Living Positive with HIV

How many of you know someone living with HIV? I can think of no one who I know openly living with HIV (although there may be people I know with the virus who are not open about it). But the prevalence of the disease in the US is about 1 %. In this area of Zambia an estimated 14 % of the population is HIV positive, and that number increases drastically (~ 40 %) in the larger cities like Livingstone. In the US, we have lots of high quality drugs available to treat HIV positive patients, and many people have insurance or are able to afford the drugs. Neither of these is true in this area. And- more than that, although HIV began infecting people in Africa (in the 80s), and the rates are the highest in southern Africa, and although drugs were available in the US in the 90s, no drugs were available at Macha (and in much of the rest of Africa) until 2002/3. Even now the antiretroviral drugs are limited to those approved by the government, may be quite expensive, and have serious side effects.

I haven't actually taken pictures of people at the ART clinic, but Marlys Book volunteers there and shared some pictures with me for the blog.

When the students were on rounds they saw a HIV + child who is 18 months old, but weighs only 2 kg (~ 9 lbs). Dr. Thuma has told us that it can take a year after a child is given anti-retroviral drugs (what they use to keep HIV levels low) before the child will begin to put on weight and start growing again. This is especially difficult to see knowing that this is a key point in brain development (and development of other things) for children, and that early detection could have meant that the child was growing normally instead of severely stunted. Many of the older patients with HIV are in the hospital for problems that are usually quite harmless and our bodies can fight off, yet with the HIV compromised immune system they are not able to respond to the sickness and become severely ill.

A little girl at the ART clinic, photo thanks to Marlys Book

 At Macha Hospital they have an ART clinic (not art as in the things you make that look pretty, but ART as in Anti-Retroviral Therapy – don’t feel bad, I was confused for a while too). This is where people can come and be voluntarily testes for HIV, and counseled before they are tested and after the results are back. Because of the significant, long term, health and social implications of a positive diagnosis, the hospital staff treats each case with great care. They ensure that someone with a positive diagnosis has people around them who will be there to support them and talk with them about treatment options early on.

Counseling is available for everyone who is tested at the ART clinic, and confidentiality is a high priority for the healthcare workers and for the patients. In fact, several of the doctors and nurses at the hospital are HIV positive, and choose to use an alias on their records so that others won't know they are HIV positive.

 One of the women who works in the ART clinic is also living openly with the fact that she is HIV positive. She came to talk with us last night to share her story and to talk about HIV in this area. She has been a nurse since 1980, and was the head nurse at Macha hospital when she became ill and got tested for HIV. She knew she had been exposed to HIV by the time of her husband’s death of AIDS in ’94, but wasn’t tested herself until 2002. This may seem strange, wouldn’t you want to know if you have a disease? But in ’94, although they now knew about HIV/AIDS, testing was not common, and (as I said before) there were NO drugs available to treat patients anyway. So the thought was: Why test? There is nothing to be done about it anyway. Shortly after her diagnosis with HIV, she became severely ill, and was in a coma for 2 weeks, and then in and out of the hospital for a long time before recovering enough to go home. Even now, the form of HIV that she has is resistant to the common drugs used, so she is on a very high dose of powerful drugs that have several bad side affects. Her slogan, that she loves to share is "One day at a time!" She loves to encourage people that they can ‘Live Positive with HIV’, and indeed, with the antiretroviral drugs that are available today, the quality and quantity of life that infected individuals can have is quite good.  

The ART clinic is labeled to House of Hope, and certainly the outcomes possible are much better now than they were a few short years ago.

 I’ll talk again about HIV tomorrow when I tell you about our visit to the rural health centers.