In Africa where I am now people who get HIV get it becausae they are promiscuous. If they are treated, they live longer and are still promiscuous, thus kill a few more other people before they die. If untreated, their bodies get weak and the die sooner thus sparing others of HIV infection. What is the most moral thing to do/ Treat or not treat?
As a sex worker who knows people's attitudes, I would not treat, if the ideas was to reduce infection. In South Africa, Zimbabwe, Botswana, Swaziland , etc, the majority of adults are positive and the few that are still negative are on their way to infection. Its a matter of time. Zimbabwe says no new infection, but that is just because the nation of those that are promiscuous is now saturated. Yes why not? They should also get the best treatment that is available and probably the way forward would be for an effective vaccine against the infection at the earliest. However, in the interim, till a potent vaccine becomes available, use all preventive measures. Furthermore, there should be a method wherein all those who are infected should protect others. That's a disgusting and immoral question. Ask yourself this: since you're a sex worker, if you were infected, would you want treatment or would you pefer to be left to die? What a dilemma! I would think the not being treated would be OK as long as it wasn't YOU how contracted HIV? if you take the pill it give you a chance to live a longer live and for most people there no side affect so take them and hopefully soon we will have a cure its a very hard one but being a terminal care nurse, i would not stop treatment to ease someones pain and suffering. If you dont treat them are you not causing them discomfort and suffering.
I think the key lies in Educating and condoms?
Ps its groovy that you work in Africa and i wish you every luck and have great admiration for you Your statement make a lot of since to me. You probably have the right view on it. Treat it in a single person, they spread it, and kill others, don't treat it, they die, sparing other people who will probably get it from someone else. I think in those places, the inhabitants are doomed, unless they start using protection against such things, or we find a cure, and cure everyone as soon as we can. If we get a cure, and only give it to a few people, they will get it again. So there really is no stopping it, unless you quarantine everyone who has it, and let them die a painful death. I know how this sounds, I am more for curing completely, than anything else, but it is not going to happen anytime soon. I would continue treating people, unless I made sure that they wouldn't spread it any more.
I was reading the other responses also, if I was one of those people who was promiscuous and living in Africa and always spreading it, what would be the point of treating me? So I can infect possibly a hundred more people while I was still alive, and then that 100 spreading it to another 100 and so on and so one. I totally get where you are coming from. But if I got it in the states, and wasn't spreading it like a wild fire, I would want to be treated. It is a matter of life style and where you live, BUT I am all for a cure. And I hope we get one soon. Good question. Please take no offense to this, but this kind of reminds me of Dr. Kevorkian. I say that because his idea was to help people who were in terrible pain end the pain. Your idea is to remove the possiblity of infection by removing the infected. As immoral as it might sound I think it's a great idea. Now before I get flamed, my mother has HIV and she is a perfect example of what to do if you are infected. Stay clean, stay abstanant, stay as healthy as you possibly can.
Really though, I think you would be making a good decision, though I don't think it could ever happen. The World Health Organisation (WHO) threw down a challenge to the international community when, at the Barcelona international AIDS conference in August, it set a target of three million HIV-positive Africans to be on antiretroviral (ARV) HIV/AIDS therapy by 2005.
AIDS activists responded with cautious optimism, not least because fewer than 30,000 people in Africa were on ARVs in 2001. WHO's target represents just half of the six million Africans who currently require ARV treatment.
SIGNS OF HOPE
A number of ARV treatment programmes were launched in 2002 by governments, private companies and NGOs, suggesting a significant shift towards improving access to ARVs.
In Malawi, the government unveiled plans to provide ARV treatment to as many as 50,000 people, bringing what UN Special Envoy for HIV/AIDS in Africa, Stephen Lewis, called a "strong quotient of hope" to those living with HIV.
The Malawians plan to use a grant from the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria to provide the drugs free of charge at public hospitals and clinics.
The Zambian government announced similar plans to treat 10,000 people, and the Kenyan Parliament opened the door to greater access to cheaper generic ARV drugs by amending copyright legislation.
Meanwhile, the Namibian government launched a pilot programme that seeks to provide ARVs to newborn babies as well as to both parents, should they be HIV positive.
The private sector also swung into action. South African mining giant Anglo-American announced it would provide ARVs to its HIV-positive workers as part of the company's expanded HIV/AIDS strategy. Other companies have vowed to follow suit.
Then, early in 2003, six multinational drug manufacturers pledged to further increase the supply of HIV/AIDS drugs to the African continent. According to the six, the number of people with access to ARVs had "increased significantly" since March 2002, although precise figures will not be available until later in the year.
The South African government, which has been reluctant to promote ARV treatment beyond a number of pilot sites, was ordered by the country's highest court to provide the drug Nevirapine to all HIV-positive pregnant women and their babies - with immediate effect.
These and similar breakthroughs throughout the continent have contributed to heightened expectation about the possibilities for prolonging the lives of millions of HIV-positive Africans.
HIDDEN HURDLES
Sceptics have argued that effective ARV treatment was not feasible in poor communities most affected by the AIDS epidemic in Africa - an argument that appears to have been disproved by some of the current treatment initiatives.
However, other less foreseen problems have emerged.
The Botswana government's decision to provide free ARV drugs to all its citizens living with HIV and AIDS attracted considerable international attention and approval last year.
But so far the programme has made limited progress, and by December, only four percent of the estimated 110,000 MoTswana currently eligible for ARV therapy had enrolled with the scheme.
"It is a humble number, but shows how much of a challenge lies ahead," Dr Ernest Darkoh, operations manager of the country's ARV programme, told IRIN.
Most HIV-positive people in Botswana have not undergone an HIV test, and many discover their HIV status only once they fall sick. Even then, stigma and denial often prevents them from participating in the treatment programme, Darkoh explained.
"Given that most people don't know their status, people have to first get tested, deal with the psychological impact of the diagnosis, come forward to the programme, fulfil the eligibility criteria, and finally be enrolled in the programme," Darkoh explained.
People did not automatically "run for therapy" after testing HIV positive, he warned.
Those who presented themselves for treatment tended to do so only when they were very sick and required intensive care and lengthy hospitalisation to stabilise them enough to begin ARV therapy.
"Anecdotally, doctors on site estimate that with the effort it takes to treat every sick patient, they could have treated 5 - 10 patients who had come forward before becoming sick," Darkoh added.
Staff shortages in the public health sector, and the need to train health workers, further hampered the programme, Darkoh explained.
INADEQUATE PLANNING
In the private sector, too, there is a growing realisation that not enough planning has been done.
In August, South African diamond company De Beers announced that it would provide ARVs to HIV-positive staff and their spouses. But, according to the company's HIV/AIDS co-ordinator Keith Markland, the company has since had to "put the brakes" on its campaign to encourage more employees to take up the treatment offer.
For starters, South African tax laws make the provision of free or subsidised medication to employees a taxable benefit. "This defeats the whole purpose of providing free drugs," Markland told IRIN.
De Beers is in the process of trying to resolve the matter with the South African Revenue Service.
The company was also in danger of falling foul of the Medical Schemes Act, as it was providing services similar to those offered by medical aid schemes.
Markland said that stigma and discrimination surrounding HIV and AIDS also made it "extremely difficult" to encourage HIV-positive employees to come forward for ARV treatment.
BOTTOM UP APPROACH
Problems such as these appear to have evaded pilot ARV programmes run by Medecines Sans Frontieres (MSF) in Khayelitsha, an impoverished township on the outskirts of Cape Town, South Africa.
Here community members, including people living with HIV, have been involved in awareness campaigns about ARV treatment, resulting in many people joining the scheme, said Dr Eric Goamaere, head of MSF in South Africa.
Members of AIDS lobby group, the Treatment Action Campaign, embarked on the "Ulwazi" (meaning "awareness" in Xhosa) project, through which they explained to Khayelitsha residents the link between HIV and AIDS, and how the disease could be prevented and treated.
The project is "extremely active" in schools, churches and other community settings, said Goamaere, who went on to warn against "top-down approaches" that tended to alienate rather than encourage people to take up treatment offers.
MOVING AHEAD
Goamaere feels it was important to continue rolling-out the ARV treatment initiatives and to address the problems as they arose. However, Darkoh is more cautious.
"First and foremost, you have to be sure of funding; the programme must be sustainable and robust," Darkoh said. "It would be disastrous to start a programme and then, two years later, find it cannot continue."
Furthermore, there appears to be no fix-all solution. Rather, Darkoh advises countries preparing to implement ARV treatment programmes to look critically at what works in their local settings.
"They cannot just copy our [Botswana] programme wholesale," he said. "It must be feasible for the individual country."
MSF estimates that, in two years time, the cost of treating one person with ARVs will have dropped to between US $50-80 a year. Currently, this amount of money barely covers an individual's ARV treatment for a month.
"Once the prices drop, we will see an exponential increase in ARV programmes in Africa. A tidal wave will invade this region," Goamaere predicted.
It is now up to African governments to seize the initiative, he added. "I don't think it will be easy to implement ARV treatment everywhere tomorrow. But is it impossible? I don't think so." in a perfect world may be you could let them die,but they are humanbeings and they deserve to get the best treatement possible they must be educated to change their way as the song says no one said it was easy. Considering your sex worker you've im quite suprised you don't know reason why people are promiscuous or resort to prositution. Well the reason is it's the only way the can earn money and feed themselves and thier families.
What about you gonna do about the children whom are born HIV positive, do you want them to live short lives in pain and suffering, because of something they can not control. The best way to deal with the problem is to increase these countries econmic strength, so instead of people resulting to they have oportunies to learn and to have career. If not just get industies to invest there so people don't have to resort to working in the sex industry. Also educating people into using condoms and about the disease is another way.
Not giving ARVs will only scratch the surface of the problem not deal with route cause of the spread which is poverty!
As you probadly know there's about 50million people in africa whom are HIV positive, considering the cost of ARV i think you have no problem in most HIV positive people not getting ARV. The idea of ARV treatment in southern African countries is currently grossly misguided. I agree that the longer those who live with HIV live, the more new cases we have. It is more humane to avoid introduction of ARV, because more people will die. As long as older men are going for young girls and marital faithfulness is a foreign concept, then ARV treament should really not be introduced. This is not an emotional issue, but a national strategic issue as well as a practical issue. People do not ask for this disease. True, some people sleep around and just don't care. But some people might have caught this disease from a partner they thought was being faithful. There are different circumstances. This disease is terrible and everyone has the right to be treated. It is a shame that people know they have this and continue to spread it around. That is life though. Some people just don't care. Where I come from you do not catch HIV if you do not want it. HIV is strictly for promiscuous people or for people who are too desperate for sex to wear a condom or to wait for a test. You do not catch HIV if you do not want to, unless you are raped or you are injected with it at the government hospital, or ZANU PF uses it as a campain tool. I work with the research and development company who pioneered a remarkable science which specifically deals with repairing and maintaining the immune system. It is not self-proclaimed as people seem to think, tens of thousands of scientific papers have already been written about this, the science also took four consecutive Nobel Prizes. More than 2,000 doctors have quit the profession in the USA, simply because they can get better results in all areas with this approach. But now I'm waffling ................
I believe we should be doing everything we can to rid the world of this awful disease, putting judgement aside. It is very evident that even a killer disease is not going to stop people being promiscuous, as you quite rightly point out. So, tackle the problem of the disease........ if you can fight your way through the mountain of political garbage.
Good Bye! they need to get the facts out in order that other will not get infection like make a law and make it a jail time if they infect someone and know they have the diseases like in the state and it will stop and lower the cases but we still need to treat people who want to die horrible I seen people with age and I will alway treat them |
