Ask an HIV/AIDS volunteer.

[emzie]

Hello, y'all.

For the past 6 months, I've been volunteering with a local HIV/AIDS charity, giving presentations about what HIV/AIDS is, how it's spread, risk factors and prevention. While not formally part of my tasks, I also interacted with HIV/AIDS patient support staff, giving me some experience with what living with HIV is like.

I started volunteering because I lost someone very close to me in 2007 to AIDS, my father. I watched his health deteriorate for ~2 years before he died. His death came about 3 hours before the results of HIV test came back positive. He died without knowing for sure what he had. This leads me to my most important point, one that if you read nothing else in this thread you should remember: HIV is not a death sentence, at least not in the west. If you suspect you might have been exposed to HIV, get tested. An HIV-positive individual undergoing ART (anti-retroviral therapy) has a normal-to-near-normal life expectancy. Put another way, being poor has a greater impact on life expectancy than HIV does, in resource-rich countries.

So, if you've ever had any questions about HIV/AIDS, ask away! There's no topic I consider too personal or won't try and answer. Be forewarned though, I won't shy away from the sexual side of STIs. If your question requires I mention the risks of anal sex, I'm going to be blunt.

edit: if you wish to ask questions anonymously, you may either PM me or even email me (augurey (at) gmail (dot) com) if you wish to remain anonymous even to me.

Contre.

 

[Zelig]

One of Canada Blood Services questions for donation eligibility is whether you've ever had an HIV test other than the one associated with donating blood. Any idea what the deal is with that?

I mean, I can't imagine it outright stops you from being allowed to donate - Vancouver has some hospitals that have been routinely testing every patient who has blood work done for HIV, and plan on rolling this out provincewide in the next year. (FYI, ~0.6% of patients tested positive for HIV, having had no idea about it beforehand.)

 

[emzie]

I imagine that if you've had an HIV test, they think it's likely that you engaged in a high-risk behaviour that concerned you in the first place. It sounds like a shorthand question asking about your sexual history and drug use. In many countries, there's a life-long ban on donating blood if you've ever had sex with another male. I doubt having been tested is grounds to keep you from donating (hell, I was tested when I immigrated to Canada -- as was every other immigrant) but rather, answering yes is a trigger to asking followup questions that might not normally be asked.

 

[ace99]

What do you think about what Obama said about AIDS? Realistic?

 

[emzie]

What do you think about what Obama said about AIDS? Realistic?

The idea of an AIDS-free generation? I think it's very unlikely to come to pass but is absolutely the right goal to have since every step towards that goal is still reducing the total number of infections. You end up running into a wall of diminishing returns though when you realize new HIV transmission is occurring between people who don't know that they're HIV+ in the first place.

I also think the the idea of an AIDS-free generation has a strong western bias. Most AIDS deaths and HIV cases are happening in Africa, where many prevention measures are out of the reach of a poor population. If an HIV-positive mother cannot afford formula, her kid is going to be faced with a stark choice: starve or run a high risk of contracting HIV from breast milk.

 

[illram]

I don't have a question but just wanted to say thank you for doing this work and I hope you keep it up.

 

[classical_hero]

What percentage are male at the presentations?

BTW, did you dad know how he might have got it?

 

[emzie]

I don't have a question but just wanted to say thank you for doing this work and I hope you keep it up.

Thanks

What percentage are male at the presentations?

That really depends on who the presentation is for. If it's for a LGBT community centre, just about everyone is going to be a gay male. If it's for IV drug users / sex workers, the ratio is more even. If it's an talk open to anyone, I'll get a mix of people, though MSM and immigrants from Africa and Caribbean are over represented.

BTW, did you dad know how he might have got it?

This is kinda long winded, but I have a point to it!

No one ever got to ask him. He got sicker and sicker and weaker and weaker, and no one knew what the hell was going on. One day he went to take a shower and he couldn't even stand for it. My mom took him straight to his doctor who sent him straight to the ER. When he got there, they realized pretty quickly what was going on. He had fungal growths in his throat and a fungal pneumonia that is almost never seen outside AIDS patients. The doctors told he and my mom this and I think that news just about destroyed him. I don't think he was just afraid he was going to die, but he was afraid he'd killed my mom too. They sedated him for a pump that helps drain the lungs and started him on a bunch of medications. While he was out, his first test came back positive. He died of heart failure before he ever woke back up.

He and my mom had been separated for 8 years before they got back together in '04. Given that he died in April of '07, it seems likely that he contracted HIV in that time frame. How is a question I grappled with for a long time. I know a woman he saw during that time ended up testing positive for HIV herself. Did she infect him? Or was he already infected and he infected her? I have no real way of knowing. I came to realize though I just didn't care. If he shot up heroin with a dirty needle (very unlikely), was a MSM (can't put a likelihood on this but it wouldn't surprise me) or if he had one girlfriend that whole time and he was infected from her: none of it matters. I love him all the same, no matter how, and I blame no one for it.

Despite having been with my mom for 3 years, she tested negative for both tests that are done. She was pretty lucky.

 

[classical_hero]

That is good that your mother is clean. The way your father went sounds so similar to the way my mother died of cancer. It is certainly not fun watching her die.

 

[luiz]

This leads me to my most important point, one that if you read nothing else in this thread you should remember: HIV is not a death sentence, at least not in the west. If you suspect you might have been exposed to HIV, get tested. An HIV-positive individual undergoing ART (anti-retroviral therapy) has a normal-to-near-normal life expectancy.

For many years the Brazilian government had emphasized precisely this point, to encourage people to get treated and also fight the prejudice that HIV-positive people are walking corpses.

But then, after many years of falling rates, HIV infections begun to rise again. Some specialists warned that emphasizing on how normal are the lives of HIV-positive people, how the treatment is free in Brazil and etc., some high-risk populations (particularly male homosexuals) lost part of the fear of the disease, and that's a bad thing in their opinion. So now the government is producing an advertising campaign again emphasizing the negative aspects of the disease, and how life's much better without it (duh).

What's your take?

 

[emzie]

For many years the Brazilian government had emphasized precisely this point, to encourage people to get treated and also fight the prejudice that HIV-positive people are walking corpses.

But then, after many years of falling rates, HIV infections begun to rise again. Some specialists warned that emphasizing on how normal are the lives of HIV-positive people, how the treatment is free in Brazil and etc., some high-risk populations (particularly male homosexuals) lost part of the fear of the disease, and that's a bad thing in their opinion. So now the government is producing an advertising campaign again emphasizing the negative aspects of the disease, and how life's much better without it (duh).

What's your take?

I've received that question a number of times and it pisses me off that people have such a caviller attitude. In the most selfish sense, yeah, HIV is treatable/manageable like diabetes is. In a broader sense, you can't pass diabetes to someone else.

I view my work is existing well beyond what I do: if I impart enough knowledge to John Doe that he takes precautions and never becomes HIV positive, then I've also kept future partners of John Doe from being exposed to HIV. In epidemiology, we talk about R-Value, which is the number of people to which a carrier will pass an infection. The average person with the flu will spread the virus to 2-3 other people (though not all will get sick). As a disease approaches 1, we're making great strides to eradicate it. Education is, I think, the most effective way to slow the spread of HIV.

Getting back to your original question, my hunch is that the rise in HIV cases observed is not due to people ceasing to take precautions with partners who know they're HIV positive, but rather, HIV-positive people not knowing their status and not taking precautions with partners in the first place. Thus, because people aren't afraid of HIV, they're being tested less. There's a balance to be struck between scaring people enough to be tested and scaring them from being tested. I'm not sure what it is though.

 

[Zelig]

Well, I'm big on doing like BC and testing everyone who has any blood-work done.

 

[illram]

Moderator Action: Moved to Tavern per OP's request

 

[TomYo689]

Are you still cool enough to laugh at aids jokes?

 

[emzie]

Are you still cool enough to laugh at aids jokes?

A quote I read or heard years ago went something like this: "A joke about Jews is no longer a joke in the mouth of a Nazi." It's a bit like that. If you're disguising a bigoted view in the pretense of a joke, no, I'm not going to laugh. If you're making fun of the absurdity in how society deals with sex, STIs or HIV in general, yes, I'll laugh and I make those jokes myself.

 

[TomYo689]

Rather be dead with aids than no sense of humor

 

[SS-18 ICBM]

Do poor people with AIDS in the West get assistance for obtaining ART?

 

[Formaldehyde]

I don't have a question but just wanted to say thank you for doing this work and I hope you keep it up.

Indeed. That goes for me as well.

 

[emzie]

Do poor people with AIDS in the West get assistance for obtaining ART?

I'm not sure about Europe, but in Canada and the US, yes. The cost of ART medications is more than a thousand dollars a month here in Canada, nearly double that in the US. Without subsidies, that's expensive enough to be unavailable for most people. Here in Canada, depending on province, you pay a percentage of your household income towards your own medications. I think Ontario is 4%.

Keep in mind that HIV tends to be more prevalent in poorer areas, so 4% can seem like more to some people than others. It's not uncommon for patients to try and stretch their medications to save money, which is a very very stupid thing to do. HIV medications only work when you're taking ~95% of your doses. If you're missing more than 10% of your doses, your virus can mutate and your medications become less effective, which allows for further resistance....

I'd like to add that HIV medications do make HIV harder to transmit. So subsidizing an HIV patient reduces the spread of HIV to others.

 

[civ_king]

Do poor people with AIDS in the West get assistance for obtaining ART?

I believe the US government covers over a third of the people with it in the US.



How do you feel that the Catholic Church and affiliated organisations is the largest provider of care for HIV/AIDS?