HIV/AIDS

Greetings.

I hope that this finds you, my dear reader, well. It is good to write again after my one week break in which I rented the blog out to Walter; who some of you have decided to call “a politician”. I am not too sure if that is the most fitting title but I am sure that you had your reasons for calling him that.

Those of you who have been Friday Readers for some time might attest to the fact that I have always tried to keep a quarter mile distance between my work and my blog. This is because I have always wanted to avoid some unethical mixtures between my doctoring and writing jobs. Lately, however, I have realized that I cannot run away from using this blog to share the message of healthy living and I have decided to make it an obligation to use this blog for the same purpose whenever I can.

Topic of the day? HIV and AIDS. I am pretty sure that all of us are aware of this pandemic. The media is awash with issues to do with HIV and AIDS and people are always telling us how best to avoid contracting the deadly virus and how to live a healthy life when we have it. There are also messages encouraging us to go for testing and counseling and sermons against discriminating people with HIV and AIDS. This is why I am pretty comfortable to say that issues to do with HIV and AIDS are not new to everyone, to say the least. I am told that the new Primary school curriculum has also incorporated in a subject called Life Skills. This knowledge has not come in without results and one of the areas in which we have made more progress is the area of discrimation. While it we might have sections of the society discriminating people with HIV and AIDS, we have made bigger strides in eliminating the malpractice in the society in general. On the other hand, I still think that we could do better in the areas of voluntary counseling and testing and prevention.

Talks about the transmission of HIV have been mostly academic and people have always mentioned things like mother to child transmission and contact with contaminated body fluids along with sexual intercourse as modes of transmission of the virus. I am not disputing the facts here, but one thing we have to understand is that a majority of the transmissions are sexual. To me, this entails that if we are to cut up on the (unsafe? Topic for another day) sex we might just be able to reduce the spread of HIV. From my observations, however, people seem not to have this HIV thing in mind when they are going about their sex lives and part of this might emanate from the fact that people do not perceive themselves to be vulnerable to the disease. The same lack of perceived vulnerability has led to sub-optimal numbers when it comes to testing and counseling and despite the fact that we have free HIV testing and counseling services across the nation, the same are underutilized. We hardly see people going for testing and counseling voluntarily by the strict meaning of the word. People usually like to go for testing when they have had exposure to HIV and would like to get PEP (post exposure prophylaxis; the drugs people get upon being exposed to the virus through sexual or blood contact, to avoid infection). The danger with this thing of not knowing your HIV status is that people miss the opportunity of getting an early intervention before the infection progresses to full blown disease, a point at which treatment becomes difficult due to the nature of both the disease and the drugs.

Needless to say, there are some people who have been going for testing and counseling but the interpretation and the application of the results has been another thing that leaves a lot to be desired. I would say that we do not have much of a problem with those who test negative for HIV. These ones are told to play it safe to maintain the status and most of them abide to the simple rule. Those who test positive, on the other hand tend to have problems on this end. You might have heard that radio play where someone thought it was the end of their life upon testing positive for HIV. Those are real life situations and while many might have moved away from such, there are people who are still stuck in that mentality. Ideally, people who test positive are also supposed to stay safe to avoid contracting resistant strains of the virus (from a medical perspective) and to avoid spreading it to others (from umunthu). We all know that there are people who have deliberately gone against this advice and they are busy giving and gathering all sorts of HIV bugs to anyone they get a chance to lie with. The other important implication of a positive test is the need for starting of HIV treatment despite disease status. This, again, has been a problem to many as some think that they are not supposed to be taking medications whilst they are still feeling okay.
Having highlighted some of the problems we have when it comes to attitudes towards HIV and AIDS, I have a couple of facts and fact-based opinions (professional opinions, if you will) to share.

I have every reason to believe that prevention is the best way of running away from the problems that arise from HIV infection and AIDS. We should not fall for the trap of undermining the disease that has affected millions worldwide and has affected almost every family (taking it from our liberal definition of family).

HIV testing and counseling services are free and are readily available for our use. We need to take advantage of such and utilize them. The results thereof need to be applied for our health living and having gone for testing and counseling, we need to be advocates for the same in our circles.
Amongst us are antiretroviral drugs which are used to suppress the virus in infected people. Though not curative, these drugs have been tested and proven to be a source of a healthy life for people living with the virus. Perhaps the one thing that many do not recognize is that with the viral suppression ARVs bring about comes the reduced risk of the transmission of the virus. This entails that people who religiously take these drugs are not as infectious as others who are not treatment. This, however, should not be used as a leeway for a careless life of having unsafe sex with people who are infected as there might be some minimal risk of transmission.

A word on post-exposure anaphylaxis. As I already shared, these are drugs that protect people that have been exposed to HIV but would like to prevent the infection. For those of us who work with sharp instruments and blood in the hospital, these drugs come in handy considering the times we spill bodily fluids and cut ourselves with contaminated needles. Outside the medical circles, the same drugs are used for people who have had exposure through such things as blood contact as well as through sexual exposure. From my observation, there are some people who are in the habit of taking PEP and some take it a couple of times a year owing to their repeated sexual exposures (unsafe sex and condom accidents; if such a thing exists). The fact that some people haven’t yet embraced is that PEP is an ARV combination which is just a bit weaker and as such people need to have their status known before they get on it. The danger about taking PEP without getting tested is that should one take the drugs while they are already positive, they risk getting resistance to ARVs and as such antiretroviral therapy may not work on them when they need it the most. I guess you will now understand why that nurse or doctor friend of yours always acts jumpy whenever you talk about them smuggling some PEP out for a brother. There are protocols surrounding these drugs and they were made for a good reason; for your good.

The above paragraphs might have been full of technical hibber jabber but I would like to bring you to the reason I wrote this whole thing. Most of us have grown up taking the HIV/AIDS pandemic lightly. I was like you, but having worked in the hospitals, I have come to understand the burden this virus lords on families, societies and this nation as a whole. I am not too sure as to how true this is, but I have heard that there was a time when one regime was thinking of stopping either the farm input subsidy or free antiretroviral treatment, considering the financial burden they exert on the nation’s economy. The point is that some of us may not fear the disease because we do not care about our own lives. If we cannot play it safe for ourselves, let us do it for our families and our nation.

Have a lovely weekend. Remember to play it safe and to get tested.