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The words HIV and AIDS initially sounded strange to Winarno and Lamiyat. The young couple had contracted HIV and yet they had no idea how it happened or what was to be done. Then their 18-month-old daughter was also infected.

It is easy to trace back how the couple, both in their late 20s, contracted the virus and then passed it to their child, an activist of a peer support group assisting the family said on Monday.

“Winarno got it from his first wife, who worked overseas. He infected his second wife, Lamiyati. She then gave it to her baby,” said Toto Dri of the Paramitha Foundation, which aims to enable people living with HIV/AIDS receive better access to antiretroviral therapy.

An AIDS activist since 2006, Toto said that he had worked with more than 100 people living with the virus and nearly 80 percent of the cases he dealt with involved heterosexual couples who neither used drugs nor engaged in bisexual activities.

“It’s common here for husbands to give it to their wives simply because they are uninformed about the risks of engaging in unprotected sex with sex workers,” Toto said.

Transmission of the virus through heterosexual sex now accounts for most infections in Indonesia, outnumbering the other mode of transmission, needle sharing among drug users, says Husein Habsyi, director of the HIV/AIDS support group Pelita Ilmu Foundation.

“The heterosexual population is much bigger than other at-risk groups,” he said. “The increase in heterosexual transmissions must be caused by a growing number of people in Indonesia engaging in unprotected sex with either multiple sex partners or without the use of condoms.”

As an AIDS campaigner, Toto noted that he knew it was not easy to spread preventative messages among heterosexual couples, particularly in remote and conservative towns and villages, where talk of sexual behavior was taboo.

“Wives trust their husbands unconditionally. Husbands, mostly the breadwinners, can do anything they want, including seeking sexual pleasure outside their homes,” he said.

“I think the most important preventative measure comes from inside the home, where husbands must take more responsibility over their sexual behaviors.”

Released in conjunction with World AIDS Day on Tuesday, the Ministry of Health’s latest records noted that at 49.7 percent, transmission of the virus through heterosexual sex accounted for most infections in Indonesia. This was followed by transmission through needle sharing among drug users at 40.7 percent. Transmission as a result of homosexual sex stood at just 3.4 percent.

Among the provinces with the most AIDS cases in the country are East and West Java, Jakarta, Papua, Bali, West Kalimantan, Central Java and North Sumatra, according to the data.

Tjandra Yoga Aditama, the Health Ministry’s director general for infectious diseases, said the increased percentage of transmissions via heterosexual sex should be seen as part of the bigger picture.

“The increase should be attributed to more and more people getting themselves checked,” he said. “The percentage [of heterosexual transmission] doesn’t represent the number of cases; it constitutes how the virus is transmitted.”

While public health observers have called for a new approach to draw more people’s attention to HIV/AIDS, the ministry believes the existing approaches have been adequate in slowing the spread of the virus.

Hasbullah Tabrany, a public health expert from the University of Indonesia, said the ministry’s awareness-raising efforts should not only focus on confusing statistics and scare tactics.

“Preventative campaigns must be designed to open people’s eyes about this disease, not to scare them,” he said.

“It’s not only about telling wives to be suspicious of their husbands going out of town or spending the night away from home.”