Providing health care with dignity

The results are in undetectable = untransmissible; it had been for sometime.  Promotion seems necessary, we are still trying to sell PrEP (Pre-exposure prophylaxis)  that is when people at very high risk for HIV take HIV medicines daily to lower their chances of getting infected… And now we have even better outcomes to share; people with undetectable viral loads cannot pass on HIV to their sex partners.

Lots of people living with HIV have injected  “I’m undetectable“… in their peer conversations.  Imagine how relieve they are to add … “uninfectious which means I will not pass on HIV to  you when disclosing to sex partners.

For the  people who make it their business to inject fear into sexuality and sexual relationships for people living with HIV it will be difficult to embrace the results undetectable = untransmissible .    Many continue to harbor (believe) outdated information on HIV.  The ones who continue to spread unhealthy fear from their places of influence; such as health care workers at HIV treatment sites.  Some are so set in their judgmental behavior  which can breed shame in the clients they serve, and shame is a known enemy of health and recovery…defeating the purpose they are engaged to fill.

Undetectable = untransmissible …mmm.  What does this really mean for women living with HIV?   Will this be motivation to tolerate the side effects of ARVs?

Will access to treatment and care become more accessible?  Health care providers that respect clients/patients and provide dignified treatment and care.  Schedule blood test with the results available in a timely manner and discussed with clients.  Pharmacist that respect your privacy and confidentiality enough to resist making snide remarks to your love ones picking up your prescription.

JCW+ will be having Test , Start and Stay conversations for women living with HIV because it is important that we are in an informed position to take responsibility for our health….and demand a quality standard of care.

In January 2017, the Ministry of Health’s National HIV Programme adopted the 2015 (World Health Organization) WHO guidelines, which recommend that anyone who is diagnosed HIV positive be offered treatment (Test and Start).  Treatment as a method of prevention is another benefit of the WHO new guidelines as more PLHIV are virally suppressed and consequently the risk of transmission is decreased.

According to the announcement made last year at the National HIV Programme annual review and planning retreat, the ‘Test & Start’ initiative anticipates that an additional 1200 new patients will be eligible for treatment.

Current estimates are that over twenty nine thousand persons are living with HIV in Jamaica; but approximately 19% are unaware of their status.

HIV is very much on the priority agenda..it is the approaches to interventions that MUST be adjusted.

RURAL HIV

We rural women account for a fourth of the world’s total population.

We are leaders, with continuous advocacy efforts for equity and equality.

We are producers of not just children, but we weed and plough the farm lands and work it effortlessly yielding in the crops and taking home the bread just as any man would. The decline in the contributions of women to agriculture, as a result of their own illness or that of family members, can create a substantial drop in agricultural productivity and in some developing countries, women account for as much as 70 percent of the agricultural labour force and an even higher percentage of food production.

We are entrepreneurs. Innovative thinkers and although we sometimes procrastinate, we also make it happen. We are service providers to everyone that comes in contact with us; and it’s not merely because are women but because we rural women face an awful lot of challenges and are more likely to negotiate our demanded result from a situation with whatever resources we have.

With all our attributes and traits though we face many socio-economic needs and sometimes end up in abusive relationships when we seek to have a man in the house to assist us financially. This sometimes lead to us contracting HIV in our endeavors to be all woman, independent and survivors. HIV/AIDS is still highly stigmatized and many women are ostracized. The effects of HIV/AIDS are not only felt at the household level but have wider repercussions, as well. Thus, help from the extended family and the community, their main safety nets, is often severed.

More households are headed by HIV/AIDS widows than widowers, left with the children to care for as men generally have a ‘don’t care’ attitude in regards to their health, refusing to see the doctor and refusing clinical treatment and care. Often times this leads to poverty as family assets and savings may be completely spent, leaving the surviving family members without means of support.

Access to land and support services that could see these women through the hard times are denied them because of their inferior social and legal status in traditionally patriarchal rural societies.

Our contributions are quite vital to the well-being of families; we are most likely to be the ones with the responsibility of caring for the children, the sick, the elderly and the grown ass men in our lives.

Today as we celebrate rural women internationally, we remind them of their importance to their families by extent communities and country’s economy as this depends on us and assertion of the Sustainable Development Goals is impossible without us.

Increase the availability of treatment and care provision in rural areas. Improve educational and social productivity. Help in preventing the spread of HIV and HIV mortality.

#ACT-CARE-COMMIT

#International Day Of Rural Women- October 15

MAD PEOPLE COMMIT SUICIDE

 

Mental health as defined by World Health Organization, is a level of psychological well-being, or an absence of mental illness. It is the “psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment”. 1

Often times we misunderstand the importance of having our mental health needs addressed. You are called mad or crazy and thus many of us suffer because of the taboo on mental health.

I asked myself if there are mental illnesses that affect men only and any that affect women only. Well I did not get a straight answer on that one but based on my research I was made aware that mental health does have some aptitude of gender biases and although men tend to suffer more from suicide, women are generally more affected by the more common mental disorders. I shall continue my research but this year as the focus of mental health week is on the prevention of suicide it is critical for me to dispel the myths of mental health and shed light on some facts with you just to get us all to understand the dire need for seeking to help persons and ourselves with our mental health issues.

FACT: “Over 800,000 people die due to suicide every year and there are many more who attempt suicide. Hence, many millions of people are affected or experience suicide bereavement every year. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year old globally in 2012.” 2

With that being said can you actually tell me a mental health myth and a mental health fact?

Mental health problems does not affect everyone. Can that one be considered a myth of a fact? Truth is mental health is pretty much like HIV or any other STI, although you may not be infected, it does affects us all. Take for instance depression. This is one of if not the most common mental disorder affecting at least 350 million people globally with majority of those being women and young people. It enables disability and has the ability to fuel suicide. We are therefore left footing the bills for treatment of any other expense that may occur and sometimes left feeling hopeless as our friends and families suffer. Thus we are all affected.

Children do not experience mental problems. Actually it is the second leading cost of death among young people between the ages of 15-29 years old. Half of these affected person start showing signs before or by the age of 14.

 People with mental health disorders find it stressful holding down a job. If we invest in our health and treatment this too can be shunned as with effective treatment person with mental disorders are just as productive as anyone else. Encouraging this will be equivalent to lower medical cost and social burden costs through increased productivity.

Persons diagnosed with a medical disorder can be due to:

  • Biological factors, such as genes, physical illness, injury, or brain chemistry
  • Life experiences, such as trauma or a history of abuse
  • Family history of mental health problems

Self-care and therapy however can aid in their process of recovery.

One of the major barrier in receiving effective treatment, as only half of these affected persons receive treatment, is the social stigma that is associated with mental health. 3 It will be a long shot for us to say we will eradicate this social taboo on mental health but family and friend support is an important factor in getting us the treatment and services we need for our mental health issues. Merely reaching out to someone and providing moral support helps a lot. Learning and sharing the facts and refraining from labeling persons by their mental health disorder also helps. But most importantly treating them with respects as you would anyone else.

This mental health week I vow to promote the social and emotional well-being of young people via shared knowledge. I strongly believe that this will increase productivity, enhance educational outcomes, strengthen our economy, lower crime rate and health care expenses and most importantly improve our quality of life and family life.

Therefore it is imperative for us to focus on the mental health needs of women and have them met in an effort to end suicide and increase our longevity because suicide is committed by people just like you and I.

 

SEE LINKS FOR ADDITIONAL INFORMATION:

1 http://www.who.int/mental_health/prevention/genderwomen/en/

2 http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

3 http://www.who.int/mediacentre/factsheets/fs369/en/

Vertical

Vertical” was originally published in spanish in january 26th 2016 on Roja Vida by L’Orangelis Thomas Negrón, member of ICW’s Chapter of Young Women, Adolescents and Girls, living in the Hispanic Caribbean, Puerto Rico.

This is the first time I write about The Cure for HIV in my blog. I never before had written on this subject and I had, and still have, some contradictory feelings and thoughts, but things have happened in recent months and I think it’s time.

As you may know, I grew up with HIV and no, I don’t know what  it is live without it, but not for its time in my body, but the time I’ve been aware of its existence in me (since I’m 8 years). HIV is part of the group of things that construct my identity as a human being on this earth and its societies, and has predisposed and put me in situations that, in other ways, possibly haven’t occurred. For better or worse, many of the most important and decisive things in my life, HIV has had an influence. From my closest friends, my most significant works and experiences, thought the way I see the world and understand it. All this and more is due to HIV, and having the thought that the HIV would no longer be part of me, scares me and gives me that loss feeling. It is a kind of Stockholm syndrome, HIV being my kidnapper.

The cure for this syndrome, in my case, I think it would be to realize that there are hundreds of young people who have no access to medication or who simply don’t take it, for any reasons, and they are dying. That doesn’t matter how I may feel when we talk about the lives of hundreds. Currently the only or main alternative we have to keep the virus low, is to take medication, but what do we do with those who no longer have more options? What do we do with those who are weary and tired? I have no answer, but what if we talk about a cure?

The vast majority of global and national strategies are based on the medicalization and condomization of people with HIV or who are “at risk” to reach the “end of AIDS“, not the End of VIH by the way. So, we have strategies that talk about “detect“, “treat” and “suppress“, but not necessarily speak of access to mental health, sexual pleasure, institutionalized and social stigma, free access to information and human rights. People talk about reducing viral load, but suddenly many people make it sounds as easy as lowering the volume of the music, when between the viral load and strategies, are human beings who carries the virus in our blood and medication by our mouths.

Treatment now is prevention, and no, I don’t speak of Truvada as PrEP. I speak that once you’re undetectable, the possibility of transmitting HIV decreases enough to not infect someone else, but God, Buddha, Allah, Pachamama, Krishna and Changó keeps you from having sex without a condom!! It sounds cute “Treatment as Prevention“, but if people will call us irresponsible when we are undetectable and have sex without a condom, so why we even use both words in the same sentence? And I don’t really think it’s because of other STI or pregnancy, because usually strategies are designed to make us less infectious.

Getting tired for a while is valid, and also getting tired indefinitely. For more wishing that people have on young people who grew with HIV, to be 100% adherent, at the end of the day, the ones who places in their mouths the pills and swallow them, are us. When we speak and say “My Body, My Territory” is not only to decide whether or not to abort, it also comes to taking medication or not, going to a protest or not, having sex or not. It’s the right to have alternatives, availability, accessibility and the power to decide on them although the decision is appropriate, correct or NOT.

Not every young person who doesn’t take the medication, do it on purpose or in a conscious manner. Not all the young people who don’t take medication, do so because they have surrendered or because they are irresponsible. The desire to live, to be healthy, to have goals and dreams, is NOT synonymous of adherence. If I think about this, with this co-dependent mindset, it makes me see ourselves as machines of taking medication, it’s makes me feel that we were born to take medication and that no matter what we want, HIV is what determines and decides what is possible for us and what’s not. This kind of view, also makes me feel like if I’m resting us humanity, and that we are nothing more than a diagnosis. And this does NOT mean that I am against medication.

Willing to live is human, just as willing to be healthy, to have goals and dreams, regardless of a diagnosis. Good and bad things will always happen, and there will always be barriers, and because of this reason, it is necessary to develop new strategies and ways to maintain good health and quality of life. Strategies that are based on dignity and participation; shifting the power “over“, for the power “of“, “for” and “with“. Inclusion, because integration is not enough. Empowerment to speak out, instead of lying every time we go to the doctor when we are not adherent, because we don’t want to hear the nagging again (I’ve been listening since he was 15 and has not changed doctor after doctor). Including medication, but also advocate for a cure.

Including medication, but understanding that we are whole beings, and that HIV does NOT have a Velcro that you can take out to treat without having to deal with the rest. Including a cure, which currently does not exist (but that doesn’t mean we won’t ask for one), but it would be a final solution to the deaths among young people. As someone who has grown up with HIV, I get tired and always has complications with adherence. However, I know my body and I stay aware of how I feel, and having this consciousness supports me. But consciousness is not all, I have to keep this present in my mind all the time and that is no simple task, even after all this time. If anything has supported me is to be honest with myself and my health care providers, recognizing which my barriers are, and from that honesty with myself, look for my true alternatives from my reality.

Even if we don’t like it, speaking of adherence it is no longer enough. Much less when we speak of vertical transmission, that although the incidence has declined, those of us who still here, sometimes are the ones having more difficulties, and no wonder. A lot is required, a lot of support, mind and heart, because sometimes it feels like we are in danger of extinction.