World AIDS Day

Celebrated on 1st December (World AIDS Day) , we marked it some days before on Saturday 29th November, 2014 with a presentation by one of our church members who is an expert in that field. She captured our attention by us asking a few simple questions about AIDS its transmission and different scenarios or situations that we might find ourselves in. I was lucky in that I had attended a presentation some years earlier by our Prof, my former room mate (Prof Shina Oladokun of UCH Ibadan) on its transmission in pregnancy and I was able to get most her questions right. The Prof told us that although the virus was in the breast milk and could spread to the child, so they would start the child on anti-retroviral therapy (although the child was HIV negative) during the time the baby was receiving breast milk it where it acted as prophylaxis therapy. Our Prof also mention because of the cultural stigma, attached to AIDS they had various techniques to discretely treat the woman and her baby and different ways and methods the woman would collect her drugs and hide them. The AIDS expert in our church presented facts and figures of treatment and diagnosis and there were lots of questions we all left with additional information. Most of the questions were along the line of doctor-patient confidentially and they thought that it was a doctors or medical personal responsibility to ‘tell on the patient’, especially if another people were at risk. The presenter did her best to clarify the issue explaining that it comes under client-patient privileges and it was protected by law and the medical personnel can lose their job and be sued both by the patient and their employers for breaching the patient’s right to confidentially.  Some people felt that they could be tested without their knowledge to which the expert did confirm that will be a breach of their rights and it is very unlikely that they would have been tested without their consent.  I could understand where they were coming from. What if the patient decided not to tell their partner, what would happen then? She did say that the law could tell the partner or others under very rare circumstances but this did have to involve a judge and courts, or if a patient were mentally ill and this would come under the Mental Health Act. One thing that I did not know was that treating one individual did ‘in a way help his or her contacts’. Now she explained that AIDS is treatable like any other chronic disease and the prognosis has improved, due to new drugs.



But AIDS remains a very serious disease, although not as infectious as Ebola, there was a time in the public imagination that people who had AIDS were treated as they treat Ebola patients now or should, because unlike AIDS, Ebola is highly contagious. Recently, I did was watching a BBC program in which people suspected of having Ebola were walking around freely mixing with the populace, quarantine procedures had broken down or non-existent. But back to AIDS, there was a time in which if people suspected you of having AIDS they would not even touch you as if you were a leper. I remember while working as a junior doctor I almost pricked myself with a needle that I had used on a patient with a serious disease. Although the patient did not have AIDS it did cause me to have a lot of stress and sleepless nights. As at that time it had a higher incidence among the gay community and a lot of celebrities who were gay developed the full blown AIDS and subsequently died, Freddie Mercury, Rock Hudson, Perry Ellis, Rudolf Nureyev, etc. since these people were in the public eye could almost see them wasting before your eyes. It was a terrible time for AIDS patients and getting the disease is like getting a death sentence passed on you. A long painful and sad death sentence …

This morning I learnt that the HIV infection that leads to AIDS has becoming less deadly and infectious according to a team at University of Oxford. Some of the virologist have suggested that the virus will become “almost harmless” if it continues to evolve at this rate. The study is saying that anti-retroviral drugs were forcing HIV to evolve into milder forms. The drugs get rid of the nastiest versions of HIV and encourage the milder ones to thrive. But still this milder form could cause AIDS. Like Ebola HIV came originally from the animal kingdom (monkeys) where it is harmless, but when it crossed over Human-Animal barrier it began to cause problems. A word of caution by Prof Andrew Freedman, a reader in infectious diseases at Cardiff University although things are getting better. HIV has  "an awfully long way" from becoming totally harmless and "other events will supersede that including wider access to treatment and eventually the development of a cure". Only 37% of those suffering from HIV have access to the anti-retroviral drugs which make the disease "almost harmless", the target is getting these life surviving drugs to everyone.