A Word About HIV
As HIV is one of the issues both FORGE and the Zambian Forge film is addressing, I want to talk about it for a minute..
I don’t think anybody really understands the HIV epidemic in Africa. I personally don’t think there is a solution short of a vaccine, and unfortunately, I don’t think that will be developed any time soon. A very tough reality.
I’ve heard many people talk about the obvious actions people should take. In response to that, I want to talk about my personal interactions with the HIV issue in Africa.
In Meheba, Arianna was the main HIV educator amongst the FORGE team. I videotaped some of the classes she taught, allowing me to absorb the material. I often was a part of the QA sessions too, as many of the students wanted a man’s perspective on condoms and other issues from the educator side. No problem. I generally could answer the technical questions. I can explain window periods, infection schemes, all that kind of stuff. I understand the mechanics of it all.
I don’t that anybody can make a claim of the infection numbers in Meheba that can be scientifically backed up with reliable statistical information. Organizations make educated guesses, based on different elements of evidence, such as the death rate / TB rate. I heard numbers as high as 70%. Undoubtedly this was an exaggeration, but within the realm of actual possibility. Scary stuff, especially when I looked around to a group of people I was interacting with on a daily basis and extrapolated.
I don’t sleep with prostitutes or use intravenous drugs, nor am I gay. I am not in any high-risk group for HIV, so before making this film, I didn’t give it quite as much consideration as I do now. While I was not sexually active in Meheba, I did recognize that I was in very close proximity to many people who were HIV+ (based on the prevalency rates). I was sharing food, drinks, toilets, and constantly shaking hands.. (it’s insulting not to shake somebody’s hand there even more than it would be here, and the handshakes are much more involved.) None of these activities are considered “unsafe”. We were teaching people not to be afraid of these same activities.
Even while I told people these same activities were safe, I became scared about my own personal exposure. I could recognize this was irrational, but I could not intellectualize the fear away. It wasn’t an overbearing fear though, think of it as equivalent to the feeling people have inside when an airplane they are in takes off. Everyone understands that planes crash in only an infinitesimal number of circumstances, but people are still nervous about that take-off. People also continue to fly, even though planes crash. That’s kind of what I felt during my time in Africa. A bit nervous, but not concerned enough to stop me from being there.
Upon returning to the US, I decided I wanted to take a HIV test to put my mind at ease. First I needed to wait for the window period to pass. [It takes a certain length of time after somebody is infected with HIV for that infection to show up in a blood test. This period of time is called the “window period”. In this window, somebody can take the test, get back a false negative result, and think they are ok, when in reality they are infected.] UNFPA gave us the number 3 months for the window period on the testing available in the Meheba area. I don’t know if it’s exactly the same window with US tests, but anyway I didn’t mind waiting.
My 3 month window period ended at the beginning of December. I did not, however, actually take a HIV test until the middle of February. Sure, I was busy during that time, and testing wasn’t on the top of my list of things to do, but also, I was also afraid. Why? Because every now and then, each one of us ends up with that 1/10,000 of 1% of life. When it comes to life and death, you don’t necessarily want to know you are in that group. The absolute truth is, I only wanted to know that I wasn’t infected. If I was infected, I would rather not know.
The point of this is not that I eventually worked over my irrational worries, made my way to a clinic, got tested, and felt better. No, I want to take my irrational fears as an educated, informed individual who has gone over the facts about HIV and then try to imagine what kind of fears many of the people in Africa are dealing with.
In the US, it is hard to imagine being the African who lives with HIV as a constant presence. Every day, everybody interacts and shares space with people who are HIV+. Everyone knows that people all around them are infected, but they don’t know who. The majority of the HIV+ population probably don’t know they are infected, and if they do, they are not telling anyone else, as then that subtle background fear in people’s minds will have an outlet.
Think about the family of 12 that lives in a 2 room house, sharing 3 beds, toothbrushes and razors. There is no space for an HIV positive person there.
How must these people feel?
Even if they tried to tell us, it would be difficult.
I asked people in Meheba questions like this, but answers were hard to come by.
Add this to the mix… many of the people living with these fears are not informed, or educated. Testing and access to condoms are both difficult. It’s a tight knit community. If somebody who learns they have HIV tells anyone, soon everyone will know. In the back of everybody’s mind, sexually active or not, is the constant irrational fear that maybe they got infected anyway, through some other means, the same fear I had. If they do get infected, there is often no medicine available anyway. Why bother getting tested if the opportunity is provided? What’s the point of addressing fears, when the next day circumstances are such that they must be addressed again, and solutions are elusive?
Education is a great way for people to distinguish between rational and irrational worries, and it is a universally positive addition to the situation. However, I could not educate my own fear away. So how can I expect others who are less educated – and at higher risk – not to be afraid as well?
Then I ponder how to address the HIV situation in Southern Africa. It’s easy to say: “Get tested before you have sex.” or “Don’t have sex.” or “Use a condom.” In reality though, things are not as easy as they sound. Life isn’t easy. There are no obvious solutions. I believe that education can help, at least so that people can make conscious decisions about their actions, and not live through guesswork, though they must live with their fears.
I also am not trying to be overly dramatic. I’m just using myself as an example, and attempting to extrapolate from that example to the people in Meheba, and a billion other people in many places around the world, including my own home. There are enormous psychological and personal issues that play into the HIV issue. These factors transcend practical problem-solving approaches to HIV prevention, and are hugely important, fundamental bases of the epidemic’s continued spread.
David
posted by David Mallin at 2/26/2005 03:03:00 AM
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