If a random section of people were tasked to select groups that stand the highest risk of getting HIV, most would invariably think about gay men and people with multiple sexual partners. I do however believe that it’s accurate to assume that anyone who has engaged in unprotected sex could potentially be HIV positive, regardless of their sexual orientation or number of sexual partners. By that logic, we could all be HIV+, unless a confirmatory HIV test says otherwise.
It’s clear from our lifestyle as Ugandans that HIV is still being treated as something to joke about, especially for people that don’t have it yet. It’s important to note that every year worldwide we get over 4 million new infections. But the thing that sucks the most about HIV is not the infection rates; it’s the stigma. Stigma is a product of ignorance.
Most of us don’t want to be called ignorant. But ignorance is not necessarily a bad thing. It’s not inability to learn but rather the state which comes before learning. So when we meet people that are coming from a place of ignorance, we should regard them as potential learners. It is our duty to dispel ignorance when we get the chance and that is the ultimate purpose of this article.
I was born in the late 80s, a few years after Uganda registered her first cases of HIV. At that time, there was a lot of stigma against HIV; as a little boy, I would hear my mom gossip with their friends about other members of the community that had fallen victim to the deadly virus. Such conversations were always made in undertones, for obvious reasons.
The prevalence rate was very high and it wasn’t long before the virus claimed one of our own, my aunt Juliet. She had just lost her husband when she came down with multiple illnesses; herpes, TB…and the likes. My mom invited her to stay with us because she needed proper care and attention. This was the first time I came up-close with an HIV patient. These were now the mid-90s; the time when the most HIV deaths were registered world-wide.
My aunt Juliet was a fighter. She kept a positive attitude throughout her battle with the disease. She was a huge inspiration to fellow victims until her death in 98. I witnessed first-hand the stigma that HIV victims are subjected to. I was powerless then to do something about it. But now I have a pen and paper; the most powerful weapons in the world.
We have made a lot of exponential progress in fighting HIV but what’s disappointing is that our perception of those that have the virus has not evolved in equal measure. Why does HIV still elicit such bad reaction from us, when it’s so easy to manage? Why hasn’t stigmatization subsidized?
There’s an unspoken rule in our communities; “Someone who is HIV+ should never have intimacy again unless they are coupling with a fellow HIV+ person.” Most of us would not dare to say something like that out-loud, but it’s what we believe in our heart of hearts. We only hope there was a formal legislation banning all the HIV+ people from mingling with the rest of us.
The Evolution of HIV Treatment
HIV treatment has gotten so much better in the last 30 yrs to the degree that people with HIV can live normal length lives, if they take their medication and avoid re-infection.
There have been massive changes in HIV treatment; we now know that if an HIV+ woman takes her medication as prescribed, throughout her pregnancy, she can’t transmit the virus to her unborn child. By 2015, the mother to child transmission rate in Uganda had dropped to 2.9%.
Undetectable = Un-transmittable
We also know today that if an HIV + person is adherent to their drug regimen, their viral load will drop to undetectable levels. Once someone’s viral load is undetectable, then they can’t transmit the virus to their partners. There’s a joke that suggests that if you were to cut open an HIV+ person with an undetectable viral load and drink their blood like a vampire, you would still not get infected with the virus. Having unprotected sex with such a person would not pose any risk to someone who is negative. Undetectable = Un-transmittable. As a matter of fact, someone with an undetectable viral load would show-up negative on a rapid HIV test kit.
Statistically, you have a greater chance of catching the virus from someone who doesn’t know their HIV status than from someone who’s HIV+ and undetectable.
Prep and how it works
There’s a new technology called pre exposure prophylaxis; prophylaxis simply means prevention. Prep involves taking a pill everyday which eventually prevents you from catching the virus.
Some women take a contraceptive pill every day, regardless of whether or not they plan to have unprotected sex; they do so because they want to have the freedom & confidence not to worry about pregnancy. Prep for HIV is exactly the same. It’s a “contraceptive” against HIV. You take prep because you don’t want to catch HIV, should you ever find yourself having unprotected sex.
Does it really work?
It’s been scientifically confirmed that if taken every day as prescribed by the doctor, prep has a 90% chance of protecting you against HIV.
Why don’t people know about Prep.?
A few of you reading this are probably wondering;- if there is this powerful technology that allows someone who’s HIV negative to stay that way, how come I’ve never heard about it? How come it’s not publicized in the media?
Sadly I don’t have the appropriate answer to that question. But the important fact is that now you know. Now that you know about it, go out and spread the word. Go and talk about this good news to anyone who might care to listen.
One would have hoped that with all this advancement in research, such information would trickle down easily to the general public and ultimately reduce the stigma. But sadly that has not been the case. We still have a large section of our population believing that HIV is caused by having a promiscuous lifestyle. Some are ridiculous enough to believe that HIV is God’s punishment against those that commit the sin of having premarital sex.
The Future for Prep
It’s exciting to know that prep is not going to stop at one pill a day. From implants to injectable prep that can last as long as 3 months, the future looks very promising. There are also flexible rings that women can plant inside the female organ. The more options we have for HIV prevention, the more we’re going to win this battle.
Some moralists have started slut shamming campaigns against people that have chosen to take Prep. They argue that if you want to take prep, it can only imply that you want to sleep around; you don’t have the discipline to stay committed to one sexual partner.
There’s so much stigma around HIV that we can’t even openly talk about prevention measures. But it’s our duty to educate the public about the availability of prep especially for people that have HIV positive partners. If you’re a discordant couple and have been struggling with deciding whether or not to stay together, I believe Prep will settle your concerns.
Where to get Prep
Almost all regional referral hospitals have prep and are giving it out for free primarily to people in high risk sexual relationships like the sex traders and discordant couples. At the moment, the government of Uganda doesn’t allow the selling of Prep over the counter at a pharmacy. This will hopefully change soon.
Your responsibility
I hope that now that you’ve received some knowledge on how HIV transmission really works, when your spouse or lover ever reveals that they are HIV+, you won’t cast them aside. You now know better. The only way to stop the stigma is by educating ourselves and our peers.
If you know someone that has been diagnosed with HIV, let them know that they matter. That their life is still worth living. That they still have a chance to live a normal life; date and marry an HIV negative person, have kids and live a purposeful life. They deserve to have a life that is free of stigma. Stop the stigma.
#stayhome #staysafe
