Yes, it is different now. It wasn’t until my final year of University that I was required to take a computer course; now one needs a computer to take a course. I recall phone booths (yes, the kind from which Superman sprang forth to save the world) cost ten cents, and then twenty-five cents, then thirty-five cents, then I didn’t see as many telephone booths on the streets, though I did see virtually everyone on the street with their own telephone……Ooops, I mean, ‘cell phone’. It’s different now. My years at University prior to the year of the computer course were spent in a building known as a ‘library’. With the internet today, most space on the planet can become a ‘library’ by activating the ‘Power On’ button and typing (‘key boarding’ in today’s terms) an ‘IP’ address (which is not a street address!), then get all the information you could possibly imagine about any subject on Earth. I remember computer ‘bulletin boards’, which are now ‘Ethernets’ and a billion times faster!! Things are changing so fast! Yes it’s verydifferent now.
With most everything today, it is different than it was. But not so much in all things. Take HIV for example. We’ve witnessed the healthcare onslaught over time for women to be cognizant about the risk of breast cancer; we’ve seen ‘Nutrition Facts’ labels appear on foods to help us choose the products we’re consuming; we see constantly on television ads for medications to relieve one thing or another; doctors’ offices are awash with information about how to stay healthy and how to exercise. Today it seems there is little difference from 32 years ago regarding HIV. People in the city of Vancouver, BC however, are beginning to narrow this HIV knowledge schism. Specifically, the STOP HIV/AIDS Project (http://www.cfenet.ubc.ca/stop-hiv-aids) involving the BC Centre for Excellence in HIV & AIDS, Vancouver Coastal Health, and Providence Health Care (an independent healthcare provider in the Vancouver Coastal Health region) have combined forces to accelerate finding ways to slow HIV transmission and normalize the HIV health issue. HIV is different than it was at the start of the epidemic.
Unfortunately, for many, the beliefs about HIV are not so different than 32 years ago. Things are different today because we’ve learned what works, what doesn’t; what’s true, what isn’t; what’s right, what’s wrong. Healthcare workers and activists in Vancouver have learned lots about this epidemic virus and are sharing it with the world. With HIV things are becoming noticeably different than they were. We know more about risks. We know more about testing. We know more about treatment. And we know the prognosis for HIV infection is that it’s possible to live a long, healthy life, full of goals and aspirations set in future years. We know these things because of research having been done and research that continues being done.
One such piece of research is the Vancouver STOP Project (Seek and Treat for Optimal Prevention). Now we need to stop for a moment here. Think of the world we live in. Think of the destruction, the wars, and the senseless violence that seems never to end. With a title like ‘Seek and Treat’, military references come to mind. Some have suggested this language makes the approach sound like an offensive against people living with HIV. It is not. It is, though, an offensive against HIV itself, not those living with the virus. According to the Public Health Agency of Canada, 25% of those living with HIV don’t know they are living with the virus and may be unknowingly transmitting it to others. Let’s agree to look at STOP without attacking the semantics of the title. Rather, let’s use what STOP has given us and reduce the HIV schism even further.
The concept is simple: encourage people to be tested for HIV. This is not based on any preconceived notions of who might, or might not, be at risk for acquiring HIV. Instead, making HIV testing a routine part of our personal health care as well as having hospitals and doctors offering HIV testing, with informed consent, to all their patients should be encouraged and routinized for all who enter the health care system. Second, if a positive test result surfaces, then post-test counseling and the discussion about treatment can occur. Note the word ‘discussion’. Next, taking HIV medications is a personal choice based on all possible information available to the individual. The human right to decide whether or not to accept treatment is an individual’s alone. Third, if all people who test positive for HIV are offered treatment (and many decide to be treated), individual viral loads will drop and the probability of forward HIV transmission will be significantly decreased. Finally, as this process unfolds more people will have lower and, hopefully, an undetectable viral load which means fewer infections in the community over the long-term. The idea is logical. The implementation process is already under way, and the results are encouraging. Another tool in the toolbox to reduce HIV in our own communities and in humankind overall – can we justify not giving it a try?
It’s our turn; we need to realize ‘it’s different now’. Like previous movements in history, change for the good of all works best when ‘you’ and ‘them’ becomes ‘me’ and ‘us’. Routine testing, numerous medications from which to choose, and the prognosis of a long, healthy, goal-pursuing life are the differences from 32 years ago. Today we can help make HIV non-stigmatizing for ‘me’ and ‘us’. It’s different now, it’s our turn.
By: A person living with HIV and a believer in the concept of “test and treat” when it is implemented within the parameters of law and human rights.