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AIDS Still challenging, but not the death sentence it once was

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By Sunshine Morgan

Hanging on the wall of the Washington County HIV Clinic in Fayetteville, is a quote by an AIDS patient: “I deal with this disease by looking at it as one of the best teachers I’ve ever had. I treat it with respect. I try to love it. I try to talk to it. I’ll say ‘You are safe with it. Do not worry. I do not hate you.’ I am not sure if befriending this virus within me has any healing impact; I know that it helps me carry on. If my attitude is good and I am happy and generous, I feel I can live with this virus within me for a very long time.”

Things have changed in recent years for those infected with HIV. Many are living fulfilling lives and are turning the disease around. The mortality rate of HIV positive patients has dropped significantly in recent years as a result of improved medication and treatment. Early detection also plays an important role in controlling the disease.

Doctors say that awareness, education and early dectection are the keys to the prevention and successful treatment of HIV and AIDS.

The HIV virus is most commonly found in those who share needles in intravenous drug use, those who have multiple sex partners and have homosexual or bisexual contact, and tragically, children who are born to mothers who are infected with HIV.

But new safeguards are in place to help curb the spread of the disease in the U.S.

To try and help reduce the spread of HIV and AIDS among intravenous drug users, some pharmacies sell syringes to customers at the pharmacist’s discretion.

In addition to recent advancements in treatment and care, there are changes in other arenas as well. Laws have been enacted to curb the spread of this disease by making it a crime to infect another person with HIV.

This is important for those who are unknowingly infected.

A 66-year-old woman who is treated at the Washington County HIV Clinic, who wanted to remain anonymous, has had HIV for 10 years. She said she believes that she caught HIV from her ex-husband who had an affair.

“People love sex and they’re not going to change what they do,” she said. “It’s the cheating. Young girls are the worst. They don’t use birth control because they don’t want their boyfriends to think they’re whores, but they are. If you play, you pay,” she said.

Dr. Linda McGhee is the only physician on staff at the Washington County HIV Clinic. One of McGhee’s patients described McGhee as compassionate and ultra-professional.

“I adore her,” the patient said. “She doesn’t cross that line.” When this patient discovered she had HIV, she went home and said to her sons: ‘Don’t baby me. If I need something, I’ll ask you. Don’t be afraid.’

AIDS has killed more than 25 million people around the world. The United States was the first country to recognize AIDS as a distinct condition in 1981.

Currently there is an estimated one million plus cases of HIV/AIDS in the U.S. according to the White House website. It is estimated that one-fourth of that number have not yet been diagnosed and are unaware that they are infected.

POZ magazine, a publication for those living with HIV, reported that the south is the country’s new epicenter for AIDS. Fifty percent of the newly diagnosed AIDS cases in the U.S. occured in the south.

Testing
Testing and early detection are crucial to the prevention and treatment of HIV. Primary care doctors can administer the test for HIV.

In Washington County, after a patient tests positive for the virus, he or she is referred to the Washington County HIV Clinic or to Dr. Stephen Hennigan, an Infectious Diseases and Internal Medicine specialist in Fayetteville.

Many of Hennigan’s patients are women or homosexual men who have acquired HIV from bisexual men. Hennigan said that anyone who is not in a monogamous relationship or who uses intravenous drugs and shares needles is at risk.

Dr. Paul Daidone, an Internal Medicine specialist at Bingham-Bledsoe Clinic in Springdale was a resident at the University of Medicine and Dentistry of New Jersey, and at St. Michael’s Medical Center in Newark, N.J. While a resident, Daidone saw around 200 patients with HIV from 1994 to 1997. He said that the majority were intravenous drug users, many of them from the inner city.

Living with HIV
Hennigan and Daidone both stressed the importance of being testing because the sooner a patient can receive treatment, the better their chances of living normal lives without suffering.

A patient with a T-Cell count of less than 200, and, or, the presence of opportunistic infections like tuberculosis, pneumocystitis and rare fungal infections, will be diagnosed with AIDS.

A patient with a T-Cell count of between 200 and 500 will be diagnosed as HIV positive. Those who are HIV positive are usually asymptomatic but may have a mono-like illness after exposure, Hennigan said.

Normal T-Cell count is between 500 and 1000.

The sooner a patient is treated with medications for HIV, the higher their chances of raising their T-cell count to a normal level.

Daidone said the key to treating HIV is getting patients on the right medication regime immediately. He also said that the spread of the disease could be prevented if more routine and regular screening for HIV was encouraged by physicians.

Hennigan sees approximately two patients a week who are newly diagnosed with HIV. He stressed the importance of being tested and offered reassurance to those who test positive.

“It’s okay,” Hennigan said. “It’s better to have HIV than diabetes because we are better at treating it. Today, the average person with an HIV infection is much more likely to be a colleague. They’re not sick like they used to be. Death from AIDS is a rare event.”

He said that people don’t want to get tested because they’re afraid of a positive result. However if the diagnosis is made early enough, those who are newly infected “just don’t get sick anymore.”

Hennigan said a positive test result is not to be feared. “Generally, if you’re unhappy without HIV, you’ll be unhappy with it. If you’re a happy person without it, you’ll be happy with it.”

When a person discovers that he or she is HIV positive, emotions are mixed. Some people are relatively comfortable with the diagnosis, while others feel it is an assault to the “sense of who they are.” These are the people who must learn that the diagnosis doesn’t affect who they are as a person, Hennigan said.

Education and disclosure
In the past, AIDS education centered upon the black and white extremes of abstinence versus protection, but Hennigan said that monogamy is also an effective way to prevent the spread of HIV.

“Sex should be about intimacy,” Hennigan said. “Promiscuity is bad and unfortunately we see a lot of it in the gay community. Monogomy not only prevents the spread of disease, but it’s about intimacy.”

He emphasized that until couples become monogamous, they should have protected sex.

Hennigan said that intimacy is a challenge for those with HIV.

Arkansas state law requires that anyone who has tested positive for HIV must disclose their illness to their sex partners. Nondisclosure is a Class A felony punishable by six to 30 years in prison. Nondisclosure occurs when when someone who has tested positive for HIV exposes another person to the disease without first disclosing that they are infected.

The purpose of AIDS education is to prevent the spread of disease and unwanted pregnancy. Hennigan said there should be a pilot study done to show what works, without regard to someone’s sex agenda, whether it is to neutralize or to moralize the issue.

“Should we educate young children about condom use when they are too young to understand? This may encourage more sexual experimentation, but it would also encourage condom use among anyone who has sex who is not monogamous,” Hennigan said.

Daidone said that preventing the spread of HIV in Northwest Arkansas should be through education about the risks that are associated with it.

Daidone said he is surprised that some people are unaware of these risks when they engage in unsafe sex and intravenous drug use. He stressed that it is important for people to know that although they may not show signs or symptoms of the disease, they could have HIV.

“Education should be practical and realistic,” Daidone said. “Abstinence may be preferable, but if you choose to have sex, you should use protection. It’s not always 100 percent effective, even then.”

Politics and AIDS
In 1992 when Mike Huckabee was governor of Arkansas, he called AIDS a plague and said that people with the disease should be isolated.

Doctors disputed Huckabee’s comments, attributing it to the governor’s ignorance of the disease, saying that Huckabee’s reaction was based on his own religious paradigm instead of caring for those suffering.

Daidone said that Huckabee’s remarks reflected a political bias that is not helpful to society because the comments were misguided and medically inaccurate.

“Politicians and homosexuals alike have made AIDS, one of the most politicized diseases, and the government should weigh the money spent on treatment with the benefit of society,” Daidone said.

The Centers for Disease Control and Prevention reported in December that Democrats dropped their demand that the 2008 foreign budget reverse President Bush’s long-standing ban on assistance to family planning groups overseas that offer abortions.

“This dogmatic adherence to an illogical position diminishes our influence around the world and prevents us from working effectively to stop the spread of HIV/AIDS and unintended pregnancies and reduce abortions,” Nita Lowey (D-NY), Chair of the House State and Foreign Operations Appropriations Subcommittee, told Congress in December.

“There is nothing wrong with politicians encouraging morality, but we must be realistic and practical,” Daidone said. “It is the parents’ job to teach morality and stress abstinence until marriage, but there must be realism. To neglect the education about condoms is misguided and ignorant.”

Hennigan, too, stressed the importance of looking at the situation realistically. “When you start implying that a lifestyle is morally responsible for an outcome, it’s a dangerous thing to do. You don’t have to be gay…everyone engages in irresponsible activities.” AIDS today
Still challenging, but not the death sentence it once was

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