HIV in Africa

And, so after spending a nearly eight months in South Africa, one of the countries most affected by the pandemic (A 2005 UNAIDS estimate for the number of people infected was 5.5. million, 18.8 % of the populace), it’s time for a blog entry devoted to the subject. For many volunteers, HIV/AIDS work is their primary focus here, but for me it is only one part of my job assignment. That being said, it is a very important part of my job here, but does not preside over all my activities.

To begin with, many people in my village are HIV positive. I visited the local clinic last year and found that nearly half of everyone that goes through with a status test (Test for HIV anti-bodies) ends up testing HIV positive. Many do not even go that far, more than half of the people that come in to be tested, leave without being tested. This probably occurs for a number of reasons, one of which is the information the patients receive in pre-testing counseling. However, despite the rather alarming numbers, I do have hope that at least people are getting tested. As more people become aware of HIV, the more they will listen to preventative measures. Awareness campaigns run from billboards to ad campaigns on the radio and TV (helps to have a state run TV station for those), to programs in schools, chapters in textbooks, and nationwide youth organizations focused on HIV/AIDS.

However, at times, I feel that in the seeming rush to get the word out about HIV, there has been some dilution of the message. Due to the complexities of South Africa, when HIV/AIDS first appeared, it was shrugged off as the Afrikaaner’s Idea for Destroying Sex. After all, in many black South African’s minds, the Afrikaaner population was bent on reducing the numbers and reproduction of black South Africans as well as depriving them of land, rights, etc. Now many say it is the American’s Idea for Destroying Sex, raising some eyebrows as the Americans, to some South Africans, seem to not want them to have children, as they also proclaim that birth control should be taken into consideration. How can Americans not want more babies in the world? Or is it just African babies?

The situation is far more complex than I have described above, compounded by the Mbeki’s government initial denial of the link between HIV and AIDS, a minister in charge of a national AIDS program proclaiming that he wouldn’t get AIDS because he took a cold shower after intercourse with an HIV positive partner, traditional healers who don’t think it is a disease, or think they can cure it with normal herbal medicines, among other factors.

When I came to South Africa, I was aware that about one out of every five people that I would meet would be HIV positive, which of course raised alarm flares. I would have to be extra careful when playing sports, cooking, treating wounds, etc. It was more of a heightened state of alert than anything else. In a way I felt like I was prejudiced, but then I felt that despite any altruistic ambitions that I had, I did not come to South Africa to be infected with either TB or HIV.

My first serious conversation about HIV/AIDS was with a university student, one studying microbiology, or at least that was the plan. Their take on HIV was that it had been in the populace all along, it was only with the increased consumption of chemicals, away from the natural order of things, that HIV could then act and progress into AIDS. I was dismayed, but diplomatic, saying I couldn’t disprove that theory, but that I had learned something else about the virus from various textbooks, going through some detail on the history of the virus. In the end I think I was successful, if not of convincing her than of sowing enough doubt that she might advocate either explanation.

In a seminar, held by the Peace Corps, the presenters where from an organization called Soul City, which through a nationally televised program and various publications, deals with problems that people living with HIV would face. Another focus is preventing the spread of HIV by presenting realistic situations and proper preventative techniques, such a how to prevent an HIV positive mother from passing the virus to her baby by breastmilk. However, even the presenters didn’t really understand what was going on with the virus. They had been trained to say what the pamphlets said, but did not have any information beyond the booklets, which, though informative, were quite basic. In the end, many of the Peace Corps volunteers had questions, which then led to me giving an impromptu presentation on the various targets of the drugs and how they worked (My Rice education at work).

Last week one of the Soul City representatives called me to ask for even more information, which I viewed as wonderful, because he had voiced concern in talking to me that he didn’t really understand the virus and the call showed his attempt to be even more prepared in his future presentations. I hope he continues to call.

But until last week, HIV didn’t have a human face. Then, someone in my village had asked me about CD4 counts and viral load and what it meant when the numbers fluctuated. This depth of knowledge made me suspect that they had either been preparing lessons or this person or someone close to them was HIV positive, because the CD4 count and viral load is the means used to measure the progress of the virus.

In the conversation that followed, which encompassed a rather cursory explanation of the immune system and how the virus works, the person let me know that they had been positive for 10 years. To me, they looked as healthy as many South Africans, and I gave them compliments on taking care of themselves and helping preventing the spread of the virus in a rather frank portion of the conversation. For me, my heart beat a little faster when I found out, more in compassion than fear, but I tried to betray no emotion, because, after all this person had come to me for information.

It was also a step forward in the right direction. This person felt they could trust me with such personal information and it shows that I have a reputation for understanding subjects well. This also makes me do more research on the virus, thus keeping my biochemical wits about me, even in rural Africa.

I know that while I’m here I will go to a funeral where the deceased has died as a result of AIDS, that while I’m here, the virus will spread to people that I know. However, I hope that I can, in just some small way, help curb the pandemic, by making those that live with the virus live healthy lives and avoid the spread of it and those that do not have it live an HIV-free existence.