Stigma Is Worse Than The Disease Itself: Aids

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SPECIAL REPORT

Stigma is worse than the disease itself

Chularat Saengpassa,

Pongphon Sarnsamak

The Nation

BANGKOK: -- While campaigning for the rights of others living with the Aids virus, one activist has kept his infection a secret with most people, especially his in-laws.

His case speaks volumes about how the Thai society - despite the many laws - is just not opening up to people living with the human immunodeficiency virus.

"I don't dare to talk about my infection because I am afraid people will treat me differently," the 38-year-old man explained.

Oat (not his real name) is among the thousands of Thais living with HIV, of whom only 250,000 have signed up for anti-retroviral drugs. Relevant authorities believe that another 250,000 are living with the virus unknowingly or want to keep it secret.

In fact, even Aids activists have been trying to get doctors not to reveal that a patient is being treated for HIV-related illnesses for fear reimbursement will be refused or the person will be discriminated against.

"We want to help them avoid stigma," said Nimit Tien-udom, of the Aids Access Foundation.

He explained that his foundation also encouraged tambon administrative organisations to stop including the names of HIV-positive people in their budget plans.

People living with HIV face immense pressure in rural societies, Nimit said.

"In villages everybody knows," he said.

Oat said that once he was at a temple, and he noticed people would not come anywhere near him.

"They wouldn't sit near me. They wouldn't eat when I was at the table. So I had to leave," he recounted.

Oat does not know when exactly he contracted the virus, but he first learned about it when he was 26 and his wife started developing suspicious symptoms.

After a blood test, they got the bad news.

"Our world fell apart - we didn't know if we could carry on," he said.

Back then, he only knew that the Aids virus was fatal and that the conditions were terrifying. Though they went to the best hospitals, his wife's condition kept deteriorating.

"I wished a fatal car crash would end it all, but my family - my older sister and her husband, to be exact - made me think twice," he said.

His sister and brother-in-law welcomed Oat and his wife into their home in Phayao and showed no repulsion. However, Oat's wife died soon afterwards and he started taking her retroviral drugs. Back then, access to this life-saving treatment was very limited and only those with serious symptoms could get it. Oat was relatively healthy, so he decided to use his late wife's account.

With the anti-retroviral drugs, Oat went from strength to strength. He found himself physically and mentally fit to return to work and was even able to fall in love again.

"She's a childhood friend. I told her about my infection and she said it was OK," Oat said.

However, her family disliked him and after four years, their relationship came to an end. Then he moved to Sing Buri and got a job at a factory. He looked perfectly fine, so nobody suspected he was HIV-positive.

"But I felt uncomfortable because I couldn't tell people I was HIV-positive," he said. He was also anxious about the annual medical check-up.

"Finally, I decided to quit," he said.

Oat then met another woman, only this time she too was HIV-positive and offered him greater support and understanding. However, they eventually went their separate ways.

After Oat started working at an Aids foundation, he met his current wife - she is 13 years his junior and not infected.

"I never thought I could love an HIV-positive man, but over time I have learned to love and accept him. It doesn't matter whether he has HIV or not," she said.

Yet despite their love for each other, it has not been smooth sailing.

"None of my friends, other than those at work, or my family know that he is HIV-positive. I just can't tell them," she said.

Stigma has haunted all HIV-positive people, but things for the poor are even worse. The homeless, in particular, are unable to get a bed in state hospitals after they become infected and start developing symptoms. Though hospitals are required by law to treat HIV-infected people under the universal healthcare scheme, they often push them out of the facility as soon as possible.

"Clearly, the homeless living with Aids face worse discrimination. Hospitals have made it very difficult for them to receive the treatment that they are entitled to, which is why they are forced to leave and their symptoms worsen fast," said Natee Sorawaree, secretary-general of Issarachon Foundation.

This year alone, at least eight homeless people in Bangkok's Sanam Luang area have died of Aids.

-- The Nation 2012-11- 30

[DGS1244]

As I mentioned previously people still do not understand the difference between AIDS and HIV, they just assume that if you have HIV the you must have AIDS, not the case.

What is AIDS? AIDS (acquired immune deficiency syndrome) is a condition caused by a virus called HIV. This virus attacks the immune system, the body's "security force" that fights off infections. When the immune system breaks down, you lose this protection and can develop many serious, often deadly infections and cancers. These are called opportunistic infections (Ols) because they take advantage of the body's weakened defenses. You have heard it said that someone "died of AIDS." This is not entirely accurate, since it is the opportunistic infections that cause death. AIDS is the condition that lets the OIs take hold.

What is HIV? HIV is a virus, like the flu or cold. A virus is really nothing but a set of instructions for making new viruses, wrapped up in some fat, protein and sugar. Without living cells, a virus can't do anything—it's like a brain with no body. In order to make more viruses (and to do all of the other nasty things that viruses do), a virus has to infect a cell. HIV mostly infects CD4 cells, also known as T cells, or T-helper cells. These are white blood cells that coordinate the immune system to fight disease, much like the quarterback of a football team. Once inside the cell, HIV starts producing millions of little viruses, which eventually kill the cell and then go out to infect other cells, this can take a long time. All of the drugs marketed to treat HIV work by interfering with this process.

[DocN]

Said it before, saying it again: education would help a lot!