At the moment the number of HIV postive persons in Germany equals the population of Brandenburg. Through new opportunities in therapy and pharmaceutical developements of the past few years, HIV is now considered a chronic infection. In large meropoles, the propogation of many HIV infections can be prevented or even in instances be completely removed from the body. According to several new evaluations, HIV infected persons can live up to 30 years longer with help from antiretroviral drugs. In spite of this and massive studies, a cure is still not in sight. What seems in print as a meteroic medical success story is rather, in individual cases, to be considered more closely: the personal success story has its conditions.
At the moment where the virus and the body’s cells interact, the virus doesn’t confront a „patient“ but rather a human with a personal history and social context. Therein the individual social and psychological statuses are as different as the medical history of the disease. A real outlook on qualitative life entails the daily intake of medicine in spite of substantial side effects. Those who do not take them stoic regularity or who cannot sustain the side effects must expect an accelerated development in the resistance of the virus towards the substance as a result of this irregularity. Those not ready to integrate a chronic illness in their (most often young) lives will waste these therapeutic options through the sporadic intake of medicine and risk adverse reactions without therapeutic effects.
Those who already began taking antiretroviral drugs in the 1990s are confronted today with factors involving body deformation: the amount of fat in the face area (according to the infividual face physiognomy) is reduced; the fat content under the skin of the arms and legs disappears. In the worst cases fat accumulates around the neck, around the belly, presses against organs and breathing becomes difficult. These are only the outer visible stigmata to say nothing of the early morning nausea following the drug intake, the permanent, sometimes severe diahrrea and the loss of feeling in the legs which affects strongly the ability to walk safely.
Nevertheless antiretroviral drug therapy constitutes today the only option to avoid the natural development of an HIV infection. Thereby the access to such medicine – in spite of all the „ifs“ and „buts“ – is a blessing for the majority of HIV infected persons. As a result of the occuring illnesses that result in sometimes long hospitalisation many infected persons are catapluted from their education or work processes. Those who also lose social contacts face living in a desolate situation: economical, psychical and social. A re-integration in the work field is difficult for many and the readiness on the part of employers decreases. Medically, many infected persons in Berlin are actually acceptably cared for. But as effective as medicine is in preventing the virus build-up, it is not able to reverse the experience of exclusion and isolation. A drug cocktail is of no mending help where the virus has destroyed social relations. So it isn’t any wonder that according to a English-based study, in spite of medical development and the introduction of new drugs, more than 30 percent of all HIV infected persons have expressed suicidal thoughts. This survey was taken in 2005/2006 by 750 HIV infected patients in five London outpatient clinics. An alarmingly high number suggesting that tmedical treatment alone is not enough to influence positively the psycho-social components.
Despite medical developments an illness is presented with a tie to sexuality and open to the possibility of scandalizing and stigmatizing. Continually having to explain is not a beneficial means of communication. Especially when an infected person as a rule when speaking about the infection divulges more about himself or herself than the discussion partner is willing to reveal about themself. An uneven starting ground for a dialog.
A good example is the media HIV outing and the prejudgement of a pop singer in 2009 who deliberately concealed her infection resulting in giving the infection to her sexual partners. The entrée for the press was her sensational arrest staged by the prosecution. In the media debates that followed, the risk factor on the part of the male sexual partners was not addressed: instead the hiding of the pop singers immune status was ruled as willful bodily injury (if not attempted murder). In a factual view this is a call for acknowledgment of HIV infected persons.
Inronically the social retraction from open discussion is tied together with medical breakthroughs. Life with HIV/Aids seems to be no longer a social reality and is confronted with little media interest. HIV/Aida seems to have changed and finds itself as a disaster element in far away Africa. It has become not worthy enough to address the social and community-political aspects of HIV infection. Cosseted by medical success, the current outcropping of socially-related questions dealing with sexuality, illness and isolation (only to mention a few) are to be answered by the afflicted themselves.
After 25 years HI-Virus remains the primary prevention of the crisis. The „condomization“ of society as reached its limits. The stagnating rate of newly infected persons has been understood by the media to mean HIV/Aids is controllable. Taking a few little pills can’t be so bad. Planning a lifetime with HIV/Aids is possible for every infected person, as media reports suggest.
We share our feelings with HIV infected persons who are addressed with these themes. But we also listen to what others have to say!