When People Thought Being Diagnosed With HIV Is A Crime, Not A Disease

While working in the clinic two days ago, I've noticed a woman who seems like in her late 20s, sitting on a chair, looking around anxiously, fidgeting while waiting for someone to fetch her home. Apparently, she was diagnosed as HIV-positive a couple of months ago, following a needle prick incidence and now she came for a routine medical checkup. She is a medical doctor who used to has the ambition of becoming a successful surgeon when she was in medical school but now, it has all be in vain. It just took a few life-changing seconds that would disqualify her from being a surgeon or even a doctor (stigma) because let's face the truth; HIV-positive people, be it a physician, a prostitute or a politician, would often be ostracised in a society. Even though there is a well-known fact that you can't get infected easily by people who have HIV, we are sometimes (or most of the times), feel uncomfortable sitting beside someone who has HIV. It's once a disease which has been considered as a death sentence but nowadays, with the advancement of medicine, they (people with HIV) would have the opportunity to lead a normal life, if they abide by a specific routine of keeping themselves healthy and take some anti-retroviral medications which have been prescribed to them for the rest of their life. Getting and giving the diagnosis of HIV positive is often difficult for both the patient and the doctor; it's difficult to inform as much as it's difficult to accept; only the latter usually accompanied by a variable degree of psychological damage that needs to be mended.

Pixabay

The majority of people knew that those who were infected by HIV will usually end up with AIDS, a condition whereby our immune system has become severely impaired, making us prone to get various fatal diseases known as the opportunistic infections. People even blame homosexuals, stating that they were the one who started all of this mess based on a well-known case of HIV in the 1980s. How many of you are aware that the original name of this disease was Gay-Related Immune Deficiency (GRID)? Since the 1980s, homosexuals have become the central causes of HIV before we realised that, this particular virus can also be transmitted among heterosexual people. By the way, just to let you know, people have been struggling with HIV way earlier than that; in the early 1980s, people started to become aware of this disease, probably because people wanted to make a point that homosexuality can do harms. Various studies have concluded that HIV was once originated from primates before it crossed to infect humans. Obviously, in primates, the name is a little bit different (Simian Immunodeficiency Virus) but once the virus has crossed from that particular species to humans, they mutated in order to adapt and survive in a new environment, forming a resistance species of retrovirus that would be able to cause serious harms while retaining its virility to be transmitted to other humans through blood and selective bodily fluid. There are still a few native cultures that hunt and eat an improperly cooked meat of a high-risk primate which made them prone to get infected by HIV; unless you want to screen every single primate before eating them, avoiding them would be wise.

Pixabay

In 1999, a study conducted by Gao F. et al concluded that the source of the HIV type 1 virus is the chimpanzee. There are currently two main types of HIV viruses which are designated as the HIV type 1 and the HIV type 2. In the past, after a few research, HIV type 2 was determined to be originated from a species of primate called the mangabey but the origin of the HIV type 1 remained unknown. It was later discovered by a study (I couldn't pinpoint the original article) that chimpanzees might have been an important group of primate which could have been the source of HIV type 1, although, we can't really say, with an utmost certainty, that the suspected SIV sp. which have been mutating to HIV were originated from the chimpanzee itself since they sometimes cannibalise and eat other species of monkeys; they could have been infected by other monkeys as well. It's more like a speculation rather than a definitive conclusion but now, we couldn't care less, which animals that have been the original culprit of infecting humans. Treatment modalities have been the primary focus of research today, and it has been great. For those, who don't know, there are three important phases of an HIV infection which are:

• Early stage (acute infection)
• Asymptomatic stage (the virus started to wear off our immune system slowly)
• Acquired Immunodeficiency Syndrome (AIDS)

There are a few people who don't really experience the acute onset of HIV infection which is usually presented as flu-like symptoms (fever, sore throat, headache, muscle pains and generalised body rashes). Our body tries to fight off the virus by producing a significant concentration of antibodies in a process called seroconversion and as a consequence, our bodies start to show a few symptoms which will usually resolve in a few days. However, due to the fact that most of the symptoms are mostly constitutional, the only way to determine whether you are infected or not is by an HIV screening test. People usually were frightened especially if they were exposed to any of the risks which would have predisposed them to HIV (some even being anxious without prior exposure to any of the HIV risks), making "doctor shopping" one of the most prevalent behaviours among these people.

HIV Is A Disease, Not A Crime

Pixabay

Even though in medicine, most of us knew that HIV is no longer a death sentence, the majority of the population were having some kind of misconception that people with HIV will end up with AIDS in 10 to 15 years top from the first day of diagnosis. That was actually no longer true. Antiretroviral therapies have been an important part of treatment modalities which could have prolonged the lifespan of people who were infected by HIV. Their viral load can be reduced up to a negligible level, minimising the amount of damage imposed on their immune system and theoretically, they were no longer contagious provided they comply and adhere to their prescribed medications (which they have to take it for the rest of their life), they would have the opportunity to live as long as the general population, even without having to go through AIDS; that's where the phrase "I hope someday, I will die with HIV, not from it". To illustrate how antiretroviral medication has been changing the lifespan of people with HIV significantly, let's say we consider two patients who were infected by HIV and progresses to AIDS. Without ARV therapies, people with AIDS can only live up to 3 years while people who have been taking their medicine consistently, can live up to 15 years with minimal complications. You can see, can't you? Therefore, it is important for people who were exposed to HIV to be screened and if they were having HIV, to start ARV therapies as soon as they were able. The problem is, the society seems to despise people with HIV, imposing stigma (in some country, criminalisation) and causes their HIV-positive status to be unknown.

Pixabay

Even me, as a medical doctor, when I was assigned to the HIV clinic, I felt anxious and quite frankly, scared. I have to make sure I'm super careful especially if I need to do any works which would have increased my chance of being infected (blood taking, for example, can lead to needle prick injury; the chances are slim but still..). After 2 weeks, I've realised how foolish I was. It has been difficult for them to live with the fact that they were ostracised by their family, friend and the community (some do have supportive families, thank god), as a doctor, I can't turn my back on them as well. They only have me, and with that in my mind, I treat them with everything I got; it was fun. They are not criminals and if they were, they should have been given the opportunity to redeem themselves; everyone deserves that, at the very least. In 2005, the International Centre for Research on Women (ICRW) has listed a few possible consequences that an individual has to go through if he/she let his/her HIV status be known (due to stigma):

• They could have been fired from their job which leads to a loss of income
• They could have lost their own livelihood, being denied certain aspects of their basic necessities
• They would have been denied or been given a poor medical care; let's say if there were two patients and one of them is HIV-positive, how many doctors you think would be willing to treat the HIV patient earnestly?
• They could have been demotivated to try and get pregnant. Most of the information held by the general mind in a society is quite outdated. Even if both the husband and wife were infected, the chances of getting an HIV-negative infant are high (very high) with ARV therapies.
• They could have shown symptoms of depression which would further lead to health deterioration
• They could lose their credibility and reputation

In 2012, an article entitled "Positive and Pregnant; How Dare You" which documented some findings regarding women with HIV and pregnancy from 6 countries (Vietnam, Nepal, Indonesia, India, Cambodia, Bangladesh) has found that approximately 40% of them were subjected to sterilisation without their consent. I'm not sure when we started to be this uncivilised with people just because they are HIV-positive; it was unethical and quite frankly, a crime. As a medical officer, we are entitled to give people our opinion, but the final decision should rest on the patient (not the doctor, not the family members and not even the husband).

Pixabay

Confidentiality has been the cornerstone of medicine, and if people (patients) don't allow you to tell regarding their HIV status, you are forbidden to do so unless it is law-related or if the patient involved in an unexpected event like an accident and is in a grave condition in which the management would involve other people, like a surgeon. So do you think every medical personnel can keep their mouth shut? The answer is no. In the same study conducted in 6 countries, 35% of the total participants have reported problems regarding confidentiality breach among health workers. This would have affected other undiagnosed people level of confidence of getting screened or treatment for their condition. This form of discrimination towards HIV patients could have affected people in different ways. Even if they were not criminals, they were treated as such. People need to be emphasised by education, that those with HIV are sick, they need medical treatment, not ostracisation, not discrimination and certainly not criminalisation. Sometimes, I have some kind of thought that education is one of the factors which could have made the stigma worse. Even if we know, in the pamphlet that we distribute among the general population contained information regarding misconception about HIV, people tend to exaggerate the negative side of HIV rather than what could have been thought as the positive side. Stop it! If you realise you are one of them, you need to stop now. HIV is a virus which causes disease, it is not a crime.

Sources

• HIV/AIDS epidemiology, pathogenesis, prevention, and treatment
• HIV criminalisation on the rise, especially in sub-Saharan Africa
• Positive and Pregnant: How Dare You
• Origin of HIV and AIDS
• HIV Stigma And Discrimination

---

---

SteemSTEM is a community project with the goal to promote and support Science, Technology, Engineering and Mathematics on the Steem blockchain. If you wish to support the steemSTEM project you can:

Contribute STEM content using the #steemstem tag | Support steemstem authors | Join our curation trail | Visit our Discord community | Delegate SP to steemstem

Convenient Delegation Links:

50 SP | 100SP | 500SP | 1,000SP | 5,000SP | 10,000SP | 50,000SP