The death of Hollywood legend Rock Hudson in 1985 highlighted the true horror of AIDS unfolding across the world. Although it had claimed victims before, this was the first public acknowledgement of the destructive force being unleashed upon mankind. The television ‘tombstone’ health warnings of the late eighties – ‘don’t die of ignorance’ – were educational, but also served to spread fear and stigma. Since the early 1990’s I have been on the front line of AIDS. I have seen friends die. I have visited AIDS wards in London hospitals where harrowing scenes of illness played out before me. As a social-work student, I did a placement in a day centre for people living with HIV/AIDS. These experiences have led me to believe that AIDS is the most appalling and crippling disease known to the modern world, allowing the immune system to be continuously attacked by serious illnesses ranging from pneumonia to cancer, until its victim is left with a ravaged skeletal body.
As we commemorate World AIDS Day on December 1st, I would like to explore how close medicine is to finding the cure for one of history’s great killers, and remember the Irish men and women amongst the 25 million lives it has claimed worldwide so far.
The most up-to-date HIV statistics indicate that there are 39 million people worldwide living with the virus. Of these 80,000 live in the UK, and this according to the NHS is the UK’s fastest-growing serious health condition; 6,000 live in Ireland where on average 100 AIDS-related deaths are recorded annually. Once it was seen as a risk to all populations, but is now recognised that outside sub-Saharan Africa, it is confined to high-risk groups including men who have sex with men, injecting drug users, and sex workers and their clients. Here in the UK those most affected fall into two main groups. Firstly, African people living and diagnosed here, but probably infected in their home country and secondly, gay men where it’s estimated that one in nine gay men in London are HIV positive. Medical experts believe at least a third of these are not yet aware they have the virus and continue to spread it unknowingly.
There was little effective treatment to slow down the progression of the disease until the introduction of anti-retroviral drugs in 1997. These inhibit the growth and replication of HIV in the body. This welcome medical breakthrough has led to an unprecedented 80% drop in Aids-related deaths in the UK over the last decade, however scientists predict they are still a century away from discovering a vaccine and cure for HIV.
Whilst in Hong Kong recently, I read in the South China Morning Post how scientists discovered evidence to suggest HIV has been present in monkeys and apes for at least 32,000 years and not just a few hundred years as previously thought, indicating the enormous time span and ignorance existing about the disease. However, for now, anti-retroviral drugs are helping prolong life and more essentially giving victims hope. It’s a far cry from the days when an HIV diagnosis often came with the advice to give up your job, sell your home, and go and live a little while you could. In simple terms someone diagnosed with HIV today can carry on with a relatively normal life with a life expectancy of another 25-30 years.
There are personal costs to those on anti-retroviral drugs, as they need regular blood tests to monitor their CD4 counts (measures the state of the immune system) and their HIV viral load (the strength of the virus in the blood), along with heart and liver function tests. The complex anti-retroviral drugs come with harsh toxic side effects from diarrhoea, nausea, rash and fat redistribution to nerve damage and cholesterol deficiencies. Once started, anti-retroviral treatment must be taken every day for life. Every missed dose increases the risk that the drugs will stop working.
AIDS has hit Africa the hardest. Although the continent is inhabited by just over 14% of the world’s population, it is estimated that 80% of people who have HIV in the world live in Africa. The main cause of AIDS there is unprotected sex. A lack of contraception and condoms along with unsafe medical injection practices add to the death toll. The United Nations and the World Health Organisation have set up the ‘World AIDS Campaign’, which is endeavouring to enable everyone in Africa to have non-discriminatory and non-judgemental access to adequate HIV prevention, treatment, care and support. But with dictatorial presidents in several of the worst hit African countries (e.g. Robert Mugabe in Zimbabwe), it is an uphill struggle. Whilst anti-retroviral drugs are freely available in the UK, only around 30% of victims in Africa receive them. The human cost of this life-saving treatment not being universally available results in 4,000 daily deaths across the African continent.
Sex is great but having safe sex is even better. People need to hear the message promoting safe sex time and time again. Charities like the Terrence Higgins Trust and Crusaid do sterling work in the promotion of HIV prevention. But with the recent ‘hurricane’ of coalition spending cuts, the future of such charities will come under great pressure. It is encouraging that the pop group JLS have set up a charity aimed at raising safe sex awareness in young people along with the release of their own branded condoms. They are helping deliver a strong message without frightening or alienating certain groups. It is this kind of work that will increase the ability for people to make an informed choice about their sexual health – and most importantly, it will lead to increased responsible behaviour which in turn will result in decreased numbers of the newly infected each year. And that is what is really needed as we wait for the cure of this horrendous disease to be found.
People do not die from AIDS. They die from serious illnesses that take hold when HIV has weakened their immune system.
There is still no cure for HIV. Scientists predict that they may not find one for another hundred years.
Published in The Irish Community News magazine