D R . E L R O I


Saturday, June 21, 2008

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.

Thursday, June 19, 2008

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.

Monday, June 16, 2008

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.

Tuesday, June 10, 2008

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.

Monday, June 9, 2008

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.

Sunday, June 8, 2008

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.

Saturday, June 7, 2008

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.

Friday, June 6, 2008

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.

Thursday, June 5, 2008

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.

Tuesday, June 3, 2008

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.