is the growing HIV / AIDS epidemic worldwide. HIV / AIDS is one of the
most feared epidemic diseases in the world today. In addition there is no drug
that kills the virus intact, HIV / AIDS increasingly spread throughout the
world, especially in developing countries. Therefore, Indonesia implements a
countermeasures system based on the values of Pancasila and the UUD 1945.

In its application, Indonesia
through the Ministry of Health established Permenkes RI No. 21 Year 2013 which
became the main foundation in understanding HIV / AIDS disease in Indonesia. In
it, there are definition, purpose, and how to overcome it as has been widely


3.2  Suggestion

The authors suggest that
people deepen their knowledge of HIV / AIDS. It will support our government to
do their programs to prevent the spread of HIV. Beside that, the authors
suggest that the government is able to optimize the existing their apparatus,
including the KPA (Commission for AIDS Prevention) so that all funds mobilized
by the government can be used as well as possible to achieve sustainable
development goals.



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