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HIV and AIDS are a bug that is afraid of one community, but the other does not think about it at all because it does not bind. However, it is quite possible that among friends and family, a person is infected with this virus, as shown by the statistics: at least one new case of infection is discovered every day in Latvia. The fact that this person dares to talk to anyone is the result of a negative attitude of people. In order to raise awareness of the problems of HIV-infected patients and promote their social integration, the "Support Group for People Infected with HIV / AIDS" (AGIHAS), in collaboration with several other organizations, has implemented an ambitious project since spring. among those who live with this infection. On the need for research and the current situation in the field of HIV, I have discussed with the chairman of the board of directors of AGIHAS Andri Veikeniek .
Why is such a study necessary? 19459005 Andris Veikenieks: I will answer with a question: Do you have children? You would like your children to grow up in a safe environment, even badually, when they are badually active. Research is needed to understand how bad the HIV patient is and what the community can do for it. With this data, we can go further and do a lot with numbers. We can not start a conversation with the Department of Health saying that it seems to us that there is a problem or another
The stigma index was established in about 90 country. Latvia has remained one of the last, in which it is not done, so now we are doing it – with the Lithuanians. The index is measured by interviewing people living with HIV. The interviews are conducted by other HIV-infected people using special questions, which occupy nearly 40 pages. The conversation lasts at least an hour. In total, there are 80 questions divided into several large groups – self-stylization, public attitudes, health care system attitudes. etc. Problems are also clbadified into contaminated categories (homobaduals, heterobaduals, injecting drug users, bad workers, etc.). This work must be done by the end of 2019, but we hope to collect the first results in December of this year.
About one person infected with HIV goes to Latvia every day. These are the statistics of recent years: in 2016, there were 365 new cases, in 2017 – 371. That's a lot! Since 1987, when the first case was recorded, more than 7,000 HIV patients are listed – a cumulative number. About a thousand and a half thousand people have died of AIDS, there are about 6000. To obtain reliable data, 10%, about 600 people, should be taken into account, but with our capacity we will be able query a slightly lower number. Discover something you do not know yet? The index has already been measured in many countries; Is the HIV situation very different in our society?
It is different because in this respect we are very similar to the dictatorial countries. The adult community is one in which you can talk about bad without losing sight of it. We are not growing in this respect. We are exaggerated morally, but only with words, not in real life. It's funny I'm convinced that behind the words of virtue lies badually incomplete life, and I admit that many of the prophets of virtue are hypocrites. I do not believe that in this respect we are more holy than the pope of Rome! Society should not be intimidated, do not feel it constantly for something guilty, but encourage it to be badual – that's normal. A person is not only a social entity but also a badual entity. The badual revolution in the West took place in the 50s and 70s of the last century. Are we really falling behind?
I'm not talking about permissiveness, but awareness. Talking about baduality also needs to talk about HIV. The reaction of society – what horror! But the reality is that not only HIV but also other badually transmitted diseases are still circulating with us. And HIV is made for a giant bubble.
Or people choose to think that it does not apply to them.
Applies to everyone. Latvia is also very different from Western Europe and Scandinavia because HIV is not a specific risk group but an infection of the general population. Groups at risk are intravenous drug users, men who have bad with men, bad workers and prisoners. We have long been HIV on these groups for us. It is possible to be infected in normal heterobadual relationships. The largest number of infected people is in the age range of 19 to 49 years, men are more infected.
Another trend in our country is most often elsewhere in postmenopausal women, with a very good social status and a high profession. Maybe they're widows, maybe the previous relationship has disappeared. These ladies find new partners. There is no longer any need to worry about contraception, and there are novels of service and novelty. They may not be occasional but durable, but after four or five years, the infection has been detected. Then there is a big shock.
Indicator questionnaires are questions about seropositive auto-stygmies. What is it?
It's a huge problem that HIV-positive people not only feel socially excluded, but also can not talk about their situation because they're scared. There are people in our community who no one knows about the disease – not a mom, no wife, no brother or sister, let alone colleagues and friends. I've already mentioned that a person is a social being – everyone has the desire to open, to talk. For many, our community is the only place to do it. If a pain can not be pronounced, a whole series of new problems, psychosomatic disorders arise.
It is also uncommon for health care services infected with HIV to be available only in Riga. In the parish of Pūpezi, people are afraid to tell this diagnosis even to the family doctor. Maybe the family doctor will not reveal the story from person to person, but other staff members work alongside him. Where is the guarantee that the information will not go further? Especially if the patient is not part of any group at risk, but the "general public", with a good reputation, a good job, as a teacher.
It must be emphasized that we are talking about the responsible party here. and seeking help, are consistent, able and able to engage. But there are also patients from social risk groups. If, for example, there is a Roma woman in Kuldiga, who has no education or work and who is HIV positive and who paid around eight euros in one direction on the Riga road, she can do so. such a journey an insurmountable obstacle!
It is also a question of how the woman mentioned in your example became aware of being infected.
There are three ways to learn this by chance: Mandatory HIV tests are performed on pregnant women, prisons and blood donors. In other cases, HIV testing is voluntary.
Do you think it's too small? Maybe family doctors should suggest to their patients, say, go check, you've never done this badysis!
That would be great, but we have the opposite. AGIHAS has both HIV-infected people and their partners in our society. But an infected woman told the partner: she told the family doctor that she would like an HIV test, but the doctor told her. Because there is a stereotype among generalists that HIV is not part of the "average" community. Why does a doctor say that? God forbid, the test will prove positive. So it's time to talk to this patient, but the door behind the door!
In general, the mechanism by which a person infected with HIV comes to treatment is terrible. When HIV is diagnosed, you must first go to your GP to get a referral to an infectious disease specialist who is not yet a live doctor. However, infectious diseases are very busy – wait two weeks to wait for a consultation. Fortunately, the Ministry of Health is also aware of this problem: it is thought that test results obtained in HIV prevention points in a country of 19 could be the basis for obtaining a specialist without a general mediator. There is also an understanding of the need to bring the service closer to the patient – so that everyone does not have to go to the Latvian Infectology Center in Riga to receive, for example, a new prescription.
Thus, it can not be said that there is no improvement in the treatment of HIV patients. He also managed to start treatment sooner than before.
In 2016, all HIV-infected patients started treatment when the number of immune cells in the body dropped to 200. Since 2016, treatment has started, but from the beginning of this year – from 500. This indicator is the last in Europe, because in all other countries treatment is started on the basis of the principle of "test and treat" (tested and treated). This means that treatment is initiated as soon as a diagnosis is established and not when the health condition deteriorates to a certain level. This benefits both the patient and the general public: a person stays in good health for a long time, they will not get sick quickly, which requires spending on the health budget, and it is not necessary to identify a disability related to social budget expenditure. The infection treated in first year does not stop, it can continue to work well and pay taxes.
And yet, such a person does not endanger other members of society because she can not infect others. Namely, HIV is still not possible to cure, but it can be very well managed. If, immediately after diagnosis, treatment is started, after three or four months the viral load in the body is undetectable. This is fine, because such a person is not dangerous for his badual partner, and is also able to create healthy children.
Immediate treatment for us is not possible due to limited funding?
Only because! The Ministry of Health can not be criticized for its lack of understanding. We have had discussions and we hope that by the end of this year or early next year, we could also move to the principle of immediate treatment. The number of patients with an insulin cell count greater than 500 is low, their treatment may not have a significant effect on the budget.
What Happens to Patients Who Have HIV but Not Yet Available Therapies?
If a person has a specific HIV infection and finds, for example, 618 immunosuppressants, she says: you have no treatment yet, but come see us after three months or six months. In the meantime, the patient is already used to thinking about HIV. Nothing wrong about his health also takes place, so he will not be missing after three months, not six, at the doctor's office. It can happen to a situation where the "average Latvian" with the "fast" is brought to the hospital to save: it no longer has the capacity for natural self-defense, so another illness has begun , in addition in a very severe form like pulmonary cartilage or tuberculosis. The treatment of such critical conditions is very expensive. It would have been much cheaper to start HIV treatment as soon as the diagnosis was made!
Is there a way to keep such a person in view?
Only motivating
HIV in figures
* At the beginning of April this year, 7,379 HIV-positive people were registered in Latvia
* in the first trimester, the total number increased by 36 people
* Treatment at the Latvian Infectious Disease Center By the end of 2017, only 35% of all HIV-infected patients were receiving treatment.
Source: LETA
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