Some Reflection on HIV/AIDS

Many of you are probably aware that HIV and AIDS is one of the major problems faced by sub-Saharan Africa. Within South Africa, there remains a high rate of infection; for every two people who are place on Anti-Retroviral Treatment (ART), there are five new cases of infection. To talk about the Bible in the context of South Africa, one must confront the realities of people living with HIV/AIDS.

During my time here, I have met with several leaders of HIV/AIDS organizations, which work to provide resources to those living with the disease and to provide information about prevention. This past week, I attended a “Theological Café” at UKZN, where Dr. Beverly Haddad spoke about her experience as a delegate to the 2010 International Conference on HIV/AIDS in Vienna, which she attended as the director of a UKZN collaborative called CHART (Collaborative for HIV and AIDS in Religion and Theology). “The vision of CHART is to increase the capacity of religious leadership in Africa through theological reflection and engagement in order to prevent and mitigates the HIV and AIDS epidemic.”

I spent yesterday in an office that works to support people living with HIV and AIDS, working with Nokuthula, who (among other things) does work with the Ujamaa Centre to use the process of Contextual Bible Study as a means of support for people living with HIV and AIDS. She told me that while many people are initially resistant to the Bible study process—often due to anger with God regarding their diagnosis—those who choose to engage with the process find new hope and new ways to talk about the disease and about their faith. Unfortunately, I will have to wait until next week to see an actual Bible study; but I did get to meet the Patient Advocates (PAs) who work with this organization. PAs make home visits to people living with HIV and AIDS (most often those considered to be VIPs [Very Important Patients], such as mothers, the elderly, children). During these visits, talk with the patients to learn how their treatment is going, to provide a listening ear, and to help patients get connected to support groups. PAs also provide assistance for patients when they have check-ups, telling them what questions they should ask of their doctors. The unfortunate truth is the, especially in poorer areas, doctors will not always give HIV/AIDS patients the most effective treatments—instead these patients may only receive medication to alleviate certain symptoms.

Dr. Haddad noted that the catchphrase at the Vienna Conference was “Treatment is Prevention.” Being on ARTs has been proven to be one of the more effective ways of preventing the spread of HIV. It also enables patients to live healthier, longer, and more active lives. One of the primary goals of the PA home visits is to encourage patients to continue taking their medications and to determine how often each patient is taking them (the goal is at least 80% of the time).

When I met with Bongi last week, she drew a comparison between treatment of diabetics and HIV/AIDS patients. As a diabetic since age four, I was struck by this comparison and how apt it is. In the past week, many of the people I am living with have asked me about my Insulin Pump, an invention they have never heard of. In the U.S., insulin pumps are generally considered medically necessary: they allow significantly better control over juvenile diabetes and help to prevent further complications of diabetes. Both diabetes and HIV/AIDS become significantly easier to manage when one is on the most advanced treatment; lack of treatment leads to complications and a much earlier death. In the first world, there is significantly better and cheaper access to treatment.

However, there is a significant lack of funding and advanced treatment for HIV/AIDS outside of the first world. Nokuthula and the PAs were noting that their work is becoming much harder because many NGOs are unable to provide the same amount of funding. As the economy has tighten, funding for HIV/AIDS treatment is decreasing. South Africa has also fallen out of international focus for HIV and AIDS relief: it is no longer considered to be in the same amount of desperate need. Southeastern Asia is now the area with the fastest growing rates of infection; in the aftermath of the World Cup, the positive image of South Africa has made it less of a target for international aid. While in many ways the positive post-World Cup image is a boost for the country, the image does ignore the economic disparity and poverty that still exists throughout South Africa.

So there is a beginning reflection on the state of HIV and AIDS in South Africa and on some of what I have seen and heard about it. There is still a lot more to say, particularly about the stigma associated with HIV/AIDS, the social issues that are adding fuel to the epidemic, and the work being done by theologians and activists to combat all of these issues. (So stay tuned…and feel free to ask questions that I can perhaps address in later postings!)