LIFE WITH A SPECIAL STATUS

Everybody has something he doesn't want to tell casual acquaintances, something that is part of his personal life. For people with HIV, their diagnosis is that secret. Somebody with HIV has the absolute right to keep his diagnosis secret but it is very hard to keep it a secret from everyone all the time. Everybody decides for himself whether he needs to tell anyone about his diagnosis and if he does, to whom and how. Sooner or later, everyone with HIV feels the need to talk to somebody about his feelings, worries and problems. In any event, all the pros and cons need to be weighed up for a secret once shared is no longer a secret.  HIV can affect relations with those close to you in different ways: they can stay the same, get worse or even get better. Revealing one's status often leads to the break up of the family and to a change in the social conditions of life. Unlike other illnesses, in the light of the prejudices existing in our society, HIV runs the risk of being met with a negative attitude, discrimination and condemnation of the infected person.

Everybody who tests HIV positive is seriously worried no matter how much he prepares himself beforehand for this news. So everyone who is to be tested is recommended to have an anonymous consultation in order to prepare themselves for possibly testing positive. Today, the National AIDS Centre is the only place where people with HIV/AIDS can feel safe and receive qualified medical and social and psychological help. Before the diagnosis is revealed, doctors at the centre make sure that the patient has psychological support from social or medical workers ready to talk to him and to calm him as far as possible. At the same time, they ask him about his sex life, about whether he shares a needle for shooting drugs intravenously and they ask him to say who of those he knows may also be HIV infected.

Tackling it in time    

AIDS is among the five main killer diseases which claim the biggest number of human lives on our planet. Research carried out in western countries has shown that roughly one third of HIV-positive people remain healthy for 10 years without any special anti-viral treatment. Sooner or later the majority of them will need to be treated but when depends on many factors. 

Where therapy is needed         

HIV turns into AIDS at different speeds - for some it is faster, for others slower. In countries where therapy is used, AIDS deaths have fallen sharply. Up until last year there was no supporting anti-retroviral therapy in Azerbaijan. However, thanks to a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria which Azerbaijan received we can prolong the lives of patients and make it fuller. The National AIDS Centre has all the resources to provide for those who need it free anti-viral therapy.   

Anti-retroviruses are a combination of agents which help to suppress HIV and to stop it from turning into full-blown AIDS for an indefinitely long time. The agents in the therapy attack HIV at various stages in its life cycle. The medicines help women, men and children. How effective they are does not depend on how a person got infected: through sexual contact, using drugs or blood transfusion. 

If the agents are taken strictly according to doctors' orders, the amount of HIV in the body drops to a minimum. Special blood tests are carried out to check that the medicine is working: an analysis of the strength of the virus determines the amount of the virus in one micro-litre of blood; an analysis of the immune status determines the strength of the immune system (the number of CD4 T cells playing the main role in protecting the body against viruses). Anti-viral agents do not of themselves increase the number of CD4 T cells.

If the patient can begin therapy, it is a decision which must be taken calmly and consciously after having consulted the doctor and obtained as much information as possible about the agents, their actions and side effects. It's hardly worth starting therapy if you have just been told of your diagnosis and you need to cope with this news yourself first of all. The treatment plan is discussed with the patient first of all and with relatives if he is not mentally competent. It is desirable for the patient to appoint someone with the right to take decisions about treatment for him should the need arise. 

The usual recommendation is to start treatment when the number of CD4 T cells fall to 300-200 and it is strongly recommended to start treatment when CD4 T cells number 100. But even with such an analysis result, you shouldn't rush into treatment if you aren't ready for it. 

Drug abuse is one of the factors leading to the rapid progress of the disease from the HIV stage to full-blown AIDS. If a patient is aged 40 or more, he or she is more likely to develop AIDS quickly. As we get older our immune system weakens and so the older the patient the more urgent it is to treat him in time. 

The decision to start therapy is very important in a person's life. Often, even when they have access to therapy, people categorically refuse to take it through fear of the side effects, myths about the toxicity or ineffectiveness of the substances. Forgetting sometimes that death is the most serious side effect of HIV infection. Many are also afraid of the prospect of having to swallow tablets for the rest of their lives. Although in most cases patients undergo therapy quite easily and it allows them to lead a full life. 

This is what we fear

Unfortunately, one of the main features of HIV infection is that it figures among the so-called stigmatised diseases. Moreover, there is presently no disease which carries a greater stigma. In our country the concept of stigma is a new one, society has not yet developed the ideology of tolerance of and respect for the differences between people. The media writes about people who are HIV positive only in negative terms and some even call for their isolation. Today, most of our fellow countrymen learn about HIV/AIDS only through the media. The absence of precise, unbiased information in society gives rise to fear and stigmatising.

In the sphere of social sciences, the concept of stigma (literally "a label", "a brand") is defined as a strong social stereotype which completely changes one's attitude to other people and to oneself, forcing one to regard a person only as somebody who has undesirable qualities. Stigmas, like medals, have two sides. It can be internal or external (self-stigma). A feature of HIV is that a person can live for a long time with the external stigma then suddenly find out that he is HIV positive, one of those he so fears and despises.

Objective and accessible information about HIV/AIDS, about the ways of spreading the virus and methods of preventing infection are presently the only means of preventing the disease and of developing tolerance to people with HIV/AIDS.  Moreover, such information is a way of preventing drug abuse, as the fear of catching HIV may prevent a teenager from trying drugs for the first time.