Stigma & Discrimination 4

Self stigma is something very familiar within the HIV and AIDS field. Often someone who test HIV positive believes that he or she is not valuable anymore. They fail to accept themselves, or over-blame themselves. They believe that they are incompetent, useless and even dangerous to other people. They believe that they will be dying soon, that they are too bad, too dirty, and too sinful to be accepted and/or to be forgiven.

This kind of stigma is very dangerous as it is often "invisible" - family members and friends might not even be aware of the feelings of this person. And as along as societal stigma related to HIV and AIDS exists, self-stigma will be a reality for many people. If we can eradicate societal stigma, we might be able to minimize self stigma!

This form of stigma was what I have experienced and it's really difficult to overcome with. But thank God we have Jesus Christ to save us and give another chance, another new life!

Self stigma is the reason why a lot of people tested HIV positive hides in the closet. If they continue to do this, they will never know what they are missing.

Next post I will discuss the impact of HIV related stigma.

Source: "Channels of Hope" workshop manual.

Stigma & Discrimination 3

Like I have said there are two types or forms of stigma. The first one is the stigma which happens in the society called societal stigma.

We observe people being isolated, insulted, judged and blamed. People talk and conduct themselves in ways that make other people feel devalued, ashamed, worthless, and guilty or discriminated against. This often happens to people who are HIV positive or are battling with HIV related illness.

In some instances not only one person is stigmatized but a whole family can suffer because they are associated with the person who is stigmatized. We call this "stigma by association". Another example of this form of stigma is when a person is discriminated against because of their association with a specific group of people, e.g. the family the person belongs to, or clan, or even the church he belongs to. In the same way, a whole family can experience stigma when one member tests HIV positive. Children often experience stigma when their parents fall ill or die because of HIV.

People can also be stigmatized because of their appearance, what they look like or even their occupation. How often has it happened the people who were falling ill or were losing weight were stigmatized because people thought they might be HIV positive!

And then there is something called "self stigma" which I will talk about on my next post.

Source: "Channels of Hope" workshop manual.

Happy Birthday To Me

Happy Birthday To Me

If you’d never been born, what would you be?
You could have been a rock, a toad or a tree.
Or worse than all that, you could have been a wasn’t.
Now a wasn’t has no fun at all, no he doesn’t.
A wasn’t just isn’t. He isn’t present
but you, you’re right here, now isn’t that pleasant?

Today you are you and it is truer than true
that there’s no one alive that is you-er than you.
Shout out loud I’m glad of who I am.

Thank God I’m not a rock
a clam or a ham or a dusty old jar of gooseberry jam.
I am what I am
and it’s a great thing to be
and if I should say so myself, Happy Birthday to me!

This poem was written by Dr.Seuss from the book "Happy Birthday To You" also written by him. He also wrote "Horton Hears a Who". I dedicate this poem to myself because today is my spiritual birthday, the day when I received Jesus Christ as my personal Lord and Savior.

Next post, I will continue the stigma and discrimination topic.

Discriminated or Not?

Before I continue with the topic let me share with you the verdict of my job application to this Christian NGO.

Last Wednesday, this person who interviewed me summoned my presence to their office just to explain their reason why they came up with the decision not to accept me to fill in the position of HIV & AIDS Coordinator.

She said that it was not discrimination on their part and their decision has nothing to do with my HIV status. It's just that they are afraid that while I am doing the duties and responsibilities of the job, something bad and health related might happen to me due to the long working hours and the workload. They have this culture that the employees tend to work and work and work for long hours and probably they thought that this might affect my health condition.

Ok. I am functioning normally and I am feeling very healthy. In fact I don't feel anything bad or abnormalities physically. In short, I am perfectly alright. Perhaps they don't want to take responsibility if something happened to me, but what about the meaningful involvement of PLWH to the advocacy programs? Besides, the working lifestyle depends on the person and I believe I am capable of having a healthy working lifestyle. In addition to that, they can choose not to give me too much load on work if that is their dilemma. I have seen the job description and I guess I can perform them within the normal working hours and a little beyond that if it calls for it.

Well, I have decided not to hold any grudges or bad feelings or thoughts towards them and their decision. I strongly believe that the Lord has something bigger and better for me where He can use me more and where I can serve Him better and reach out to many people. I still thank God for this and all the blessings. Jeremiah 29:11 says, for I know the plans I have for you, declares the Lord, plans to prosper you and not to harm you, plans to give you hope and a future.

Am I discriminated or not? Be the judge.

Stigma & Discrimination 2

What does stigma mean? It is an imputation attaching to character, moral spot or stand or brand. Stigmatize is to cast an imputation. In simple term, it is a label usually negative given to a person.

The word "stigma" is often associated with discrimination, negative feelings and attitudes. Stigma is something negative in your mind but when acted on that something either verbally or physically then that is discrimination.

For instance, when you learned that a person is HIV positive more often than not if you're not educated with the right information on HIV & AIDS and it's mode of transmission probably you would think that this person is promiscuous or a prostitute; that is stigma. When you said something bad towards the person fueled by that thought or you simply avoid him or isolated him then that is discrimination.

There are two types of stigma, the self stigma and societal stigma or stigma by association. I will discuss it on my next post.

Source: "Channels of Hope" workshop manual.

Stigma & Discrimination 1

What really kills people living with HIV and AIDS all over the world is not the opportunistic infections that attack the body when the immune system is already depleted, it's the stigma and discrimination feels and experience by HIV positive people. But before I talked about what is stigma and discrimination in the context of HIV & AIDS, let me tell you my own experience of stigma and discrimination.

I applied for a position related to HIV & AIDS in this Christian non-government organization. The result was negative, though it was not final yet according to my friends there, due to my HIV status! At first I was really hurt because for the very first time, I was discriminated against because of my health condition. I cried for a couple of minutes but I asked the Lord why, then I began to understand that perhaps these people are just concerned about my health coz they are afraid I might not able to do all the responsibilities of the position. Apparently, it is still plain and simple discrimination and it's against the RA8504.

I was amazed by the support and trust given to me by my friends there and sooner than I thought, I felt better and trust the Lord that He has something far better for me. So after a few minutes of that negative feeling, I was truly alright and it did not bother me at all.

The Lord only showed me that not all Christians exude true Christianity or Christ-likeness to themselves. It's like a warning to me that I must be really careful to whom I will reveal and entrust my status at the same time. Honestly, I have nothing against with that organization or to any people from that group. In fact, I will be still willing to help them in their HIV & AIDS project and I will treat them the same way I treated them before that incident happened.

Anyway, it is not a closed book yet I guess and only God knows what will happen next. It really feels good to trust God with all my heart. It feels great to know that the Lord will take care of every aspect of my life especially on the areas like this.

Stigma and discrimination will not kill me and should not kill other people living with HIV. The Lord is my strength and my shield. My heart trusts in Him and I am helped. My heart leaps for joy and I will give thanks to Him in song. That is Psalm 28:7. So if you are living with HIV like me and feel stigma and discrimination, I would encourage you and suggest surrendering yourself to Lord Jesus Christ and everything will be alright coz He will take charge.

Next post, what is really stigma and discrimination?

All Saints Day

Hello readers! Happy Halloween!

Please allow me to thank you today, "All Saints Day" for taking time to visit and read my blogs. I want you to know that I really appreciate it. Thank you for writing some comments. I just hope and pray that this website of mine will be known to people who are struggling with homosexuality and people living with HIV. Also I pray that it will be known to people who did not know anything about HIV and AIDS and to those people who are sick and tired of living the homosexual lifestyle. All these I pray in the mighty name of Jesus Christ! Amen.

Next time I will be talking about the most dreadful thing that gradually kills the HIV positive people around the globe, stigma and discrimination.

God Bless you people!

Sri Lanka HIV Youth Conference

REACH '08 or Rise for Equality and Act for a Change and Hope is the theme of the HIV & AIDS National Youth Conference of Sri Lanka by Save Lanka Kids organization and Community Concern Society held last October 19-21 at Waters Edge, Colombo the capital city.

I was invited to be a speaker and I talked about discovering and dealing sexual orientation and stigma and discrimination. In relation to HIV and AIDS, I dwelt more on homosexuality and its root cause and why they are more prone to infections. The funny thing that happened was when I presented the idea that a gay person can change, I have created a lot of curiosity and tension inside the conference hall. Since most of the people there believed that it is inborn or a choice, the idea that it was developed and started out within the family as well as the idea of change is somewhat new to them.

To be honest, I really felt bad after my talk coz I have no intention of creating controversies. I did not even mention about Christianity and Jesus Christ to show them respect for their spiritual and moral beliefs. I asked the Lord why am I feeling that way and why is this happening and later on God gave me an affirmation that everything is alright thru all the delegates and especially the organizers who approached me at the end of the day and after the conference and told me that my presentation was really good and beautiful and they liked it! I felt relieved and thank God for that. I almost turn my back on my Christian beliefs and go with the world the moment after my talk but the Lord reminded me immediately of His words in 1 Corinthian 6:9-11 and then I suddenly refreshed by the Holy Spirit!

The Lord has been truly with me all throughout the conference and during my flight going there and back to Manila coz I had very safe and smooth travel.

Thanks to my dear friend Clement of WV India for his recommendation, I became a part of this conference and I have gained a lot of friends there and met a lot of Christians! Thank you Lord for giving me this very wonderful experience! I hope and pray that this is only the beginning. I really want to share my life and what I know to the people around the world and hopefully be able to promote to them that kingdom living is the answer to cease the spread of HIV pandemic.

HIV Prevention Strategies 3 - SAVE

Voluntary counseling and testing is a very good prevention strategy and indicator to know the actual number of people living with HIV and AIDS. It knows your HIV status.

Individuals who know their HIV status are in a better position to protect themselves from infection; and if they are HIV positive, from infecting another. Someone who is HIV positive can be provided with information and support to enable them to live positively. People who are ignorant of their HIV status or who are not cared for, can be sources of new HIV infection.

Empowerment of people with knowledge and skills especially women, protect themselves against HIV infection. It is not possible to make informed decisions about any aspect of HIV or sexual behavior without access to all the relevant facts. Inaccurate information and ignorance are two of the greatest factors driving HIV and AIDS related stigma and discrimination.

Correct, non-judgmental information needs to be disseminated to all; inside and outside of churches. This will assist people to live positively - whatever their HIV status - and to break down barriers which HIV has created between people and within communities. Education also includes information on good nutrition, stress management, and the need for physical exercise.

The acronym "SAVE" provides the added benefit that all religious and non-religious groups can identify with the fact that we want to save lives through multiple prevention strategies for instance, some denominations would not feel comfortable with the promotion or use of condoms and others might find it difficult to promote and distribute sterile needles to injecting drug users. But everyone will be able to identify with some of the strategies included in the "SAVE" acronym.

Let us "SAVE"!

Source: "Channels of Hope" workshop manual.

HIV Prevention Strategies 2

Greetings to all my readers! Happy birthday to my doctor!

Before I continue with the prevention strategies let me mentioned the local statistics of HIV infection as of July 2008. There were 53 who tested positive to HIV and more than half of it was through homosexual contact. It brings the total since 1984 to 3,358 and according to my doctor; there are 63 who were tested positive in SLH alone this August. You can check the NEC at www.doh.gov.ph and click the HIV icon there for updates.

Our duty is to move from ABC to SAVE. S stands for safe(r) practices, A is for access to treatment, V is for voluntary testing and E stands for empowerment.

Safe(r) sexual practices include all avoidance and risk reduction strategies like abstinence, delay of first sexual experience, mutual faithfulness in marriage, and correct and consistent use of condoms and reduction of number of sexual partners. It also includes policies and procedures to ensure safe blood supply, sterile equipment, adoption of universal precautions, and prevention of mother to child transmission, provision of sterile needles and syringes for injecting drug users and post exposure prophylaxis or PEP. You will notice that ABC is present already within safe or safer practices.

Access implies more than only the availability of medications, and the word "treatment" encompasses more than the word "medication". Therefore "access to treatment" includes the availability of medication, as well as access to the medication and all the necessary support services. It includes the access and availability of medication like ARVs, treatment of STIs and other OIs, treatment - education and support such as access to blood tests for monitoring and adherence as well as counseling, and nutrition for people with compromised immunities or on ARVs.

Access also implies the availability of comprehensive and correct information and education in order to make informed decisions for prevention, care and support. It also implies a supportive environment where stigma and discrimination have been reduced.

Next post I'll talk about the V and E.

Source: "Channels of Hope" workshop manual.

HIV Prevention Strategies 1 - ABC

As a Christian living with HIV, my ultimate goal is to promote Kingdom living as the effective way to stop the increasing numbers of people being infected with this virus. Of course, not everybody can follow Jesus Christ without committing any sin that will put them at risk of contracting HIV but I am sure that all of us really want to prevent more people of becoming infected.

Most people have heard about the ABC approach which stands for abstinence, be mutually faithful and condoms towards HIV prevention. Its main focus is on preventing HIV transmission caused by sexual intercourse but we also learned that sexual activity is only one way of how HIV is transmitted.

Originally the ABC message was developed in Uganda. It was never meant to be the only answer to HIV prevention. It is therefore essential that we also introduce other acronym in combination with the ABC message to demonstrate that there is more than one way of protecting oneself against HIV. The complexity of the cultural and societal context in which HIV is transmitted demands a multifaceted approach.

A very popular new acronym that manages to capture the multifaceted approach is "SAVE". Even as an acronym, SAVE reflects the underlying purpose of prevention programs; that is our whole purpose - we are here to SAVE lives through education and providing skills.

I will discuss on my next post what SAVE is all about.

Source: "Channels of Hope" workshop manual.

COH in Bohol

Greetings to all my readers!

It was my first time in Bohol and that's where I had my third COH facilitation happened. The participants were so very active and participative and I sensed their zealousness to learn everything about HIV and AIDS and how to respond to it. I am glad that all of them were happy after the two days workshop and I thank God coz once again, more than 30 people has been blessed and inspired with my story. I thank God and praise Him for what He's doing in my life now!

The province of Bohol is a very placid and beautiful place. It is so clean, fresh and you can feel the nature as you travel around the city on the coastal highway. For the very first time, I saw the wonderful chocolate hills and the tarsiers of Bohol. I thank God for giving me all these opportunities to see His creations and I am looking forward for more as I do his work as His servant.

May the Lord Jesus Christ continue to bless me and my family. Heavenly Father, you are truly worthy of the highest praise!

Benefits of ARV

Drug cocktails prevent further damage to the immune system and in some cases, allow the body to repair the immune system.

Because of this, ARV prevents opportunistic infections and death. People with AIDS who were terminal and had nothing to live for, recover and go back to work and start to dream again and plan their futures like me. ARV is also very effective in preventing mother-to-child transmission of HIV.

There is no doubt that these drugs are working and that HIV is becoming a manageable disease similar to, for example, diabetes. Again, it's not a cure but a treatment only and you can still infect others if you do not practice safer sex.

Developments such as the initiation of the Global Fund is currently helping Filipinos living with HIV to avail the ARV free of charge. I just hope and pray that it will last for a lifetime.

Source: "Channels of Hope" workshop manual.

Drawbacks of ARV

There are clear drawbacks or disadvantages and benefits to the use of antiretroviral therapy, but let's focus first on the former.

ARV is very expensive and cannot be afforded by the majority. The estimate cost for one type of drug is around 25,000 PHP per month. Therefore, if the person is taking three combinations of drugs it will cost around 75,000 PHP in a month. Praise God that there is global fund for the Philippines for ARV that all people living with HIV can take the medication for free.

A limited number of patients like around 5-7% can have very bad side effects such as making too little blood and becoming anemic, damage to the liver, kidney stones, changes in appearance and high cholesterol, skin rashes, etc. Quite a few people experience milder and less serious side effects which often disappear after the first month or so of treatment. Thank God that the only side effect that occurred to me was feeling nauseated.

People have to be very compliant in taking the medicine exactly as prescribed. This is to constantly keep the levels of the drug in the blood high enough to block the virus' growth, remember that ARV does not kill the virus. Missing a dose results in the level of the drug in the blood dropping, thereby giving the virus a chance to build up resistance against these drugs. Once the virus is resistant, there is no turning back. It is therefore very important that a person taking ARV does not skip any drugs at any time, even if they make the person feel ill.

People need to be closely monitored for side effects and resistance. As soon as resistance starts to appear, the person needs to move on to another regimen which is usually more complicated and expensive. As for me, I praise the Lord that my body has tolerated the combination I am taking and I am feeling normal.

Source: "Channels of Hope" workshop manual.

What Is ARV?

I have been talking about ARV previously but let's take a deeper look on what ARV is.

ARV or antiretroviral is the drug used to strengthen the immune system of people living with HIV & AIDS. The aim of this drug is to reduce the rate at which the virus multiplies in the CD4 cell or T-helper cell. It is imperative to realize that ARV DOES NOT KILL HIV. What they do is block the virus' growth. If a person stops taking ARV, the virus immediately starts multiplying again. The HIV can quickly build up resistance against one or even two drugs; therefore these drugs are normally used in combinations of three - one non-nuke with two nukes, or one protease with two nukes. This is often referred to as triple therapy, combination therapy or a drug cocktail.

Non-nuke is the short term for Non-nucleoside Reverse Transcriptase Inhibitors. It interrupts the reverse transcriptase process but do so in a different way to the "nukes". Examples of this drug are delaviridine, efavirenz or sustiva and of the three drugs I am taking which is nevirapine.

Nukes are also known as Nucleoside Reverse Transcriptase Inhibitors. These drugs interrupt the reverse transcriptase process. They block or disable the "translator or intrepreter virus". Example of these drugs are d4T or stavudine, ddl or didanosine, ddc or zalcitabine, abacavir and the other two drugs I am taking which are AZT or zidovudine and 3TC or lamivudine.

Protease inhibitors are drugs that foil replication by neutralising the protease enzyme that puts new HIV together. Some of the examples of these drugs are saquinavir, indinavir, nelfinavir, amprenavir and ritonavir.

Entry inhibitors are the newest class of drugs against HIV. They stop the virus from getting into the CD4 cell. While the first three classes of drugs are relatively cheap and widely available, these are very expensive and not easily available. Enfuvirtide or T20 is an example of protease inhibitors.

I'll talk about the drawbacks and then the benefits of taking ARV on my next posts.

Source: "Channels of Hope" workshop manual.

Living Positively 3

As an HIV positive person, our body needs more than just medication. We as human beings are as a matter of fact not only body, but a unique combination or unification of body, soul and mind.

Think of a time when you were sick. Can you still see yourself alone, sick and miserable in bed? Aside from medicine, what will help you get well again?

Since when are flowers, SMS, chocolates became medicines? These things will make you feel better is not it? Then these must be some form of medication don't you think?

Positive living is not just about accessing medication, or the government providing free ARVS. It is about having a reason to live - about wanting to be alive.

Health is not about knowing all the facts, it is about wanting to be alive and therefore using knowledge to achieve that.

Would you therefore agree with me that positive living is also about doing the things I always dreamed about, spending sometime with people I love and people who make me laugh and feel good about myself, about claiming control of my life, my future, about being loved and supported, about celebrating life as a spiritual being, etc.?

In my case, I surrendered my life to the Lord Jesus Christ and accepted Him as my personal Lord and Savior and that is positive living! Living a Christian life is living positively.

Each one of us needs this whether we are HIV positive or not.

Source: "Channels of Hope" workshop manual.

Living Positively 2

Let's take a look first in strengthening the immune system. Since HIV weakens the immune system, we need to look at healthy habits that can strengthen it. Eating properly and healthy foods, getting enough rest and exercise, reducing stress levels in our lives and avoiding unhealthy habits such as smoking and alcohol consumption amongst others do indeed have a positive impact on our general health. The body can further be strengthened by specific multivitamins and immune boosters which should be taken in consultation with a health practitioner or doctor. These general habits do in fact apply to all people who wish to take proper care of their bodies regardless if you are HIV positive or negative. The best time to implement these habits in your life is today!

Treat all the opportunistic infections or OIs. Although there is no cure for HIV, the majority of minor OIs can be healed. Ergo it is very important to treat the symptoms of all OIs as soon as it appears. This is to limit the damage it can cause to your body and to relieve you from the symptoms. A simple cold and sore throats could lead to meningitis. Untreated flu could lead to bronchitis or pneumonia. These are chances an HIV positive person should not take.

HIV will remain in the body but that does not mean all of the opportunistic infections also have to!

Antiretroviral treatment or ARVs or ART. Despite our attempts to strengthen the immune system and to keep the body generally healthy, there does come a time when the immune system is not strong enough to provide sufficient protection to the body and then it is advised that people should start taking ARVs. It's a strong medication that directly attacks the virus in the body and suppresses the multiplication of the virus. With fewer viruses or lower viral load, the attack on the CD4 cells is reduced and this gives the CD4 cells the opportunity to recover and multiply again. A higher CD4 count implies a stronger immune system.

Source: "Channels of Hope" workshop manual.

Cagayan De Oro Experience

Before I proceed to the second part of Living Positively, let me tell you about my Cagayan De Oro experience. My second facilitation for Channels of Hope - HIV & AIDS happened last August 5 and 6 at Cha-li Beach Resort in Cugman, Cagayan de Oro City, Misamis Oriental.

I have improved as a facilitator but still a lot of things to learn. I found out that it's easier to facilitate the information part compared to the attitude and behavior exercises as I need to put more emotions or drama into it to touch the emotions of the participants and not just their heads. Though over all, I guess we made our point and most of them if not all of them, has changed their behavior and attitude towards people living with HIV. All of them are HIV advocates and they concluded that they have so much to learn when it comes to Christian response.

Their over all evaluation is very good and they want more information and knowledge. After our two day workshop, we went relaxing on the 7th.

World Vision ADP staff brought us to CDO's tourist destination, the White Water Rafting and Zipping. It was my first time to do such adventures and it was really a great and very unforgettable experience. During the more than 2 hours water rafting, all we did was to scream and laugh just to forget about being nervous. With the zipping experience, well, when I was there all I ever did was overcome my fear and jump until I get to the end of the line.

If all my service to the Lord will have fun like this or even more, I guess I could not ask for more. What a Cagayan De Oro experience! Praise the Lord Jesus Christ!

Living Positively 1

One of the most paralyzing myths regarding HIV and AIDS is that there is nothing we can do about it. Part of the message of hope that we need to spread is that albeit there is no cure for HIV, it is possible to live a healthy and productive life despite HIV infection. It is possible to take some control of our lives and equip our selves as well as our immune system with strategies of coping better with HIV.

Now let's talk about the different treatment options. Remember that treatment is different from cure. When we refer to the term "cure", it means a type of medicine that will completely heal us or take away a specific disease. When we use the term "treatment", we use it in the context of medication and general health guidelines that help a person to manage a disease or illness. The purpose of this treatment is not to remove the disease, but to help the person to manage and limit the effect of the disease on his body.

Remember this virus weakens the immune system, which is responsible for the body's defense against other diseases and infections. With a proactive approach to treatment we need to aim at reducing the negative impact of the virus as far as possible. How can this be done?

First is strengthening the immune system, next is treating all the opportunistic infections and then taking ARV or antiretroviral treatment. Let's take a brief look at each of these individually on my next post.

Source: "Channels of Hope" workshop manual.

Root Cause

I had my one on one with my spiritual counselor last week and then I talked and opened up my life to our church leader and it revealed me two things. Though I am well aware of these things, it's just this time only when I realized that it is really deep and should be fixed as soon as possible. It's not that easy that's why I am praying to God on this.

My struggle as a Christian is my same sex attraction and the flashbacks of my past life that comes along with it from time to time. It's like a war or battle in the mind that sometimes triggers my sexual or physical desires to burn up. I became HIV positive because of my homosexual struggle which I thought at first that engaging into gay lifestyle will free myself and make me happy only to end up empty, depressed, dirty and worst of all sick with a life-threatening disease. Now that I am living a Christian life and doing God's work in a ministry, I came to a realization that I need to address these two things which I am pretty sure will greatly affect positively to my healing sexually.

First thing I realized is that I have experienced those difficulties and failures because of disobedience to God and not having a personal relationship with Him, though I have mentioned this in my previous postings already. Now that I have surrendered my life and accepted the Lord as my personal Lord and Savior 7 months ago to be exact, the second thing I realized that I need to restore is my relationship to my father and then eventually to the whole family. These are the root cause of everything that happened to me and it's alright because in God's time everything will be restored the way it should be.

I praise and thank the Lord for turning my life upside down, shifting it to a 180 degrees turn. I am now enjoying my life as a Christian and happy doing God's work or ministry while blessing other people's lives every time I give my testimony to them whether on HIV & AIDS workshop that I am doing or on TV or radio invitations. I am glad and blessed that God send people into my life that will help me live the kind of life He wanted me to be.

I pray that the Lord will help me and continue to shower me with the blessings of His wisdom and courage to carry out His works. Also I pray that He will make a way and touch the lives of other HIV positive people I know to come to God and build a relationship with Him through Lord Jesus Christ. Amen.

My First As COH Facilitator

The Pastors and faith leaders from Bais and Dumaguete City were my first participants as "Channels of Hope" facilitator with World Vision.

It happened last June 24 and 25. I found out that it was the fourth time since the leaders planned to hold the COH HIV/AIDS workshop. It was postponed three times and it explained why from the original 45 participants, the number went down to only 13 faith leaders. During the first day, they were only 7 then the rest attended the second day. The number somehow affected me coz I have lost a bit my enthusiasm and it was reflected on me on day one according to my two co-facilitators. That feedback helped me to gather myself and on the second day, I have showed enthusiasm as I tell my testimony to them.

I was blessed for I have touched their lives and it helped them to change their attitude and behavior towards people living with HIV. Somehow, they were enlightened and realized how big their role is as church leaders on the awareness, prevention and de-stigmatization of this pandemic.

The first experience was great that I have learned a lot of things from facilitation, workshop and from the participants as well. The over all feedback from them was very good. Nevertheless, I have so many things to improve to be an effective facilitator for COH and lots of things to learn.

I am looking forward to my next workshop as facilitator and very excited to tell how good God is by sharing to them my testimony. Praise the Lord Jesus Christ!

From Diagnosis to Acceptance 4

In the last phase, which is the rebuilding phase, the healthy HIV positive person accepts his status, with all its consequences and continues with life. Whether a person ever reaches this stage will depend on his own internal coping skills and his support structure.

The first move towards acceptance is to realize: I am still here! The person realizes that he is HIV positive but is not going today or next month.... and has a life and family and people around. The person can make the choice to remain sorry for him or herself or can start to live and love again. This implies that he starts to appreciate life and live it to the full, appreciating every small detail life can offer!

One of the biggest problems of HIV and AIDS being a slow but progressive disease is that the infected person loses the will or ability to dream about the future. The challenge is to think beyond next year - to think what you would like to do with your life if you were not HIV positive.

On hearing that they are HIV positive, a person might start to "eat, drink and be merry because tomorrow we die!" But as you accept the fact that you have a life-threatening illness, you change this into a healthy lifestyle - not fatalism but of appreciating life and the people around you.

Currently, I am in this phase of my life and I am so happy that I have accepted the Lord as my personal Lord and Savior. God has turned this nightmare into a beautiful dream that is gradually becoming a reality. I have prayed for a ministry and God has given it to me. Being an advocate for HIV and AIDS and de-stigmatization and promoting Christian living to stop the spread of HIV is an honor for me and I am happy where I am now. God is truly working on my life now and walking beside me every step of the way. Yes, there are still struggles but with the Lord, I can take control of them and not the other way around. Teaching HIV & AIDS and de-stigmatization to faith or church leaders is a wonderful experience and a privilege to me as well. I'll talk about it next time.

Source: "Channels of Hope" workshop manual.

From Diagnosis to Acceptance 3

In the remembering phase the person is considering when and how he might have become infected. What about previous sexual partners - who infected him? Or could he have been the cause of infecting any previous sexual partners? Must he go back to these partners and tell them that he tested positive (which is by the way, highly recommended)? Will he have the courage to do so?

During this phase the HIV positive person is struggling with himself. This person might be questioning his own lifestyle and while questioning his own lifestyle, the person becomes very sensitive to any judgmental attitudes from people around him.

What is the first question person normally ask when they hear someone is HIV positive? The answer would be: "Where did he get it?" Why do we ask this? People normally want to determine: Guilty or not guilty? Who we are to judge? Have you never made any choices in your life that you now regret? What difference would it make to know how the person got infected? It could only lead to stigma, discrimination and a judgmental attitude. The fact is: the person is now HIV positive - he now needs to know that we will not reject him. This is the last question you should ever ask.

Source: "Channels of Hope" workshop manual.

From Diagnosis to Acceptance 2

The shock phase is quickly replaced by the reality phase. In this phase, the person starts to realize what their HIV status implies. Suddenly he realizes that he is infected with a life threatening disease; is HIV positive will fall ill at some stage but nobody can tell him when. To make things worse, it is not cancer or any other "normal" illness. It is HIV and AIDS, feared by many, seen by others as God's punishment for a promiscuous lifestyle - a disease associated with stigma and discrimination. He is confronted with the implications for his life: What about my family? What about my wife? Should I tell anybody that I am HIV positive, and if I do tell - who? What about medication? Can I afford it? Should I go on a trial? When do I start to look for medication? All these questions and realities lead to a severe experience of loss.

This brings on another set of emotions which could again range between anger and becoming very emotional. As the shock phase fades, and the person starts to realize the implications of his HIV positive status, they become very open to help from the outside. There is a desperate need for information and to talk to people with similar experiences or people who would be able to provide good advice. This could be a doctor, nurse or counselor. But very often a person needs to talk to someone outside the medical profession. All HIV positive people wish they could tell the people closest to them; their family and friends. But very often they are so afraid that they will lose these valuable pillars of support, that they do not have the nerve to tell them.

But at the same time, while open for help, the person is also hypersensitive in two ways: On the one hand the person might trust some people with the fact that he is HIV positive, but now he fears that those people will suddenly start to treat him differently than before. But it goes beyond people knowing your HIV status. One HIV positive person said: "It feels as if my HIV status is written on my forehead, as if everybody knows!"

On the other hand, you know that you are HIV positive. You know you will become ill at some stage but you do not know when. This suddenly causes the HIV positive person to be hypersensitive about his health. Any small illness or symptom becomes a major concern.

Confidentiality is a major concern for any HIV positive and his family. Nobody has the right to share any information about your HIV status. This becomes a major issue for any HIV positive person. They always wonder: Who knows and what do they know? Where did they find out? It is very easy to say that people should be open about their status. Remember, each person's situation is very different from the next person's situation. For some people it can be very dangerous to talk about their HIV status. We must respect a person's right to confidentiality.

Source: "Channels of Hope" workshop manual.

From Diagnosis to Acceptance 1

HIV and AIDS is a weird disease. On the one hand you hear that you have a terminal disease but, due to the long disease progression you might only become ill and die some years in the future.

We do not always understand what emotional impact HIV has on an individual's life. There are four potential phases a person might experience from diagnosis to a phase of acceptance and rebuilding. The phases we will cover will refer to the HIV infected person who is still healthy like me.

The first phase is the shock phase. When a person hears that he is HIV positive, there is normally some kind of shock reaction. This reaction differs from person to person. Mostly the first shock reaction includes some kind of emotional reaction. This could include anger, crying or a feeling of total numbness.

In this initial shock phase people might be so shocked that they say or do things they would not normally say or do; things they would later regret and this is called irrational behavior. For instance, a person might walk out of the doctor's office and start to spend money - buy everything he always wanted. Other people might say to themselves or to others: "I'm not going to die alone - why must I be infected - I am going to take some others with me."

Fortunately the initial shock phase does not last long, usually a few hours to two days.

The most important thing to remember if you should ever have to tell a person that he is HIV positive is to realize that this person is very often shocked upon hearing the news that anything said after hearing this tends to fade from their memories. Counselors or doctors sometimes forget this and would then try to provide all the possible information and prevention messages - but at that stage the person is not absorbing anything. Proper post-test counseling however is very important. It will help the person to think about the consequences of the news, how they will cope up in the next few hours, whom they will tell - if they want to tell, etc.

Source: Channels of Hope workshop manual.

Living With HIV & AIDS

HIV and AIDS do not affect only individuals. They affect families and friends and even communities. They affect each one of us directly or indirectly.

Sometimes people become very negative when they hear about the realities of HIV and AIDS - the rejection, stigma and suffering associated with the illness is very real. But although it is a reality that cannot be ignored, the challenge is to see the other side of this disease; and there is another side. If we start to care for the people infected and affected by HIV and AIDS, and if we can help people to change their attitudes towards people living with HIV and AIDS or PLWHA, the other side will become clear.

With the prevalence of HIV, however, there is a possibility that somebody you love might tell you that he or she is HIV positive. It might even have been a reality to you. What would you say? How would you feel? What is the first thing that you would ask this person - "Where did you get it? From whom?"

When the person we love dearly tells us that he is HIV positive, we are shocked, angry, disappointed and ask "Where did you get this?" The reaction is always negative. But when WE test positive, we only want encouragement and support.

This is what often happens in the real world. That is why it is so difficult for HIV positive people to come out and share their status.

As human beings, we all have a need to be valued and accepted for who we are. During difficult times in our lives, this need becomes even more prominent. It is also impossible to contend with difficult situations without the support and encouragement of people close to us believing in our abilities and affirming our value.

Unfortunately, during good times we tend to become very self-sufficient and self-righteous. We find it much easier to judge and condemn a person with HIV or AIDS than to reach out to him with understanding and acceptance. We'd like to believe that such a person is reaping the fruit of their behavior and that something like that would never happen to us because we know how to behave. This might indeed be true and maybe you or I will never contract HIV. The fact is that we can not foretell the future. We don't know what calamity awaits us round the next corner, when we desperately in need of other's acceptance and compassion.

Most people support the principle: "Do to others what you want them to do to you." Unless we put ourselves in the shoes of another person, it's very difficult to understand what our needs would be in a similar situation. This is not something we automatically do. It requires a conscious decision to postpone judgment and instead try to understand the world of the other person. Only then will we know what we would have liked others to do to us in a similar situation. Choosing to value another person as a special God-created being adds value and worth to your life. AIDS is but one opportunity to put this into practice.

Source: Channels of Hope workshop manual.

How HIV Is Not Transmitted

HIV cannot be transmitted using the same transport. The virus cannot penetrate your skin. There is therefore no way that the virus can be "passed on" by sitting on a seat where an infected person has been sitting.

HIV cannot be transmitted by using the food and eating utensils used by the HIV infected person. The HI virus has a thin protein layer that protects it against the outside world; if that protein layer is destroyed, the virus is destroyed. So if you eat any food that contains the virus, that virus will end up in your stomach with the food. The protein layer around the virus will be digested by the acidic gastric juices and the virus will be destroyed immediately.

While there is a theoretical risk of HIV transmission from an HIV infected player to an uninfected player during athletic practice or competition, most experts agree that the risk of sports-related HIV transmission is so small that it can be ignored. Universal precautions should be taken on the sports filed though. If a player is bleeding, take him off the field and treat him. If there is no free-flowing blood, there's no chance of infection.

Again, if one considers the conditions needed for the virus to survive, the chance of getting infected through toilet seats is impossible. If the virus gets onto a toilet seat, it would be in contact with air, become dry and die. Also remember that the concentration of HIV in urine is too low for any infection.

People are still worried about a mosquito sucking blood from an HIV infected person and then biting them, thus infecting them. HIV cannot be transmitted by a mosquito or any other insect bite. The HI virus is not capable of getting from the stomach of the mosquito into its bloodstream or from the bloodstream into the salivary glands. Mosquitoes can thus not pass HIV from one person to another. Malaria is a different case.

Many people think that you can contract HIV by being bewitched. This is impossible, as you need the conditions of transmission which includes an HIV positive person.

The last example of a situation in which HIV cannot be transmitted is one of the most important to remember, the physical contact. People always wonder how they should treat an HIV positive person. It's easy, absolutely normally! Remember that you cannot be infected through casual contact and that to the person who is HIV positive, it means a lot to have normal contact with others. People with HIV need positive contact as much as they need the most advanced ARV therapies. They need normal and healthy lives that include love, companionship, family and friends' support, medical care, housing, access to job, social, educational and recreational facilities, and access to places of worship.

If your friend or a member of your family is HIV positive, show friendship and love simply by being there for that person. Make physical contact by hugging him. Your friendship will not only mean a lot to that person but you will become richer person in the process.

Source: Channels of Hope workshop manual.

HIV Transmissions - Certain Actions / Situations

What are the dangerous "actions" or situations that place you at risk of being infected? The main ways in which HIV is transmitted is through blood, mother to child, and sexual activity.

Let's first take a look at blood. When infected blood comes into contact with another person's blood, the virus can be transmitted. The following three ways a person can be infected through blood are blood transfusions, needle pricks and injecting drug use.

The rapid escalation of the HIV epidemic is placing pressure on blood transfusion services to keep the blood supply safe. The blood transfusion services however, take all possible precautions to ensure that nobody who is HIV positive donates blood. Injecting drug users very often share needles or a shot of drugs amongst one another. The infected blood within the syringe that they use is then injected into the next person. Most people still have irrational fears about blood. If you practice universal precautions when dealing with any person's blood in the event of an injury, there is no risk of infection. Remember that in all cases, direct blood exchange must occur for infection to take place.

The next "action" that can result in infection is when an HIV positive mother is pregnant or has a baby. HIV transmission occurs directly from the mother to the baby. It can occur during pregnancy, breastfeeding and during birth.

During pregnancy, the mother and baby do not share the same blood system. The baby receives nutrition from the mother via a process of osmosis through the placenta. No direct contact takes place so infection very seldom occurs during pregnancy, approximately 5-10% of babies born to HIV positive mothers would have been infected during pregnancy. However, if the mother is at the stage where she has a very high viral load there is then also a great chance that the baby will be infected.

Most infections which are about 10-15% of babies born to mothers with HIV occur during birth. During the birth process there might be direct blood contact in various ways: Blood exchange between mother and child when the placenta separates from the uterus wall, blood or vaginal fluid contact with the eyes or mouth of the baby as it moves through the vagina during the birth process, and blood or vaginal fluid into broken skin if instrument delivery had to be performed. If caesarean section is performed before the onset of labor, this can greatly reduce the risk of infection.

Approximately 5-20% of babies, who are born HIV negative, become infected through infected breast milk. Breastfeeding is believed to be more risky when the mother has a high viral load, the mother's nipples are cracked or she has abscesses and other breast diseases, and the baby has sores in the mouth or an inflamed gut.

But in the end, the main culprit in spreading HIV from one person to next is unprotected sexual activity! Most people still think that it will never happen to them. Ask any HIV positive person, he or she did not think it would happen to him or her either! People forget that if you are having sex, you are not having sex with that one person only.

You are in a sense having sex with everyone that person had sex with before, and with all their former sexual partners! If they had unprotected sex that could mean up to 30 or 40 other sexual partners whose HIV status you do not know. So if you're into orgies or group sex, this number could be doubled or tripled.

Note: Information was excerpt from the "Channels of Hope" manual.

Conditions for HIV Transmission

HIV is a simple virus. The most important thing to remember is that it cannot survive outside the body at all. But inside a human a body, conditions are perfect for the virus to survive and multiply. Why?

Body temperature is ideal. High temperatures cause the virus to die quickly. Anything higher than 50 degrees C is enough to destroy the virus. The moistness of the body is ideal, outside the body the virus will die. No contact with air, this is the most important one. The outer protein layer of the HI virus oxidizes on coming into contact with air and it therefore dies very quickly. In the body it does not come into contact with air and consequently survives. The correct pH balance plays a vital role, as the virus needs a pH balance very close to that which we find within the human body. As soon as the environment changes to being too acidic or alkaline, the virus would die.

During sex, all these conditions are present together with the body fluids that can carry high concentrations of HIV. This is why so many people are infected during unprotected sex.

There are some conditions or situations that will make a person more vulnerable to becoming HIV infected. First is the entry point. There must be a point for the virus to enter the body. People very often think only in terms of an open wound, cut or injection needle injury. Yes, if there were direct contact of infected, high concentration body fluids into that cut, there would be a definite risk of infection. But the point of entry could also occur during sexual intercourse, through a small lesion occurring in the mucous membranes of the sexual organs.

The presence of Sexually Transmitted Infections or STIs is also a risk-increasing condition. Most STIs cause small sores or small areas of broken skin on the sexual organs or in the mouth. This creates an ideal place for the virus to enter the bloodstream. There is therefore a very strong correlation between the occurrence of STIs and HIV.

The higher the concentration of the virus or the greater the quantity of viruses present, the easier it is to be infected. The lower the concentration, the smaller the chance of infection. This applies both to the concentration of the virus due to the stage of disease progression the HIV infected person might be in. If you remember, the level fluctuates during the course of the disease. Just after infection and in the fourth phase, there is a very high concentration of the virus. Your chance of becoming infected during these phases as a result of direct contact with high concentration body fluids are therefore greater than in other phases.

Note: Information was excerpt from the "Channels of Hope" manual.

How Is HIV Transmitted?

For the HI virus to be transmitted, it needs certain body fluids, conducive conditions and certain "actions" that could lead to infection.

In some body fluids of an infected person, the HI virus is found in such high concentrations that someone can be infected if they come into direct contact with it. These fluids are blood, semen, vaginal fluid and breast milk. During unprotected sex, a person will have direct contact with semen or vaginal fluid and sometimes even with blood. This is once again, why HIV infection takes place mostly when people are having unprotected sex.

On the other hand, body fluids such as saliva, tears, perspiration and urine will have such low concentrations of HIV that there is no chance of infection. This is why normal social contact and kissing is not dangerous and will not lead to HIV infection. Let's have a closer look at these different fluids.

Blood, two or three drops in an open wound could infect a person but the contact must be between a fresh, bleeding wound and an open wound. If the wound has already formed a scab, infection cannot take place.

Semen and vaginal fluid, both are sexual fluids in which this virus occurs in just as high a concentration as in blood. During unprotected sex, the partners definitely come into contact with semen or vaginal fluid. This is why 90% of infections in Africa occur sexually.

Breast milk, during earlier studies it was said that there is only a high enough concentration of HIV during the first week after breastfeeding has started - the so called colostrums phase. It was said that during this period the milk has a high protein content which includes antibodies from the mother and also a high concentration of the HI virus that could infect the baby if it has an open sore or a throat infection. At this stage, breast milk is considered a high concentration fluid throughout the period of breastfeeding. It is important to note, however, that infection from mother to child through breastfeeding can also be caused by blood contact if the mother has cracked nipples.

The virus occurs in such a low concentrations in saliva, tears, urine and perspiration that infection is highly unlikely to occur. To date there has been no evidence of transmission via these fluids. It has been said that a person would have to swallow about 7 liters of saliva before running the risk of being infected as a result of an open-mouthed kiss (a "French kiss")! It would be even more true to say that you would have to be injected intravenously with 7 liters of saliva before there would be a high concentration of viruses to infect you.

So, although precautions should definitely be taken in terms of especially blood and semen, the low concentration fluids just mentioned need not concern anyone.

What then, are the conditions necessary for the infection? See next post.

Note: Information was excerpt from the "Channels of Hope" manual.

HIV Treatment Options Part 2

Treatment Options

In the same manner it is also important to know that HIV can also be managed. Remember this virus weakens the immune system which is responsible for the body's defense against other diseases and infections. With a proactive approach to treatment we need to aim at reducing the negative impact of the virus as far as possible. How can this be done? First is strengthening the immune system, treating all opportunistic infections and lastly, the use of ARV or antiretroviral treatment or therapy.

Strengthening the immune system, since HIV weakens it we need to look at healthy habits that can strengthen the immune system. Eating properly and healthy foods, getting enough rest and exercise, reducing stress levels in our lives and avoiding unhealthy habits such as smoking and alcohol consumption amongst others do indeed have a positive impact on our general health. The body can further be strengthened by specific multivitamins and immune boosters which should be taken in consultation with a health practitioner or doctor. These general healthy habits do in fact apply to all people who wish to take proper care of their bodies regardless if you are HIV positive or negative. The best time to implement these habits in your life is today!

Treat all opportunistic infections. Although there is no cure for HIV infections the majority of minor opportunistic infections can be healed. Therefore it is very important to treat the symptoms of all opportunistic infections as soon as it appears. This is to limit the damage it can cause to your body and to relieve you from the symptoms. A simple cold and sore throat could lead to meningitis. Untreated flu could lead to bronchitis or pneumonia. These are chances an HIV positive person should not take.

Antiretroviral treatment or ARV or ART, despite our attempts to strengthen the immune system and to keep the body generally healthy, there does come a time when the immune system is not strong enough to provide sufficient protection to the body and then it is advised that people should start taking ARVs. It's a strong medication that directly attacks the virus in the body and suppresses the multiplication of the virus in the body. With fewer viruses (lower viral load) the attack on the CD4 cells is reduced and this gives the CD4 cells the opportunity to recover and multiply again. A higher CD4 count implies a stronger immune system.

I will discuss more about ARV in the future for there's lot to talk about this.

Note: Information was excerpt from the "Channels of Hope" manual.

A Year After ARV

The topic I am writing about is very timely coz on the 8th of this month; I'll be celebrating my one year of taking the antiretroviral or ARV. The sad thing about that is until now; I have not done my CD4 count test yet. The last time I had my CD4 test was in February 2007 where I found out that I need to take ARV coz my count is below 350, its only 331.

I remember when I had my trial period for 14 days at the H4 ward in San Lazaro Hospital. Nothing happened with regards to the side effects of the drugs until the 20th day of my trial period and I was already back at home. I started to throw up every morning and evening after my meal for the next ten consecutive days. It's like I was in the early stage of pregnancy. I got over it after ten days then my skin on my fingers and feet started to peel off gradually. It was like a skin allergy that stopped me from doing the laundry that I need to keep my hands and feet dry all the time. Another side effect that I am still feeling right now from time to time is I feel nauseated after taking my meal and when I am really hungry; that's why I started to eat in a small amount but more frequently. Somehow, it lessened the nauseous feeling.

So far, those are the only side effects I have experienced after a year and I am perfectly fine right now. I hope time will come that I won't feel any of these nor any side effects of ARV and my skin may continue to heal and gets back to normal.

Hopefully my CD4 will be very high when I had my test and I am praying that time will come when the virus in my blood will be undetected when I have the money for viral load test. Also I am praying that God will continue to bless me with good health physically, mentally, emotionally and spiritually so that I will be able to serve my purpose He had designed for me in this world.

Next post is the second part of treatment.

HIV Treatment Options Part 1

The Difference Between Cure and Treatment

One very common misconception that we find amongst people is that since there is no cure for HIV there is nothing we can do once we discover that we are HIV positive. What do we mean when we refer to the term "cure"? We refer to type of medicine that will completely heal us or take away a specific disease. Is there a cure for HIV? Sadly at this point, we must say no for there is no medicine that can remove HIV from one's body once you are HIV positive.

When we use the term "treatment" we use it in the context of medication and general health guidelines that help a person to manage a disease or illness. The purpose of this treatment is not to remove the disease, but to help the person to manage and limit the effect of the disease on his body. In the absence of a cure, this approach allows people to actively contribute to their own health and in the process to prolong it and add value to it.

One example of an illness without any cure but with sufficient treatment available is that of diabetics who with the right medication and diet can manage the effect of diabetes albeit it can not be cured.

Note: Information was excerpt from the "Channels of Hope" manual.

HIV Progression and Testing Part 4 - Tests

Testing for HIV Viral Load, Antibody Tests and CD4 Count Test

We can perform tests to test for the HI virus. There are three tests that can be used to determine how many viruses are present in blood and it is called the viral load. These are the PCR or Polymerase Chain Reaction, NASBA and Branched Chain tests. The tests are very expensive approximately per test. However, the tests for HIV antibodies are much cheaper and easier to perform.

There are three types of tests for HIV antibodies. They are the ELISA and Western Blot tests. Recently the newly developed Rapid test replaced the first two tests as a screening test for HIV. With a Rapid test, it is not necessary to draw blood which then needs to be sent to a pathology laboratory. A smear is taken from the inside of the mouth or a small sample of blood is taken after a finger prick. Using these samples, the test provides a positive or negative result within 20 minutes. Recent developments made these tests accurate and trustworthy.

It is very important to note that the tests used to determine if someone is infected with HIV are not testing for the HIV virus but for the antibodies that are formed as soon as the body detects the presence of the virus. If we therefore say someone is "HIV positive," it only means he tested positive for the presence of HIV specific antibodies. The limitations to this test are; it does not tell you when you were infected, how you were infected, what the viral load in your blood is and what your CD4 count is.

The period from the time a person is infected until the antibodies have been manufactured, is called the window period. During the window period there will be no antibodies present in the blood, and a person therefore tests negative even though the virus is already in the blood. Usually these antibodies form within 2-6 weeks, but sometimes it can take as long as 3 months.

Another test would be the CD4 count. This test does not test for HIV or HIV antibodies. It counts the number of CD4 cells in your blood and gives a good indication of how strong the immune system of a person is. This test is normally used to determine if a person is eligible to start with antiretroviral therapy or ARV. In most countries the protocol is to only put HIV positive people on ARV once their CD4 count is below 200.

According to my doctor, the protocol now including the Philippines is below 350 coz the side effects of the drug is much lesser. I have started my ARV last June 2007 because my CD4 count was 331.

If you want to get tested for HIV antibodies or HIV itself, you can visit San Lazaro Hospital in Manila. The HIV antibodies test costs around 400-450 pesos while the viral load test is around 6000 pesos. I would suggest the HIV antibodies test for it is much cheaper.

Note: Information was excerpt from the "Channels of Hope" facilitator's manual.

HIV Progression and Testing Part 3

Relationship Between Health Status, Viral Load and CD4 Count

It is very important to know the CD4 count and the viral load to manage a person living with HIV and AIDS effectively. A high CD4 count and a low viral load implies that the person may be in an earlier stage of HIV infection and thus likely to remain asymptomatic and looks very healthy.

As soon as the viral load increases and the person's CD4 count decreases, he may start to experience symptoms in the form of opportunistic infections. At first it would be infrequent and mild infections such as skin infections or mouth infections, but as the viral load goes extremely high and the CD4 count drops to below 200, the person is likely to become ill with more severe opportunistic infections. Now the person has AIDS and death normally follows within 16 months to 3 years, unless the person has access to ARV or antiretroviral drug therapy.

There are two things to note at this stage. A person with a high viral load (shortly after infection and in the final stage), would also be likely to have high levels of HIV in their semen or vaginal fluid and therefore they may be more infectious. It is also important to note that if a person's CD4 count drops below 200, it does not mean they will become ill; it simply means that their chances of becoming ill are greater. Some people remain quite healthy until their CD4 count drops as low as 10-20!

HIV Progression and Testing Part 2 - CD4 Test

Impact on CD4 Cells (T-lymphocytes)

Another test that is very important in the management of a person living with HIV and AIDS is the CD4 count. CD4 is a protein molecule found almost exclusively on the surface of the T-lymphocytes. For this reason, these cells are also called CD4 cells. The terminology is very often used interchangeably.) This molecule is crucial for HIV's attack on the body - the HI virus attaches onto this molecule to enter the T-lymphocytes cell.

Before being infected with HIV, a person would normally have 800 - 1200 T-cells or CD4 per milliliter of blood. Shortly after infection, this number drops dramatically due to the high number of HI viruses present.

As the viral load is brought under control, the CD4 cell count returns close to normal. But over the next eight to ten years, there is a gradual reduction in the CD4 cell count as the HIV manages to destroy more and more of these cells.

When I learned that I am positive with HIV and asked to have my CD4 count test, it was 331 only as of February 2007. It was my baseline and I never had my CD4 test again yet after a year of taking ARV. An HIV positive person with 350 and below CD4 count is advised to take the ARV or antiretroviral by the world standard to lessen the side effects of the drug. You will learn more on that on my next posts. Well, I will have my test next month.

Note: Information was excerpt from the "Channels of Hope" manual.

HIV Progression and Testing Part 1

Understanding the HIV Viral Load and Antibodies

We often think tend to think that if someone gets infected with HIV, the number of HI viruses will slowly increase until the person's death. This is not the case. Immediately after a person has been infected, the virus multiplies very quickly in the blood. Within a few days there will be a million HI viruses per milliliter of blood. This implies that there is now a very high concentration of the HI virus in the person's blood. We also call this a high viral load.

About a week to ten days after having been infected, the person's body starts producing antibodies. These antibodies are designed by the body to attach only to the HI virus and basically operate like mini-landmines. They attach to newly formed HI viruses and "blow up" the viruses. Partly as a result of this, there is a severe drop in the initial high concentration of viruses. The antibodies remain in the blood in high concentrations.

During the next eight to ten years the viral load remains at a relatively low concentration of between 1000 to 10000 viral copies per milliliter. During the following two to three years the virus starts winning the battle in the body and the viral load increases dramatically. This is the stage at which AIDS starts to develop, and at which the person starts to become sick.

Note: Information was taken from the "Channels of Hope" manual. I am so sorry if there are topics in between that are not related to each other for sometimes I really need to write my thoughts and feelings about how's going on with my Christian walk.

Faith

The past two weeks were not normal for me as I have been sick for a week, I am so lost with my Christian walk that I have found it hard to trust and know God with all my heart, my sister have chosen to live with her boyfriend without getting married making my mother felt very bad with it and then only to lose the baby thru miscarriage last night. All of these predicaments made me feel so low emotionally and spiritually.

Totally I have felt so lost with my Christian journey for I don't know myself anymore and I can't seem to fathom what's going on with me. I am reading the bible everyday and yet it is still hard for me to know God by heart, my prayers were left unanswered and still trying very hard to be patient thinking I am still in my own "three days" and feeling lost that I have no idea what am I gonna do with my life. It feels like that I am in the middle of nowhere and afraid to take big steps and decisions in life. Then yesterday, I think God has spoken to me through my dear friend J.

J asked me how I was and I said I am physically alright but emotionally and spiritually devastated. At first, I refused to open up myself because I am sick and tired of being comforted by other people which makes me feel useless in some ways since I became a Christian but eventually I have decided to pour out myself to him. I am glad that I did it for he made me understand very clearly what I have been going through by telling me his personal story.

I have learned that knowing God through our own mind is not enough to put our full trust to Him. It's hard to trust someone you do not know by heart and it will take time and leap of faith to do that. I told J that part of my everyday prayers is asking God to reveal himself because I want to know Him more, to trust Him more, to serve Him and to love Him more. My friend said that God is listening to my prayers and all I need to do is to allow Him to reveal himself on His way and not on my terms. I must admit that I am asking God to speak to me through my dreams for I am having a hard time discerning His words through the bible and people around me sent by Him. The silence I am receiving from God made me feel at lost with myself and alienated in this world for I have no idea what to do and where to go.

God is not like a genie who will grant our prayers instantly. He has his own ways of answering our prayers. Sometimes God wants us to open a door to receive the answer to that prayer or He would ask us to clear some paths before us able to get to the answer God has prepared for us. Instead of direct answer to our prayers, God sometimes gives directions and guidance for us to get what we asked for.

When J told me his pains and sufferings with his own journey and relating them to all these things, he made me understand what faith really is. Trusting God does not mean simply knowing Him with the mind, submitting ourselves to Him and praying. Faith is seeking God with all our heart and taking bold steps and doing something that we are truly unfamiliar with and lifting them up to the Lord. Getting involve into something we already knew is not faith. Faith is stepping into the unknown and allowing God to work on it.

Upon learning that my sister lost her two month old baby last night, it ripped my heart for I know how my sister wanted to have a baby to the point of committing a lot mistakes just to have it. I grieved for the lost but this time instead of feeling disheartened to the Lord, it made me feel closer to Him and simply lifted up this to Him. I have prayed that God will give my sister enough courage and strength to get through with this and hopefully this will become the way of giving herself to the Lord. I must admit I am still weeping right now for I know how it is hard to lose something that you really want just like that. I hope God has something better in store for my beloved sister.

I am so glad and thankful that God has sent people that will help me understand all the things that I've been going through like J. Taking a leap of faith is not easy but nothing is impossible with God.

HIV Opportunistic Infections

A person with HIV is very vulnerable to different illnesses or infections especially if he's unaware that he's HIV positive and not taking any treatment such as ARV or simply having a healthy lifestyle.

There are all kinds of infections that can attack a person whose body has been weakened by HIV. We call such infections opportunistic infections because the HI virus has destroyed your immune system, they have the perfect opportunity to attack your body. These infections will not usually be found in a person with a normal, healthy immune system.

Opportunistic infections can include swollen glands, mouth infections, skin conditions, brain infections, lung infections and serious weight loss. Let's take a look at these in more detail.

Swollen glands or enlarged glands can occur in the earlier phase of infection, but then disappear again completely. This swelling is an indication that the person's body is fighting the HI virus and is not due to the glands being infected. During the fourth phase however, lymphomas or glandular cancers can develop. There are different types of glandular cancers. The types of lymphomas most commonly associated with HIV infection are called non-Hodgkin's lymphomas or B-cell lymphomas. In these types of cancers, certain cells of the lymphatic system grow abnormally. They grow rapidly growing into tumors.

Thrush is an ailment that commonly occurs in perfectly healthy babies. But when the effect of the HI virus seriously affects their immune system, adults also tend to develop thrush. It is quite normal to find these yeast-like fungi in the mouth, skin, intestinal tract and vagina, but they usually do not make people ill. However, when a person's immune system is suppressed, these fungi can start growing like wildfire to cause thrush of the mouth. The infection can even spread the body and result in death.

People with AIDS may develop brain infections, including meningitis, toxoplasmosis and tuberculosis. Others contract infections which attack the eye nerves, causing the person to gradually go blind. One of the most feared brain diseases is dementia. It is a disease most commonly found in older people, but people with AIDS also suffer from it. The symptoms of dementia are as follows: the person's mental state deteriorates; they have a very short attention span and cannot concentrate or remember.

A wide variety of condition affecting the skin can occur. These vary from athlete's foot in the early stages of HIV infection (it is very common for people with a healthy immune system to get athlete's foot - people with HIV infection are affected much more often and severely) to Kaposi's sarcoma - a kind of skin cancer resulting from AIDS. Shingles is another opportunistic infection. It is caused by the same virus that causes chicken pox in children and is extremely painful.

Most AIDS patients die as a result of one lung infection or another. The most common lung infection in developed countries is pneumocystis carinii pneumonia or PCP. More than three quarters of all people with HIV will develop PCP if they do not receive treatment to prevent it. It is characterized by chronic fatigue and exhaustion from the slightest exertion. It can easily be identified by X-ray. TB also commonly occurs as an opportunistic infection. Not everybody who becomes infected with the germ that causes TB will develop the disease. Someone who has healthy immune system and becomes infected with the TB germ has a 10% chance of developing TB as a disease during the course of their life. Someone who is HIV positive and who becomes infected with TB however has a 10% chance every year of developing the disease TB because of his weakened immune system.

People with AIDS tend to lose an enormous amount of weight. Weight loss is due to an opportunistic infection. However, some people develop what is known as "wasting syndrome." The HIV wasting syndrome involves involuntary weight loss of 10% of normal body weight, plus either chronic diarrhea (two loose stools per day for more than 30 days) and documented fever (for 30 days or more, intermittent or constant) without the person having an illness or condition other than HIV infection that would explain the condition.

Just remember that these infections are because of a weak immune system - just because someone has some kind of infection or is very thin does not mean he has AIDS! These opportunistic infections or OI can be avoided by means of the ARV or antiretroviral treatment; it gives the HIV positive person a chance to live a normal and much longer life. More information about ARV on my next posts.

Note: Information was excerpt from the "Channels of Hope" manual.

The Stages of HIV Infection

AIDS is the fourth stage of HIV infection. A person is said to have AIDS when he has HIV infection and subsequently develops one of a long list of conditions that usually only occur in people with a severe immune deficiency. A CD4 cell count below 200 per milliliter blood in the presence of HIV infection also constitutes an AIDS diagnosis.

The period between infection with HIV and the onset of AIDS averages 8-10 years. In some cases, it is longer, in others, shorter than this. People with AIDS often suffer infections of the lungs, brain, eyes and other organs, and frequently suffer debilitating weight loss, diarrhea and a type of cancer called Kaposi's sarcoma. Without antiretroviral treatment or ARV, most people with AIDS die within 2 years of developing infections or cancers that take advantage of their weakened immune systems.

The World Health Organization or WHO divides the course of the disease into four stages. Primary HIV infection is the first stage. From the time of infection with the virus until the antibodies are manufactured in the blood. A mild cold, night sweats, etc., could accompany this phase. This phase also covers the window period which is 3 months.

Asymptomatic stage is the second stage. The person is as healthy as can be, as his immune system is still strong enough like me. This stage can be prolonged for more than 20 or 25 years or sometimes even longer with the help of ARV. The person takes this lifetime medication to live a normal healthy lifestyle.

The third stage is the symptomatic HIV infection. Person has occasional mild mouth sores, skin infections or night sweats. The person receives treatment for the infections and they are completely healed. Months later, he may pick up another infection. These mild infections indicate a slight degree of immune suppression. It means the HI virus has already damaged the immune system to the point that it can no longer perform its normal functions.

The last stage is the progression from HIV to AIDS or AIDS stage; regular incidences of serious opportunistic infections such as TB, PCP or serious opportunistic lung infection, diarrhea and Kaposi's sarcoma which is a kind of skin cancer. There is a progressive deterioration in health, ultimately resulting in death. In this last phase you could say that the person has AIDS.

It is only in the last phase that a person's condition deteriorates to the extent that he will no longer be able to work. This phase lasts about 16 to 18 months. With some people this period is even shorter. The media have created the impression that the deterioration continues for years, with the person having to remain at home or in hospital. This actually only applies in the last few months of the fourth phase. For most of this period the person is healthy enough to continue working. It obviously varies from one person to the next. Some people are inclined to be chronically ill for longer, while others display the symptoms of AIDS for a long time while still being able to function normally.

There are also cases where a person positive to HIV has very low CD4 cell count and yet still looks healthy and very normal, while some suffers from different infections. I will discuss about testing, opportunistic infections, and treatments on my next posts.

How Does HIV Attack The Immune System?

Our body is protected by the immune system made up of white blood cells or WBC. These WBC have only one job and that is to keep us healthy. We could say that they are our body's army or police force.

We are surrounded by all kinds of viruses and germs that attack our body and make us ill. The WBC fights these viruses and diseases, usually manage to keep us healthy and protect us from disease. Sometimes though, in the case of more serious illnesses such as pneumonia or tuberculosis (TB), we need medication to help the white blood cells destroy these diseases. However, these white blood cells, with the help of the medication would normally get us healthy again.

HIV is totally different. It does not attack the body but it attacks the white blood cells that protect us. So what happens is that HIV slowly but surely kills our whole army or police force. After some years, our body will not have enough WBC left to protect itself; which means that it has no defenses against all the other diseases such as pneumonia, TB, cancer and skin infections that can make us ill. When that starts happening, we say that someone has AIDS. He now has an acquired immune deficiency syndrome.

But if he dies, what does he die of? Not of AIDS. Yes, he may have AIDS but that only means that his body no longer has an army or police force to protect itself. That is why he will become ill easily, and why it is diseases such as pneumonia, TB or cancer that will ultimately kill him.

For much deeper explanation, your blood contains different types of white blood cells: T-lymphocytes, B-lymphocytes, killer T-cells and macrophages. The most important WBC in the body is the T-lymphocyte or the CD4 cell. The CD4 cell or T-lymphocyte basically acts as the commanding officer or commander of the body's army. If any virus or germs arrives in the body, it is the CD4 cells that identify these viruses. They emit a chemical signal which activates all the other WBC. The other WBC reacts to the chemical signal of the CD4 cell and destroys the viruses or germs.

The HI virus is different. The moment it enters the body, it begins to attack the T-lymphocytes or CD4 cells. It penetrates the CD4 cell and uses them as a factory where it manufactures hundreds of new viruses. These new viruses are then released into the blood, in the process destroying the CD4 cells.

The longer a person is HIV positive, the more rapidly the HI viruses multiply, and the more CD4 cells are destroyed. Your body is constantly manufacturing new CD4 cells, but the virus multiplies so rapidly that there ultimately comes a time when the CD4 cells are destroyed more quickly than your body can manufacture new ones.

This process can take up to 8-10 years, but it means that the body's defense system is gradually being worn down. In other words, the commanders of the army, the ones that give the command to attack are being destroyed. The body's alarm system is being switched off. All the other WBC are still there and they can still do their job, but now there is no one to tell them to attack. So the body's immune system is neutralized.

Your body is now susceptible to all kinds of diseases, because there is no longer a defense system to protect you. Now all the other diseases can cause chaos in the body. This condition is AIDS. In other words, your body is susceptible to all sorts of opportunistic infections that will eventually become so serious that you will probably die of them.

A normal person has between 800-1200 T-lymphocytes or CD4 cells per milliliter of blood. When an HIV positive person has fewer than 200, there are no longer enough CD4 cells to set off the chain reaction. The person falls ill easily. By definition, this person now has AIDS.

Note: Information was excerpt from the "Channels of Hope" manual.

HIV and AIDS

Many people view HIV and AIDS in the same light, and therefore have the underlying prejudice that someone who is HIV positive could die tomorrow.

Well, I must admit I used to believe that way two decades ago. Also, I never thought that I would have become a victim of this pandemic a couple of years ago. Believe it or not, the victims nowadays are younger like college students and young professionals. Unlike in the early years, the victims usually were OFWs but now it is being transmitted locally like in my case. I have never gone out of the country and yet I got infected. I was about to migrate that's why I got detected. But where did HIV or AIDS originated?

Research shows that HI virus originated in Africa. A particular kind of chimpanzee is known to carry a virus quite similar in structure to HIV. This chimpanzee virus (SIV) is a great deal older than the HI virus. In certain areas of Africa, the monkey and chimpanzee are considered a luxury food. Possibly the first human was infected by eating some uncooked organs, or through an accidental cut while preparing a carcass. The disease may have begun in this simple, quiet manner, spreading to others from this point through sexual intercourse and later through shared needle use.

Many African government representatives are sensitive about this view. Understandably so, as it is often phrased in a way that seems to blame Africa for the appearance of the virus. While scientific events are not themselves racist, observations and reporting of them may be so. It is important to remember that no one person, nation or population is responsible for the development of HIV and AIDS. We must all share the responsibility for stopping the spread of the virus.

Though currently, HIV is considered to be the worst kind of sexually transmitted disease or STD; let us also considered that a person can be infected through shared needle use, blood transfusion, or direct blood contact via open wounds or cuts. Many people still don't understand the important difference between HIV and AIDS. Let's start with HIV.

HIV stands for Human Immune-Deficiency Virus. After a person has been infected, the virus starts breaking down their immune system. After sometime, the person's immune system is so weak that they become susceptible to a variety of illnesses. So, a person who is HIV positive has the virus in their body, but does not yet have AIDS. As time passes, their immune system will deteriorate as the HIV multiplies and destroys the CD4 cells that compose our immune system, and the person develops AIDS.

AIDS stands for Acquired Immune Deficiency Syndrome. Acquired implies that you had to get the virus causing this syndrome from someone else. To "acquire" anything, you must "do something" to be exposed to it. The virus is not transmitted through the air. You can only get it through unprotected sex or direct blood contact with a person who is HIV positive.

Immune deficiency means, after some years of being infected with the HI virus, your immune system will have been destroyed to the point where you have no defense system left in your body; a total lack of immunity or an immune deficiency.

Syndrome means, if your body no longer has a defense system, in other words you have an immune deficiency; you become an easy target for all kinds of diseases like skin and mouth infections to TB or cancer. It is called a syndrome because the person with AIDS does not become ill from only one disease, but from all kinds of diseases caused by a weak immune system. It is very important to remember that AIDS is the fourth stage in a very long process of deterioration, and it is caused by a virus called HIV. I'll talk about more of the stages and how it gradually attacks our immune system.

Note: Information was excerpt from "Channels of Hope" Manual.