HIV in Thailand

A while back there were some discussions around the topic of HIV and AIDS and I recall that Stickman published a poignant picture of the poor lass who died from the latter, with her partner’s permission. It is a horrible disease and only the other day I read of a South African rugby player who topped – literally and figuratively – three guys who had raped his teenage daughter and in the process they had given her an HIV infection. I’d free the guy today if it were my call but it's prompted me to put pen to paper to try and communicate some thoughts and facts that might one day save someone’s life. I all but lost mine recently and wish I’d read/known what follows.

Please respond via Stickman if technical stuff is wrong though and I’d prefer to remain anonymous.

I’m HIV positive – in fact I technically have AIDS but hopefully will not have that in the near future. You’ll have to read the whole article though to know why. Anyway, I found out by complete chance and thank God to this day that I had the test and got the result when I did. It was another infection picked up in the course of a profligate mongering career through the byways of Thailand and other parts of the world that I’d tested for and when they suggested a full screen I ticked all the boxes – after all I was fine, I’d had all clears before, my partners were always clear when they tested after the event and I was in great shape.

The positive result was not an easy message to take and mine was delivered over the phone – that skytrain is remarkably unreliable – which hardly added to the effect. Yes, I was dazed for a day or two but handled it reasonably manfully I thought although my new partner was, as you would imagine, rather pissed off. In Thailand they test in a different manner to my home country so I had the hope that it was a false positive here and I allowed myself the Xmas break to enjoy a reprieve, convincing myself in part that I’d be lucky and it’d be a different final diagnosis.

It wasn’t but it was reassuring to be treated so well and professionally back home, where they assured me all would be well with medication. So, now time for some facts.

Fact One – HIV is not fatal and the medication regimes are now so advanced that it need not be a major cause of death, other ‘standard’ Western diseases such as heart failure will take the majority of folks who start HIV treatment at a normal age.

Fact Two – AIDS is defined as having a CD4 count (look it up) of below 200. Off I trolled after I was told this – while not feeling better at least somewhat reassured in advance of the full blood results I would get the next week. Those old enough like me to recall Tom Hanks in the film ‘Philadelphia’ will have imagery of purple growths, debilitating diseases and death. True enough fifteen years ago… so finding out that my CD4 count was below that of the IQ an average Pattaya bar girl was a sobering moment. Again, the clinic and staff were outstanding; they simply said that you have only AIDS when you have an AIDS defining – i.e. pretty shitty – illness. These are specific, usually fatal but can all be prevented. Even ten years ago this might not have been the case but today it is a 5 baht a day antibiotic prohyllaxis for a while until the count gets up again. Apparently Thailand has a particularly high TB risk which makes it such a bad place to be for this condition.

Fact Three – I had absolutely no idea and no-one else would have had or did have that I was that ill. I am not trying to smoke and mirror this but I am a sturdy rugger-bugger type, coming in around 100 kg or so. Sure, I’d had a couple of nasty bugs in the last few years but these had shifted with the right antibiotics and I was feeling OK. I repeat, I had no idea and no physical symptoms yet was arguably a few months away from a grisly demise. Do not assume that all is well – its a silent disease in its first years.

Fact Four – the medications work. I thank my parents every day that I was born in a culture where medicine is seen as a right not a privilege and this is where opinions will diverge. The one pill a day I now take is pushing me way back to health, at least in terms of CD4 counts which doubled after a month. And as long as I don’t mess with this little gift from God, I’ll be fine. Many fifty-up guys have similar regimes for heart, diabetes or whatever. HIV is a chronic condition but it needn’t be a death sentence if you have access to the right medicine. Sure these cost but there are generics and the key of this message is that people need to realise how effective the medication is and make sure it gets made available to people who need it rather than reserved for those who can boost a drug firm’s share price. And get Healthcare wherever and whenever you can.

Fact Five – it is not the most communicable of diseases. I have no idea where I picked it up but thank Heaven my partner, who was pregnant by now, was clear and everyone I could contact and get to check (let's skip numbers here) was fine. I had convinced myself by now that mine was a recent encounter but the statistics suggest that one gets five to ten years of relatively symptom free existence before needing medication – or getting real issues. Seeing how I’ve bulked back up now makes me realise how long in fact I’d been gradually wasting away, putting that down to all sorts of other and more obviously plausible causes.

And that is why I’ve chosen to write this piece. Sure, it is a shitty thing to happen and I wake up each morning hoping it is all a bad dream. But I found out in the nick of time. My life expectancy is now (said in a humanistic manner) back to being better than that of the average Thai rural farmer and family. The medications were a bit gruesome in the first month or so but that calms down and can be managed. Sure, they will likely never cure HIV but then they’ll
never cure cancer completely either and anyone who has seen the slow death of an aged relative will know that there are few certainties in life other than death.

Please take from this story that HIV is NOT a death sentence and take the necessary steps to save your own life just in case you are as arrogant and stupid as me and think it can’t happen. Stickman advocates taking precautions beforehand (during) but from what I gather the bareback crowd is predominant here in Thailand – get tested once in a while and make certain, one way or another. Take action early as the sooner you know the better the reactions and the long-term prognosis.

NB: This post was prompted by the paragraph in the Stickman column earlier in April.