Misconceptions about antiretroviral drugs hampering the dream for an AIDS-free generation

30 years since the first documented cases of HIV, there are reports of major milestones in the fight against an epidemic that has devastated some parts of the world. UNAids reports that in the last decade the global rate of infections dropped by nearly 25%, while according to the World Health Organization, an estimated 6.6 million people with HIV in developing countries are now on antiretroviral therapy drugs –drugs that keep them from developing Aids and help them live longer.

But as we hail the achievements of the last decade, one very important question begs an urgent answer: “Have we done enough to expect an AIDS-free generation any time soon?” As I’ve recently witnessed, complacency related to antiretroviral drugs may be fast eating into this dream.

EstherWambui/Photos
Participants at Toronto AIDS Walk For Life arrive
at the city's AIDS Memorial

A recent conversation with three young women in Kenya gave me a window into how far we might be from achieving that goal and left me wondering whether time has come to re-examine basic HIV/AIDS education [Esther Wambui/Photos].

I was concluding a visit there after five years of living abroad. And as it is customary I ended up at a hair salon for some braids that would take several hours to do. With so much time to pass, I eventually broached my favourite topic…HIV/AIDS. I instantly noticed something positively different. Unlike five years ago, people are no longer shy to discuss the epidemic. They have seen and heard enough about it already to become part of daily conversation. One of the women was in her mid-30s and she vehemently declared that if some guy thought to “bring” her HIV, she would personally kill him.

The other two women however, were in their early twenties and had a different tone. One said that she did all she could to avoid infection, but that accidents do happen anyway. Then the third woman made a statement that forms the crust of my viewpoint today. Unfazed by all our (ABCD*) talk, she boldly declared that medication for HIV was now available and there was no more need for all the panic. She went on to say that people should be left alone to “enjoy fear-free, guilt-free sex”.

I froze to my bone on hearing this. As a certified basic HIV/AIDS educator, I’m aware that antiretroviral therapy is an important part of the curriculum, with an emphasis on ARVs as one of a number of ways to enhance the life of sufferers. ARVs never have and do not cure AIDS or HIV for that matter.

Thus as we commemorate three decades of HIV, we need to remember the under-thirty generation, for whom the epidemic has always been a way of both vocabulary and life; a generation that didn’t have to deal with the shock-value of the emergence of an incurable disease. For them, HIV/AIDS is one of the many other chronic diseases.

EstherWambui/Photos
Two TCE [South Africa] Field Officers give an HIV/AIDS
awareness lesson to a teenage girl

Is it time to revisit the focus of ARVs education or do we need to implement an altogether new program?

While we must continue giving hope to those already infected, we need to make sure that the uninfected know all there is to know about these drugs. Let’s have an ARV-only program. A program that tells the young that yes ARVs are there. Yes, they are available although to a relatively small and select number in poor countries. And yes, they do improve the quality of life for the infected. Likewise, I believe time has come to revisit the education of earlier years. Be forthright, open, frank, and remind people that these drugs are not a cure.

Let emphasis be placed on the ills of long-term use of these drug: The numerous side effects that range from relatively mild ones, to very serious ones that in themselves impact quality of life. Add that to treatment failure, drug toxicity and in some cases, resistance to these drugs. This in itself should disturb the unfazed, the fact that once you’re on ARVs you’re always on ARVs. That you never stop taking them, a concoction of pills for the remainder of your life!

In the fight against HIV, we always hope that everyone gets the message. But as is the way of life, some people might or probably will always fall through the cracks. I’m okay with that as long as they fall knowing that crack is a life-altering one to fall into - one that you eventually pay for with your life.

With an estimated 33.3 million people currently living with the virus, the only thing I can hope for is that the young woman is by all means an exception, not an indicator of her generation’s mindset.

*Abstain, Be Faithful, Condomize, or Do-it-Yourself.