HIV In 2015 – How Have Things Changed?

In 1981, 34 years ago, the world’s press began to scrutinize [1] a mysterious and ultimately fatal illness which was sweeping through America. Even with few available facts and medical mystification, it did not take long to build a picture of a devastating virus which systematically ate away at the body’s defences, resulting in an often slow and agonising death. Victims appeared aged long before their time, and those who witnessed their suffering were deeply affected by it. Nor did it escape the press’s notice that this disease seemed to affect the gay community more than others – a fact which would ultimately both hinder and help the progress of gay rights in the Western world. The AIDS epidemic in its early stages came at a terrible human cost, taking many lives and causing a good deal of fear. Coming hard on the heels of the general freeing up of sexual attitudes which had predominated in the 60s and 70s, the AIDs crisis of the 80s  (in conjunction with the hard-right political and economic turn overseen by Reagan and Bush Sr in the USA and Thatcher in the UK) seemed to symbolise the corrosion and toxification of all the idealistic hopes and reforms of the previous few decades. The world reacted with a degree of backlashing, fastening a strong stigma upon sufferers of HIV/AIDS and condemning them as sexual libertines of a foul and perverse nature. So feared and reviled were those with HIV/AIDS that they were treated much as lepers were in days gone by. Now, medical advances have improved the lifespan and health of those with HIV, but how much of the social stigma still remains? 34 years after the the disease first achieved prominence, how much has changed?

The Physical Picture

Let us start with something positive: HIV/AIDS is no longer a deadly condition. Thanks to incredible medical advances over the last few decades, we can now effectively control the virus. From a rather nasty death sentence, HIV/AIDS has in the space of a few short years been downgraded to a chronic health issue [2]. It’s even been noted that diabetes is generally more deadly than HIV these days [3]. While it’s still crushingly deadly in the developing world, where people lack access to the antiretroviral drugs they so desperately need, in the developed world it is now really quite rare for someone to die of AIDS. The medical establishment responded with truly astonishing speed to the AIDS crisis, developing antiretroviral drugs with a speed and efficiency that stands as a testament to what humanity can do when it truly puts its mind to something. These were then refined and combined, and work was done to render side effects less severe. Now, with the help of medication, HIV-positive individuals can live a reasonably happy, healthy, and normal life (albeit with a few nutritional provisos – more on that later). And we’re putting our minds to a total cure. Within the last few days, trials using stem cells from umbilical cords have begun in Spain [4], from which people have high hopes that a permanent and useable cure may be developed. Apart from the disparity in treatment availability, the scientific picture as regards medical treatment for HIV/AIDs is a very different story to that of 34 years ago.

The Cultural Picture

Unfortunately, however, the socio-cultural picture is not quite so rose-tinted. AIDS was arguably one of the greatest demons of the 80s and 90s, and its legacy has left an enormous social scar. While the disease has now been stripped of its physical powers to kill, it still exerts a huge amount of cultural power. Like Voldemort, people avoid mentioning it – and when they do it’s in hushed, horrified tones which both belie its non-deadly status and enhance the stigma faced by those who are HIV-positive. Interestingly, and worryingly, this reluctance to talk about HIV/AIDs, combined with its lessened threat-level, is resulting in a curious kind of ignorance/apathy amongst the young. It is no longer a matter of urgency to educate young people on this matter, and when educational programs do take it into account, they lack the shocking impetus they used to have when the disease was deadly. Meanwhile, the cultural taboo keeps the issue out of the limelight on a more personal level. As a result, it appears that American teenagers are far more ignorant [5] of the risks associated with HIV than previous generations. This is dangerous, as it threatens the country with a resurgence in HIV/AIDs as these teenagers grow older – already it’s thought that most young HIV positive people have no idea that they’re infected [6]. At the same time, many are still unaware of the real nature of the condition, which impacts poorly upon those who suffer from it. Many people still behave as though HIV can be passed on simply by breathing the same air as someone with the virus, which leads to a good deal of social exclusion of and negative behavior towards those who are openly HIV positive. Essentially, the downgrading of HIV/AIDS’s ‘danger’ status has resulted in a lack of urgency when it comes to educating our young people about it – and that is bringing about an apathy which could ultimately prove dangerous. Furthermore, the lack of education about and discussion of the condition leads to a type of cultural ignorance which is very damaging for sufferers. HIV/AIDS may no longer be deadly, but it’s not pleasant to be on antiretroviral medication for the rest of one’s life. Nor is it pleasant to be treated as though one has the Black Death. Although discussion about HIV/AIDS does exist in 2015, it’s generally on a socio-cultural level. A renewal of education about this issue and its practicalities is sorely needed.

The Psychological Picture

Many psychological burdens have been removed from HIV positive individuals in the wake of medical advances. Knowing that HIV/AIDS need no longer sentence one to a lingering death certainly eliminates a lot of psychological stress. However, this does not mean that the picture is perfect. Historically, those who suffer from HIV/AIDS have been subjected to an immense amount of social exclusion and victimization, and a great deal of misunderstanding still veils the condition. There have been several high-profile campaigns to eliminate the stigma surrounding HIV/AIDS, and they have, in all fairness, done a great deal of good. Sufferers these days no longer need to hide their condition quite as much as they used to, and are much less likely to be met with open horror and disgust as they were a few years ago. Sympathy and support are increasingly being offered to those with HIV/AIDS, and the world is slowly coming round to the idea that those with the condition may not be quite the bogeyman they were made out to be. However, deeply entrenched ideas can take time to eradicate. At the back of most people’s minds, HIV/AIDS is still something of a monster – not least the minds of those who are diagnosed with the virus. Social exclusion and the still-existent stigma acting upon the reactions of others to you is one thing, but your own reaction to your HIV positive status is quite another. Receiving an HIV-positive diagnosis still causes significant emotional distress [7], despite the relative manageability of the condition, and the shock can have significant psychological impacts. For one thing, it can disrupt a person’s sense of identity. For another, it alters their view of and often participation in relationships. And, of course, the ever-present (if slowly changing) societal stigma still exerts a considerable hold over the mental health of HIV/AIDS sufferers. It’s not nice to be a social pariah in anyone’s eyes, even if you are receiving love and support from more quarters than you used to. Depression and anxiety are incredibly common for those with HIV.

Gradual Change

It’s certainly easier to be diagnosed with HIV now than it was in the 1980s. For a start – and perhaps most significantly – the diagnosis is no longer a traumatic affair indicating a painful and lingering death in the near future. The condition can be managed effectively and, physically speaking, sufferers can live what equates to a normal life, with a life-expectancy equivalent to that of non-sufferers (assuming that they continue to take their medication). Furthermore, medical scientists are working hard at a cure, and the scientific community is confident that one will be found before too long. Culturally, HIV/AIDS still casts a very long shadow, and it is needful that much more discussion is opened about this condition. While great efforts have been made to address the social and cultural issues surrounding HIV/AIDS, it would be helpful if greater understanding of the physical aspects of the condition were promoted. Not only would this prevent ignorance regarding safe sex issues in our youth, it would also spare a great many HIV positive individuals from social exclusion stemming from a basic lack of understanding of their condition. Much has been done in the last thirty years to lessen the stigma surrounding HIV/AIDS, and there is a lot more sympathy and support out there for sufferers than there used to be, but so heavy was the pressure of the AIDS crisis in the 80s and 90s that it will take a long time for the social and cultural issues surrounding it to be eradicated fully. Modern sufferers still experience considerable emotional distress resulting from misunderstanding and prejudice. Educational work could help to reduce this. Troublingly, despite the fact that effective medication exists to curb the deadly nature of the virus, many in the developing world still lack access to antiretroviral drugs – meaning that HIV/AIDS is still a terrible scourge for many thousands of people. This is shocking given how far we’ve come in the treatment of HIV/AIDS by 2015, and is another issue which seriously needs addressing.

Living With HIV

Living with HIV nowadays requires a degree of condition management, but need not be difficult. If you have been newly diagnosed, make sure to maintain a good connection with a healthcare provider – knowledge and teamwork are not only reassuring, but a great help in keeping the virus under control. Be sure to take your medication religiously, and talk to your healthcare provider if you have trouble sticking to a medication schedule. Try to garner a degree of human support, as well. If you feel comfortable doing so, explain the situation carefully to family and friends. If you’d prefer not to tell them, then find one of the many support groups out there. Human contact and understanding can be a great psychological aid, and can provide assistance and knowledge when it comes to things like your rights and responsibilities. Health wise, it’s a good idea to follow a healthy diet, packed with plenty of immune-boosting vitamins and minerals [8]. Vitamin C is fantastic for keeping your immune system in good working order, and can be found in abundance in most fruits and vegetables. Vitamin E is an antioxidant which will aid your body in fighting infection, and comes highly recommended by doctors. Iron will improve the quality of your blood, and folic acid will strengthen your body. Other good vitamins to think about are Vitamins B6, A, and D. Generally maintaining a healthy lifestyle, with a balanced, vegetable rich diet and plenty of exercise will keep you in the peak of health.

[1] AVERT, “History of HIV/AIDS”

[2] Roberta I. Belda, “AIDS Now a Manageable Disease, No Longer a Deadly Condition”, Liberty Voice, Nov 2013

[3] Max Pemberton, “As a doctor, I’d rather have HIV than diabetes”, The Spectator

[4] Dileep Thekkethil, “Cure for HIV may be in sight as clinical trial using umbilical cords set to begin”, American Bazaar Online, Oct 2015

[5] KwikMed, “American Teens Unaware of HIV Risks”

[6] Liz Szabo, “Most young people with HIV don’t know they’re infected”, USA Today, Nov 2012

[7] Hannah Webster, “Living With the Psychological Effects of HIV”, US News, Jan 2015

[8] Linus Pauling Institute, “Immunity”, Oregon State University

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