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HIV/AIDS: Where do we stand?
They have pulled. They have sniffed. They have chased.They have shot. They have pushed. They have been found smoking and lying unconscious in the alleys. Their friends have bailed them out from the one night stay at the jail. And they are still human.
They were found naked in the streets. They have been abused. They have abused others. They have lost count of their sexual encounters and they don’t remember when they lost their virginity. Yet they are happy and courageous enough to say that they have HIV.
Having been rejected by their society, they live in a world of their own created by those who have been there. These people are their guides for a stable future. These guides are their hope for the life ahead and they have very little to look forward to. But optimism is surprisingly high to the level beyond normalcy.
I couldn’t help but admire the stand. I couldn’t help but feel sorry for myself. They have done everything they’ve wanted to in their lives. They have lived their lives in their own terms; defining their own set of rules—rules of freedom and they think they are free.
There are few who feel guilty for their mistakes. There are many who feel they need extra care from whatever agency they can get their hands on, set aside their deeds. There are innumerable who can’t afford to say they are HIV positive and lastly, there are many who don’t know they are positive.
Many don’t even know what they have done wrong to have acquired such a disaster. Many don’t even know it could be a disaster. Some aren’t old enough to realize what is going on and a neonate dies without even knowing what went wrong. Some have committed mistakes that have made their counter parts suffer and unknowingly their off springs too. The lucky ones will be free from the monster but the unlucky ones will carry it until the burden becomes too heavy that childhood gives away. And most of the time it gives way.
So, the bleak picture has been painted but the question remains: What is there to be optimistic about? What else can we do for them and for ourselves? But the biggest question of all: when will we succeed in defeating the virus? These questions are difficult to answer but needs to be pondered upon. With money going to research in hefty numbers can we expect any definitive cure or at least hope for some means of prolonging life? We hope so.
But we need to look forward. Someone will definitely come up with something for us to rejoice upon. That day will come. But the human mind usually doesn’t work according to the rules set by mother nature and, thus, she challenges it again and again. Every a disease is not a small pox. Every disease should not resurrect like malaria. And we cannot afford any diseases to wipe out humanity.
The monster has now made alliance with tuberculosis to strengthen its existence and an alliance is always lethal. If this is the struggle for existence we can only try to be the fittest. Then perhaps we will ensure our survival.
Sanjeet Shrestha
Sanjeet Shrestha is a student of internal medicine doing his master's in the Post Graduate Institute of Medical Education and Research in Chandigarh, India. He did his bachelors in medicine and surgery from Kathmandu, KMCTH. He is a writer, painter and loves to irritate people around him by singing a lot. He volunteered for Diabetes Awareness Programme 'Astha Nepal' and was a medical officer for drug addiction and HIV associations around Kathmandu before leaving for India.
( Apr 8th 2009, 11:13 PM ) says:
It is agreed upon the fact that the first two paragraphs are sensationalised. but go through each paragraphs, as the concept evolves. i know the paragraphs are intentionally stratified show the evolution of HIV. see when you are first introduced to any topic related to HIV, things that come to your mind is drugs, sex and everything bad. suppose one is currently diagnosed with HIV, immediately people will think that the person has sinned in one way or the other. and most people are shamed to reveal the diagnosis for that matter only. but both mental and physical burden is on the person. we know everyone is human. after 1 year of association with drug addiction centres, last two years in the immunology/HIV clinic in chandigarh it all comes down to only hope. everyone tries hard to live life normally but sometimes there's the society and sometimes its the disease that breaks people down. any comments?
( Apr 4th 2009, 10:09 PM ) says:
there are aids victims who are in that kind of situation i think but there are victims who are not necessarily in that situation. i agree with thinkinink that the article is a bit sensationalised but maybe it's meant to capture the story's essence....khoi
( Apr 9th 2009, 01:49 AM ) says:
To say that PLWHAs (people living with HIV/AIDS) are exactly same from everyone else is a politically correct statement. But the reality is different. The article emphasizes on people from every aspect of life as you say from the ones in the alleys to the ones who are naïve and innocent .
the harshness is well appreciated as we are not harsh enough as far as HIV is concerned.
For the last three years I have been in constant medical interaction with the people of the concerned class. All of them know are human beings and everyone is well versed in their rights as well. But at the same time they know that their system is completely different and highly vulnerable to so many complications of the disease. So we try to make them aware of the danger signs and change their concept of living to modify for the disease. Everyone happily modifies their life style. But the society stops the attempt.
People may be offended by the starkness of the article but look around even you might hesitate to sit and eat together..
( Apr 9th 2009, 11:10 AM ) says:
i'm glad you agree that the first two paragraphs are sensationalised. but i dont understand how the 'concept evolves' as you've put it. by placing a nameless 'they' you have extrapolated the experiences of a few to all. now, instead of 'they' if you had used 'some' it would've made more sense and i would never have said what i said. i am not questioning your later assertions or the fact that you have experience dealing with patients. all i'm doing is critiquing your writing. the basis of your argument is fine and i agree with it, its only the way you've presented it that i take issue with. when confronted with HIV, people will automatically think of unprotected sex, drugs and other negative things. our job as writers is to dissuade that, not encourage or rectify that (which is what your first few paragraphs do). i'm not a doctor nor a medical student but i've met people with HIV, i've talked and interacted with them. and i know there is a need for understanding and acceptance, your article encourages that and i applaud you. language is a powerful tool and the way you write things, the words you choose, the way sentences are phrased, all send messages to people that affect them, maybe not always consciously. anyway, enough of this. good job, please keep up the good work.
( Apr 11th 2009, 01:38 AM ) says:
sanjeet i think your association with PLWHAs is too long for such a short article. i agree with the rest of the comments. bit glorified indeed but it's what makes you stand out and your article. you know them better than anyone else in the circuit. you need to cover the entire aspects of PLWHAs you keep on talking about, if you are planning to write something more in the future.
( Apr 11th 2009, 08:12 PM ) says:
planning on writing a non glorified aspects on this but i think we will cover few other aspects first then we will venture back to the familiar terrains. things will definitely come in the future. thanx for the comments.
( Apr 13th 2009, 08:48 PM ) says:
i think its a tangential article dai as far as the title and the content goes where are the recent updates on the HIV. the title says "where do we stand?" so where do we actually stand? please explain?
( Apr 14th 2009, 02:30 PM ) says:
yes i know the title was different when we started the article. i wanted to add up the updates but the requirement of the article was too creative to make it a statistical update. and if you really need to know the update, here are the new data on the WHO/ USAIDS HIV program.
latest updates from WHO/UNAIDS only have census till the end of 2007
total number of PLWHAs was 33 million which included 30.8 milion adults, total of 15.5 million women and 2 million children.
total new infections of HIV in 2007 was 2.7 million which included 2.3 million adults and 370 000 children
total of 2 million deaths occured due to AIDS in 2007 among which 1.8 million were adults and 270 000 children.
if you want to know the global status of HIV and the status of each country web sites available from WHO/UNAIDS.
www.unaids.org
ww.who.int
( Apr 18th 2009, 11:27 PM ) says:
Now its clear hoina. You should have included this in the article. So whens the new post coming? You should write about the new progress that we discussed last time.
( Apr 20th 2009, 04:52 PM ) says:
yes. the new article is on the way. it takes time. and thank the UNAIDS and WHO for the data. not me!
( May 1st 2009, 06:43 PM ) says:
few really hopeful prospects have come up in recent medical journals including bone marrow transplant and genetic mutations. ill update you all soon.
( May 9th 2009, 03:32 PM ) says:
african studies have shown significant reduction of transmission of HIV in circumscised males. however the recent recommendations dont include circumscision as this study came after the recommendations were formulated. but the evidence is highly compelling
( May 30th 2009, 12:10 AM ) says:
usual trend for a clinical trial is to begin antiretroviral for HIV below 200 CD4 count but recently studies have shown that early initiation of antiretroviral therapy before the CD4+ count fell below prespecified thresholds significantly improved survival.but implementation such polivy entirely lies on the national programs.
( May 31st 2009, 01:15 AM ) says:
While Sanjeet is drafting a non-glorified article, may be people will benefit from the article below...
http://nepaliaashish.wordpress.com/2008/12/04/hivaids-what-the-wikipedia...
( Jun 5th 2009, 10:41 PM ) says:
yes....follow the lead given by nepali ashish..
( Jun 5th 2009, 10:52 PM ) says:
Some people have a genetic mutation that makes them resistant or partially immune to HIV.
A 32-base pair deletion (delta 32) in the gene for the human chemokine receptor 5 (CCR5) is responsible for this. HIV needs to attach to the CCR5 receptor to infect CD4+ T cells. People with these mutations either have no CCR5 receptors or have far fewer CCR5 receptors than an average person. This greatly reduces the possibility of HIV infection.
Studies indicate that two copies (homozygous) prevent infection by all but the rarest non-R5 strains, and one copy (heterozygous) will provide some resistance to infection.
A study in the Journal of Acquired Immune Deficiency Syndrome concludes that men who have sex with men who are heterozygous for the CCR5 Delta 32 mutation "had a 70% reduced risk of HIV infection" compared to those without the mutation.
A study in the May 22nd, 2002 publication of The Lancet indicates: "The CCR5Δ32 polymorphism confers a high degree of resistance against infection by HIV-1 strains that use the CCR5 receptor to enter host cells, the most transmitted strains from person to person. However, rare cases of HIV-1 infection in individuals homozygous for CCR5Δ32 have been reported.
( Jun 17th 2009, 12:08 AM ) says:
When bonemarrow transplant was done to a hiv positive leukemia, the clinicians experimented on transplanting from a ccr5 mutant individual. The response was remarkable. But ccr5 mutants are extremely rare to find. So far we are unable to find one in north india.
( Sep 3rd 2009, 07:29 PM ) says:
hello doc... I didn't get what the writer wanted to convey through his such-a long essay...... I just felt the preface is long and even at the end of the article, I was still waiting for the message to come..... but the effort put to start a discussion cannot be left unappreciated....... keep it up
( Sep 4th 2009, 06:34 PM ) says:
to Jyothsna: this article was written just to state the presence of the disease and to start a healthy discussion on the concerned topic. I think in the long run it did serve its purpose, and I know that the preface was dramatic and will stay like that because i wanted the eyes drawn towards the article. However, the preface does not divulge the crux of it at all.
( Dec 13th 2009, 08:05 PM ) says:
oh that was a long list of comments!! and man when will be the next time to write about HIV. you should write about your research paper in a similar way. if that is possible. isn't your thesis on HIV nephropathy.
( Jan 8th 2010, 01:11 AM ) says:
yes! my research and papers are on HIV and its already completed, printed and dispatched for reviewers. writing about same thing over and over again may not interest the readers.
( Jul 13th 2010, 07:16 PM ) says:
"They have done everything they’ve wanted to in their lives. They have lived their lives in their own terms; defining their own set of rules—rules of freedom and they think they are free." -- Please explain ??? They are FREE of what?
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this is sensationalist writing. people with HIV/AIDS dont need this kind of hyperbolic exaggerated writing. i disagree vehemently with the first few paragraphs, it irks me that you would choose to sensationalise the plight of those so afflicted already. most of the people with HIV (from all walks of society) that i know are quiet, humble people. they've never been found in alleys, unconscious and naked. they've never been to jail and they've never lost count of their sexual encounters, and they remember when they lost their virginity. you say that they're ordinary people, so we need to treat them like ordinary people, not exaggerate their plight. they're the same as you or me, the only difference being that they have the HIV. treat them like people, not like degenerates who are constantly in jail or lying naked and unconscious in alleys. i'm sorry being such so harsh, but it needed to be said.