Life with HIV

29/11/2018

"We had to be infected like most women." They were infected by their husbands. Maria learned that she was suffering from the Human Immunodeficiency Virus (HIV) in the sixth month of her pregnancy. Paola had a similar experience: she had routine checkups with pregnant women and a positive result. Like them, Beto also learned 20 years ago of his new situation.

With the diagnosis, Maria also discovered that her partner was unfaithful and that she was bisexual. He died of HIV. It is more painful than her neighbors to talk about her case to her son, as she was waiting for the best age to tell her. Like all HIV-positive women, she stoically endured insults and clichés. Fortunately, his son accepted his condition. For her, it is the most important thing.

María, Paola and Beto are "peer counselors" at Loayza Hospital. Their presence reduces the impact of information, which falls as a bucket of cold water, when a person is diagnosed with HIV.

That's when you most need a helping hand. Then they inform them of "adhesions": taking medication is for life, and that there is going to be a lifestyle change and risky behavior.

According to the Ministry of Health, about 72,000 people are living with HIV in Peru, 79% of whom are already diagnosed by the increase in the number of rapid tests between 2013 and 2017.

Two decades ago, the prospects for a person living with HIV were more negative. "Science has advanced so much that we are better off than other people with chronic diseases, I have friends with diabetes and cancer, they know my diagnosis, before feeling sorry for me, but now I live better than them, "says Beto.

A bit of history

In 1991, infectious medicine doctor Carlos Benites was in the first year of medicine when news shocked the world: the death of singer Freddie Mercury, leader of the Queen group. I have suffered from HIV-AIDS. The first case of HIV was detected in 1981, the first drug appeared in 1987. Six years later, the second.

"From 1995, one can only speak of highly effective antiretroviral therapy, thanks to a combination of three drugs.The curves of deaths due to HIV complications are also decreasing in the country," said today. the head of preventive medicine and public health in Loayza.

For two years in this hospital, the cocktail was reduced to a single tablet containing antiretroviral drugs Tenofovir Disoproxil Fumarate, Efavirenz and Emtricitabine. Patients take one capsule each night. It's for life. More than 98% of patients improved with this treatment.

stigmata

Medicine has progressed, but the stigma of society does not do it at the same speed. "Until now, there is rejection," say the three advisers. Families continue to treat the sick as outcasts. We always think that with a simple hug or a kiss, they will be infected. Therefore, when they ask for it, counselors inform families or couples. After information, in most cases, the ill-treatment decreases.

The other discrimination is that of the doctors themselves. Some still hesitate to discover that they will operate an HIV-positive patient, whether it's a pregnant woman or simple cases of calculations or appendages. Patients must enforce their rights.

Access to free antiretroviral therapy has been obtained in Peru over the past decade thanks to the action of hundreds of activists. "The treatment is administered without the person being obliged to take out comprehensive health insurance (SIS) .It is a right earned," they explain.

In the armed forces and the National Police of Peru, HIV is a taboo subject. Paola's husband was a policeman, but she was not entitled to a widow's pension because in the legal case of the police, he was infected outside the institution.

At the Loayza Infectiology Department, eight infectious disease specialists are present. Each month, they receive between 30 and 50 new HIV-positive patients. Of these, more than 90% will receive antiretroviral treatment at the hospital.

Disease profile

In Peru, every HIV-positive woman has between 3 and 4 men. 97% of cases of transmission occurred by sexual transmission and they are young, aged 15 to 45 years. The frequency of the presence of the virus in the Peruvian population is low (0.23%) compared to neighboring countries.

"But this apparent low prevalence of the general population changes when subpopulations are mentioned, with increased risk and vulnerability: Men who have sex with men (12% prevalence), transgender women ( 20%), sex workers (3%), "says Dr. Benites.

This year, the largest number of HIV-positive foreign patients in the Loayza are Venezuelans. Suman 250. In Peru, unlike Colombia and Ecuador, treatment is easier.

Benites explains: "A person under treatment has very little chance of passing on the disease." Minsa's responsibility is to treat this person, regardless of his nationality, so that the possibility of transmitting to another person is much less important. "

Awajún in danger

The other scenario is what is happening in the jungle with indigenous people. In Condorcanqui (Amazon region), 21,289 people who had access to HIV / AIDS testing were examined. The study, conducted between 2016 and this year, showed that the population of Awajún is the most affected with a prevalence of more than 1% of HIV. That is, in 40% of the more than 200 scattered communities, at least one case was found. The work was made possible by Minsa, the Global Fund to Fight AIDS and the non-governmental organization Pathfinder International. Treatment is a challenge facing the state and the regional health network.

The data

5,049 patients have been receiving antiretroviral therapy since 2004 in Loayza.