Text produced by William Meneses, a journalism student at IDP.
"It all depends on your ability to take the sourest lemon and make lemonade," said Dr. Nathan Katowski. This dialogue is part of a scene from the series. This Is Us In which a doctor who works with HIV/AIDS patients talks to a distressed father. You don't even need to have watched it to understand what it means.
Basically, it's about facing a major problem, confronting it, and overcoming it. This process is necessary when one discovers they are HIV positive, the virus that causes AIDS. Raimundo Nonato Lima is an example of overcoming this challenge. The diagnosis occurred at what he considers to be the peak of his personal and professional life.
“I found out when I was 43. It was a very critical moment because I was at the peak of my career, of my whole life. I was unwell for a long time, but I'm doing great now. That's why I'm very grateful every day,” recalled Raimundo, currently 61 years old.
Nonato is a psychologist and sociologist trained at the University of Brasília (UnB), a community therapist, and is retired. Originally from Maranhão, he moved to Brasília in 1980. Interestingly, it was precisely during this period of his move that the AIDS epidemic was discovered and spread worldwide. At the time, the disease was shrouded in misunderstanding, paradigms, and much prejudice. To overcome the impact of the diagnosis, Raimundo relied on the support of his family, especially his wife, friends, and his doctor.
According to Eliane Maria Fleury Seidl, PhD in Psychology and coordinator of the extension project "Coexistence and Integrated Actions for Study and Care of People with HIV and AIDS and their Families" at the Institute of Psychology of the University of Brasília (UnB), this type of support that Nonato received is of great importance. However, she emphasizes that the reaction of each diagnosed patient is unique.
“Unlike other chronic conditions, HIV-positive status has the issue of not telling, not revealing, so people often choose to postpone this moment. This is very much a matter of stigma, so when a person feels they need to tell, upon receiving the diagnosis, the way to help without being invasive is precisely to respect them, with great sensitivity,” she explains.
The psychologist warns that the support network can often become uncomfortable for the patient if it is intrusive. "It's as if the social support system doubts how autonomously and independently the person can manage their treatment through self-care," she pointed out.
HIV is not synonymous with AIDS.
The Human Immunodeficiency Virus (HIV) is celebrating 40 years since its first diagnosis. It is important to emphasize that not everyone who has HIV (the virus) has AIDS (the disease). It's exactly the opposite. With advances in science over the years, ways have been created to prevent HIV-positive individuals from reaching the stage of the disease, including making the virus almost imperceptible. Formally, a person with a low viral load is called undetectable.
There are two forms of treatment to reach this level: one to prevent infection (PrEP) and another to treat the problem (PEP). Prevention, called Combined Prevention, opens up a range of possibilities, precisely so that people can find and engage in the most convenient behaviors and strategies. PEP, Post-Exposure Prophylaxis, is for people who have been exposed to the virus and who are taking steps to protect themselves from infection. PrEP, Pre-Exposure Prophylaxis, is for those who want to be protected from infection before sexual intercourse. This strategy is used by those who have a partner with HIV or who have had unprotected sex.
Infection is not 'simple'⠀⠀
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For a long time, it was believed that transmission occurred easily, such as through the simple sharing of cutlery, for example. Today it is known that not even kissing is capable of passing the disease from one person to another. The ways in which transmission occurs are through blood transfusion, sharing infected syringes, unsterilized piercing objects, pregnancy, childbirth, breastfeeding, and sexual relations, the latter being the most common.
HIV is a microorganism that weakens the body's defenses, acting cautiously and progressively, resulting in a greater susceptibility to disease. Therefore, the virus 'opens the door' for other types of illnesses to take hold. Thus, AIDS leaves those who are HIV-positive in a state of profound vulnerability.
Using condoms during sexual intercourse is a good way to try to prevent transmission, which in other cases can be done through routine testing to find out if you have the virus or if you are simply at a high risk of passing it on to another person. This is where PrEP and PEP come in. For pregnant women, it is important to know if they are HIV-positive or not so that measures can be taken to reduce the chance that the baby will also carry the virus.
Results are not immediate.
Assuming you have been exposed to the virus, taking the test immediately will not reveal a result. This is called the 'serological window'. The time between exposure and infection, and the time it takes for the test to become positive, is due to the body's ability to mount an immune response and produce antibodies detectable in the test. Currently, this window can be as short as 22 days. A few years ago, it took at least 3 months for the virus to be present in the body for detection.
Even with all the advances in testing, 'false negatives' still exist. At the current stage, the effectiveness rate of the tests is 99,8%. With proper treatment, the viral load can decrease to the point where the viruses don't even appear in follow-up tests. This is the case of Raimundo Nonato, for example.
Life goes on ⠀
Dr. Eliane emphasizes that many HIV-positive individuals, once their viral load is reduced, do not need to change their life plans. “There is the possibility of having children without transmitting HIV, which makes aspects of motherhood and fatherhood very hopeful and peaceful. The possibility exists that life plans can be maintained and that the person can live well, with physical and mental health. Medications with a much smaller number of pills—most treatment regimens involve one or two pills a day—reduce side effects, so there has been significant progress,” said the professor.
Raimundo himself, with all the support he received, managed to move forward even with the virus. Particularly well-adjusted, it can be said that he doesn't distance himself professionally: “In the job market I didn't have much difficulty because I already had a job and all of this was easier to overcome. Today, even retired, I continue working,” revealed the psychologist. Raimundo's regularity of checkups, however, is a little higher than average. “I have medical checkups every 6 months, I get tests done, to see how my health is.”
Nonato and many other Brazilians benefit from advances in medicine regarding HIV and AIDS, which is still on the path to finding a definitive cure. Speaking specifically about Brazil, Eliane Maria recalled that the Brazilian system has historically been copied by several countries. “Universal free treatment means that anyone living in Brazilian territory, including foreigners, is entitled to free medication and treatment. There is no shortage of medicine. We also have a good, solid network, of course better in the capitals or larger cities, but it exists,” the doctor analyzed. The Federal District, for example, has eight health units specializing in HIV treatment.
Reduction of
According to the Department of Chronic Diseases and Sexually Transmitted Infections of the Ministry of Health, in December 2020, Brazil registered a significant drop in the number of AIDS infections in recent years, as shown in the graph below.
Link to the chart: https://app.flourish.studio/visualisation/7944620/
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