HIV vs mankind: The battle continues

Halim Danusantoso ,  Jakarta   |  Sat, 11/07/2009 1:02 PM  |  Opinion

Almost all aspects of HIV have now been elucidated and more than 15 potent Anti-RetroVirals, with more to follow, have become available.

Each country has its own HIV programs, involving countless government agencies and NGOs. Nevertheless, the disease continues to spread and people living with AIDS are still dying every day, especially in developing countries. This is the greatest irony of the end of the late 20th century, spilling-over into the 21st century

The good news is that now people of rich countries or those in more financially capable of seeking good medical care, no longer need to suffer or die from AIDS, despite being still HIV positive.

Such people can lead normal lives and may have the same life-expectancies as those uninfected. The best example of this is former basketball star Magic Johnson who has appeared in TIME magazine several times.

Unfortunately, Magic's fate cannot be replicated yet in most, if not all, developing countries, simply because of their lack of similar resources to those Magic has. All these efforts are still in the context of attempts to contain this monster, since killing it is still a long way off. Compounding this unfavorable position, the following situations are clearly detrimental to our efforts to win this battle.

Human Immunodeficiency Virus (HIV) spreads through reckless human behavior. By nature, humans are inclined to seek pleasure, including through (illicit) sexual experiences and highs associated with intravenous drug use.

As these activities are generally carried out behind closed doors, no body but those involve can be there to blow the whistle at those critical times.

And again, unfortunately, modern times, with progressively easy-going attitudes and permissiveness, provide so many facilities and opportunities in this respect.

The disease enters the human body like a submarine attack. Once HIV infects someone, either through well-known routes (unprotected sex, contaminated syringes, blood-transfusions etc) or through lesser-known means (unsafe dental practices, unsafe tattooing, incidental pricks or cuts from HIV-contaminated sharps etc.) it will not kill them immediately.

The virus takes its time, repli-cating itself endlessly and is usually unnoticed.

After several years, these clones will begin to devour their victim. Only then will HIV begin to appear more clearly, although 3 months after becoming infected, simple lab tests can detect an infection.

But then who would care to ask for an HIV blood test, especially if they are in the prime of their life, having no health complaints and being able to do whatever they like? Even if by pure chance a doctor suspects someone is at high risk of being HIV positive, it not be easy to have them undergo a test.

Because of the multiple aspects of HIV infection and AIDS, many different groups, institutions and individuals are involved in this battle.

Thus, advocating different policies is generally not difficult, with each side recognizing its own undisputable views (depending on which side), making the situation ripe for internecine strife and frictions.

Sometimes it is simply impossible to compromise on basically opposing views, such as those surrounding the provision of sterile syringes to heroin addicts (a "harm reduction" strategy), where there are those strongly in favor and those vehemently against, all having their own logical and valid arguments.

And how about the use of condoms? The initial purpose is to prevent an eventual infection by not allowing direct contact between genital mucosa and genital secretions of lovers to occur.

Unfortunately, a rubber sheath, no matter how thin it might be and how useful it may be supposed to be, will always carry the connotation of being cumbersome at such critical moments, posing a barrier between those fine nerve endings aroused during sexual contact. Therefore, ultimately it is doomed to failure.

Besides, the use of condoms to prevent HIV infection has yet to be proven. To date, no clinical studies have been carried out that can show the condom is indeed effective in this respect.

It has become clear that the mortal battle between HIV and mankind still has a long way to go, and will certainly continue to take its toll on countless lives, require unimaginable amounts of money, efforts and time, which otherwise could be used to benefit the lot of the poor and the sick on a global scale. Will we ever be able to conquer HIV? Only time will tell.

The writer is a pulmonologist.

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