I am scared of ARVs

May 01, 2007

Dear Doctor, <br>I am want to have an HIV-test but I fear because I do not like to think about the possibility of being on ARVs for the rest of my life! You said you have lived with HIV for 21 years but have been on ARVs for only six years.

I am scared of ARVs

Dear Doctor,

I am want to have an HIV-test but I fear because I do not like to think about the possibility of being on ARVs for the rest of my life! You said you have lived with HIV for 21 years but have been on ARVs for only six years. I am interested in knowing how one can live for such a long time before needing to start using ARVs. I don’t think I would be so scared about knowing my HIV status if I could spend many years before needing to start on ARVs
Amina

Dear Amina,

I think part of your problem is that you are trying to cross the bridge before you reach it. In case you are HIV-positive, postponing doing an HIV test for so long can harm you as it denies you the knowledge that would alert you to begin taking care of yourself with a purpose of improving the quality of your life and therefore creating a possibility of staying long before you are put on ARVs.

Doing an HIV test in most cases has been seen to positively change one’s attitude regardless of whether the results are negative or positive. Most people tend to adopt a more health-seeking behaviour after knowing their HIV status.
Contrary to your feelings, being on ARVs is not such an ordeal. For me I actually think positively about ARVs, and almost every time I take them I do it with gratefulness because I always reflect on the fact that had it not been for ARVs I would probably not be alive today. When I feel discouraged about the daily taking of ARVs I usually look back and remember how sick I was when I was not on them and how we could help more people with HIV/AIDS live longer and have a better quality of life on ARVs if they were to access them.

It is difficult for me to tell you how long one can live with HIV before he or she develops AIDS, a condition that would require one to be on ARVs. However, many people with HIV have lived for a long time without using ARVs just by being on what is termed as the Basic Care Package for PWHAs. This requires one to be on septrin prophylaxis, to observe proper hygiene, to use safe drinking water, to observe good nutrition in the preparation of meals and to sleep under an insecticide treated mosquito net. This is part of what is commonly known as the philosophy of positive living with HIV/AIDS.

Other factors that may influence the rate at which HIV infection progresses to AIDS in an individual are; the natural immunity of the individual plus the virulence of the virus that one is infected with. Adhering to the philosophy of positive living plays an important role in enabling one live a long and quality life often without the use of ARVs.
Positive living means one accepting their status, making positive decisions like avoiding infecting others plus doing all that is required to lessen one’s vulnerability to opportunistic infections.

Organisations like TASO used this philosophy to help many people at a time when we had no access to ARVs and many of their clients stayed alive until ARVs became available. All what I have said will be useful if you find out your HIV status by taking HIV test, so go for it!

I want a child with him
Dear Doctor,

I am a married woman and have just found out that I am HIV-positive. My husband who loves me very much is HIV-negative. I would like to have a baby with him but now cannot since we have to use condoms each time we have sex. How can I have a baby who is free of HIV and at the same time do not infect my husband with HIV?
Teresa

Dear Teresa,

It is good that your husband who loves you has not abandoned you during this very trying moment. In regard to the issue of pregnancy both of you need to seek counsel from a qualified HIV/AIDS counsellor and your doctor as the issues involved in taking this kind of decision cannot exhaustively be discussed in this article.

However, before you think much about having a baby it is important that you get to know your CD4 count and if possible the viral load. The CD4 count measures how much damage HIV has done to your immune system and the viral load measures how active HIV is in your body. A high viral load and a low CD4 mean you are actually not well though at the moment you may look clinically all right with no physical ailment. Pregnancy is itself immune-suppressive and if you go into it with a weak immune system, you will most likely have serious problems.

In case you find that your immune system is already badly damaged it may be necessary for you to start on antiretroviral drugs (ARVs) because this will help you. Emerging evidence also shows that people with a maximally suppressed viral load through the use of ARVs reduce the risk of passing on the virus to their sexual partners or babies in a process that is now commonly termed as mother to child transmission (MTCT).

When you discuss the issue of pregnancy with your doctor you will realise that in the event that your viral load is maximally suppressed, you need to find out on which days of your menstrual cycle, you are fertile and most likely to conceive and then abstain from sex the week before to maximise the effect. I suggest that you discuss with your doctor and husband the rest and what should actually be done. However, remember that it is still possible to give birth to an HIV-infected baby when you are HIV-positive in spite of the precautions taken. MTCT can occur, during pregnancy, during the birth process and during breastfeeding and therefore you will benefit a lot from prevention of mother-to-child transmission counselling once you discover you are pregnant.

Send your question on HIV to Health Editor,
The New Vision. P. O. Box 9815, Kampala or
health&beauty@newvision.co.ug

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