In 1981, the first case of AIDS (Acquired Immunodeficiency Disease Syndrome) was identified in the United States. The disease has changed in many ways since then. Once it was a deadly disease with high infectivity and no Antiretroviral Therapy (ART). Today, it is very much under control with the use of better ART.
HIV carriers can now live quite a normal life. Their life span is now approaching close to the normal lifespan of the general population, if they are diagnosed and treated early. Their infectivity is virtually brought down to zero if they (the HIV carriers) maintain their continuous treatment as advised by their health professional.
HIV carriers of this century are like the lepers of the past century. They are being shunned by the society, not because of their appearance but rather the fear of contracting HIV infection by touching them, eating or working with them. The fear is real but certainly unwarranted. Nonetheless, this phobic fear of most people of HIV carriers shall stay on for a long time due to the continuous ignorance of society at large. The perception of HIV carriers in the minds of many in the general population remains archaic because many of them read, heard and remembered old information about HIV infection and never cared to update their knowledge about new developments.
The words ‘HIV’ and ‘AIDS’ no longer stir up the sort of excitement that it used to, at one time, in the history of mankind. Thus, the unfair stigmatisation by society shall remain until the right education replaces the old thinking of our society at large.
At this juncture, let me emphasise that HIV infection does NOT spread by casual non-sexual contact.
Time moves on. New development and information continue to emerge. People should update themselves otherwise their knowledge and perception about HIV infection shall remain stuck at a time of the past.
As it is now, when somebody is told that he has HIV infection, his thought may just go bizarre. What crosses his mind could likely be something like this, “Oh my gosh, I am going to suffer horrendously and die soon.” He may then plunge into the misery of extreme anger, disbelief, depression and fear of social stigmatisation. This experience is horrendous. It is like ‘Hell on Earth’.
Breaking the bad news of a devastating disease like HIV can be challenging. How bad or good the outcome is, on the victim, really depends on the doctor in front of him. An uncaring unskillful doctor may break the news like a judge giving his verdict: “I am sorry to tell you that you have HIV infection. It is a terrible disease that can spread to any of your sex partners or people living with you.” Seriously, breaking the bad news is an important art that all doctors should have. It calls for much tactfulness, compassion and empathy. Without these, the precarious patient may tip over into depression or in the worse scenario, even commits suicide.
The HIV virus mutates or changes genetically so fast that a vaccine cannot be developed to this day. Thus, HIV is here to stay. Nonetheless, there are good news of the various ingenious developments that we should know. The disease has somehow quietened down a lot as a result of the development of newer more effective anti-HIV regimes of medication and new strategies to control the spread of the disease.
ART is the use of HIV medicines to treat HIV infection. It is recommended for everyone who is infected with HIV virus. It helps them to live longer and healthier while reducing their risk of transmitting the HIV virus. ART should be started as soon as possible and this is especially important in people with pregnancy, AIDS and people with other HIV related diseases such as lung infection or skin cancer. It is important to emphasise the importance of strict adherence to ART – taking the HIV medicines every day and exactly as prescribed.
Gone were the days when most people with HIV infection progress quickly to AIDS and die from as early as 6 months to perhaps 15 or 20 years in the absence of ART treatment. It is important to note that without ART treatment, an HIV infected person progresses to Acquired Immunodeficiency Disease Syndrome (AIDS) on an average of 10 to 11 years. People with AIDS continue to live for an average of 3.7 years.
AIDS is the most advanced stage of HIV infection. At this stage, the body defense or immune system of the victim collapses. He/she will suffer life threatening conditions like cancers such as lymphoma and infections such as tuberculosis.
According to the country factsheet, in 2017, 67,000 Cambodians are living with HIV, out of the total population of about 16 million. Less than 1,000 new HIV infections were detected in 2017. More women were infected than men. The prevalence rate or percentage of people with the infection is 0.6 in women and 0.5 in men, between the ages of 15 to 49. This means that 6 out of a thousand women and 5 out of a thousand men at that age range have HIV infection in Cambodia. Out of the 67,000 Cambodians living with HIV, 59,000 or 87 percent of them are on ART treatment.
The prevalence of HIV/AIDS in Cambodia is among the highest in Asia. Although Cambodia is one of the poorest countries in the world, the extraordinary HIV prevention and control efforts exerted by the Royal Government of Cambodia and its partners have helped to reduce the spread of HIV significantly.
My next column will be: ‘Psychoneuroimmunology – Mind, body and immune system’.
Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases and excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skill in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via email [email protected] Tel: 023900446 or Whatsapp: +60164122977 Facebook name: Victor Ti.