HIV: Living with the Scarlet Letters

Laura Redpath, Senior Gleaner Writer

"Sir, do you know why you're here?" the chief medical officer asked a man five years ago.

"No," Anthony said.

"Well," the officer responded, pausing for effect, "you're HIV-positive."

Six years later, Anthony sat with a small gathering to share some of his most intimate memories since being diagnosed with HIV.

Anthony bit his bottom lip as he recalled being told about his illness.

"The chief medical officer turned the paper down, walked out of the room and went about his business. There was no counselling.

"I got up and walked across the road. Every public transit bus I saw just made me mad. I wanted one of them to run down the road and lick me down," he said, making eye contact with a volunteer who identified herself as Karen.

Since 2005, some months after being dealt this challenge, Anthony has been working as an advocate in prevention treatment and care, as well as a peer educator.

"As my supervisor would put it: I'm head cook and bottle washer," he said.

Blood donation gone wrong

Anthony approached staff at the Jamaica AIDS Support following a series of occurrences, leading up to his diagnosis.

In 2004, Anthony donated blood for a transfusion one of his relatives needed. That same year, he noticed a rash on his leg, which prompted his visit to the doctor. Anthony said he was treated for what he called a "rare mosquito bite infection".

Anthony's voice was clear and controlled. He seemed to have a firm grasp on the events in chronological order, and he maintained eye contact with Karen for most of the time during which he spoke.

When he tried to donate blood again, a doctor met with Anthony (who contracted the virus during sexual intercourse) and advised him to consult with the chief medical officer.

While experiencing feelings of blame, guilt and shame, Anthony outlined that it took a couple of months - during the referral process - before he was put on medication.

He said his fighter cell count was low, making him vulnerable to many illnesses. He was exposed to tuberculosis, diagnosed with clinical AIDS and he weighed 90lb. However, two weeks after starting his treatment, Anthony gained 20lb and was left to face a hopeful yet difficult year of treatment.

"The first year of taking medication is crucial and it's the hardest. It is the time you have nightmares and wish you don't go to sleep. You're ever drunk, battered and beaten and look like old truck."

He eventually went back to his roots, to be with his family in the country, despite what he described as "fear of stigmatisation".

Anthony shared a bit of family history in addition to his story: In the early 1980s, he said, a relative of his travelled overseas on the farm-work programme and returned HIV-positive.

"Him siddung and bawl himself to death. He was dead in three weeks. When they were burying him, they wrapped him in a plastic bag and they couldn't open the casket."

However, Anthony was greeted by friends who were happy to see him and wanted to spend time with him, which moved him to tears for the first time since diagnosis, he said.

Discrimination or precaution?

The pace of the recounting of events slowed once Anthony accepted a salt-free box lunch. Karen sat across from him, the lines deepened in her face as she rocked a toddler who was gently snoring in her arms. Karen was full of questions and she fired them one after the other as they came to her.

"(My father) washed my plates in hot water, rinsed them in bleached water separate from the other dishes and put them in an airtight container. Nobody touches anything for me. The cook can't share for me because she can't touch my plate.

"He touches my plate," Anthony said. "What he was doing was in my best interest, but it came across as discrimination (at first)."

David, who was listening to Anthony's story, shared an incident of stigmatisation when visiting the dentist.

"The man put on all five, six pairs of gloves fi tek out me teeth. He couldn't even do it properly. I had take the rest out myself," he said, pointing at his gum.

Aside from stigmatisation, there is the issue of confidentiality in the health-care system, as described by Anthony:

"You come in for treatment and the nurse know yuh husband and before you know it everybody know your business."

Some of the challenges that persons with HIV/AIDS face, as Anthony has seen, include reliving childhood illnesses as the immune system breaks down, being unable to walk or going blind. He also noted that medication used to be very expensive, with one dosage costing as much as $80,000.

Nowadays, Anthony pays nothing for his antiretroviral treatment.

He said Jamaica has one of the best treatment regimes in the world and persons living with HIV/AIDS are able to access treatment for more than a year, whereas in some countries, persons living with the condition are unable to access treatment for more than two months.

TODAY IS World AIDS Day. Started on December 1, 1988, World AIDS Day is
about raising money, increasing awareness, fighting prejudice and
improving education.

The World AIDS Day theme for 2010 is 'Universal
Access and Human Rights'. World AIDS Day is important for reminding
people that HIV has not gone away, and that there are many things still
to be done.

According to UNAIDS estimates, there are now 33.3
million people living with HIV, including 2.5 million children. During
2009, some 2.6 million people became newly infected with the virus and
an estimated 1.8 million people died from AIDS

While the number of
HIV cases in Jamaica has increased, fewer patients are developing AIDS,
the more severe stage of the disease.

The Ministry of Health has
attributed the reduction in the number of persons developing AIDS in
Jamaica to the introduction of the public access to antiretroviral (ARV)
drugs.

Information from the National HIV/STI programme in the
ministry suggested that 1,489 persons with advanced HIV were reported in
2009 compared to 1197 in 2008. Of these persons, 909 were diagnosed
with AIDS compared to 1,112 persons in 2004 when ARVs were introduced.

The number of AIDS deaths has also decreased, with 378 deaths reported in 2009 compared to 665 in 2004.