By: Kate Cyr
HIV/AIDS is a disease that has always had a presence in my life. My mother has dedicated a substantial portion of her life to helping those afflicted with the disease. For most of my childhood, I just accepted HIV/AIDS as a part of dinner table conversation without actively engaging. While that changed for me a few years ago, for others, the importance of HIV/AIDS seems to be fading while there is still no cure and little mainstream advocacy for those most in need of help fighting this virus.
Prominent figures like Bill and Hillary Clinton, Laura Bush, Bill Gates, and Elton John stood up to talk about the disease and what’s going on to fix it at this year’s International AIDS Conference in Washington, D.C. (aids2012). They got a bit of press, and then the press moved on. HIV/AIDS is no longer a taboo here, though it still is many places, but it is also no longer on the forefront of people’s minds. Even the idea that HIV started when people had sex with monkeys is still popular.
HIV did come from monkeys—both types of the virus, HIV-1 and HIV-2, though many variations have evolved from both over the years. HIV evolved from SIV, a similar immuno-deficiency virus in chimps (HIV-1) and the sooty mangabey (HIV-2). It is widely held that HIV originated in the south of Cameroon[i]. Most scientists believe it was transferred to hunters who had killed infected chimps. The first confirmed cases can be found in blood and plasma samples dating back to 1959, though recent evidence places HIV’s origin possibly as far back as 1884.
The worry, on the other hand, began in the 1980’s, when AIDS appeared in American gay men and injecting drug users, though the virus probably traveled to the US around 1970.[ii] AIDS caused an absolute panic when it was discovered in non-drug using women and children in 1983. It wasn’t until after this, in 1984, that Western scientists realized this virus had been ravaging Africa in enormous quantities. AIDS was the dreaded disease. People with it were ostracized, and terror spread faster than the disease itself. At first, no one knew what AIDS even was or what caused it.
HIV and AIDS are defined by how they affect the level of CD4 (a type of white blood cell) in the body.[iii] A person can live for years with HIV before having AIDS, which is characterized by a CD4 count of under 200 or the appearance of certain complications mostly found with AIDS.[iv] HIV is so dangerous because it is passed on so easily: sex, to a child during pregnancy, or blood transfer. People unaware of the disease passed it on to sexual partners, mothers infected children, and patients were given transfusions of tainted blood.
Now, of course, there are treatments to keep all of AIDS’s nasty side-effects from encroaching on a person’s daily life. Antiretrovirals (ARVs) are the most common drugs, and they keep the amount of HIV in the bloodstream low and decrease the risk of passing HIV on to a child in utero. But they’re a stop-gap. Usually patients need to take two, three, or more ARVs at once to keep resistance from developing. And these medicines need to be taken for the rest of the patient’s life.[v]
But ARVs only reach a certain number of people. By the end of 2011, only eight million people of the 34.2 million living with the disease were treated.[vi] That’s not even a quarter of the people who need it. About two thirds of those affected by HIV/AIDS are in sub-saharan Africa and many can’t afford ARVs. The newer, more effective drugs are usually only available in the West. Most people don’t get tested or don’t know they’re at risk.
Three things need to happen, and happen more often, if the AIDS epidemic is to be slowed or halted. One, there needs to be more education and dialogue about it. Two, people need to seek treatment. Three, drugs need to be available to everyone with HIV. Sure, there needs to be a cure, but before it is discovered, those three steps will do the most to help those suffering the most.
Few people know much about HIV/AIDS. The fact that it is a sexually transmitted disease is not common knowledge in far-flung villages. The use of condoms, therefore, is not a big priority, and for many women, there is little say in condom use. Men who work outside the home cheat and accidentally bring the virus home. Mothers don’t realize that they’re infected or that the virus can be passed on to their children before or during birth and breastfeeding. Then their children are sick. Simple measures, like using a condom, male circumcision (which can lower risk of acquisition by 60%), and not breastfeeding can drastically lower the spread of HIV.
No one wants to talk about HIV/AIDS. Cheating isn’t a conversation men are going to have. Women are often abandoned when they find out they are HIV positive. Children are orphaned by the disease and have nowhere to go. When no one talks about it, prevention methods are never discussed, and the stigma keeps many from testing and treatment. The fear prevents people from getting better.
Even for those who are aware they need treatment, it’s not always available.[vii] ARVs are expensive. An abandoned woman or child won’t have the funds for medication. While some NGOs and governments are working to subsidize medicine, so many people fall outside of that reach without any hope. Drugs are often not covered by insurance in the US or by governments in the developing world. While those suffering in developed nations may be able to purchase medication, very, very few in developing countries have that opportunity.
Now that you’re thoroughly depressed, I ask only one thing. That this conversation move from my dinner table to yours. I want it to spread farther, so people have to talk about HIV/AIDS, at least once. I think we owe it to everyone suffering in silence and in pain, stigmatized and largely ignored. If nothing else, I hope you at least take away that this world-wide epidemic did not start from someone having sex with a monkey.
[iii] Staff, Mayo Clinic. “Definition.” Mayo Clinic. Mayo Foundation for Medical Education and Research, 24July 2012. Web. 02 Aug. 2012. <http://www.mayoclinic.com/health/hiv-aids/ds00005/dsection=causes>.