Lack of ARV Supply?

Finally, I got my ARV's after the reported shortage in HIV hubs in the country. PLHIV have been anxious for the past few weeks due to depleting supply. If some of us used to get a 3-month supply of ARV, we were only given a 1-moth supply for the past few months. In some hubs, PLHIV were only given a 15-day supply. Who wouldn't be anxious about that? ARVs are our lifeline. They prevent HIV from replicating and damaging our immune systems.  To put in layman's term, ARVs act as containers, imprisoning the virus in an enclosure, thereby preventing it from multiplying outside its container. But the container has an expiration. They are effective for a mere 12-24 hours only. Beyond that, the container disintegrates, and the virus will get out of its cage, and attack other healthy immune cells (CD4). Of course, low CD4 means AIDS, which makes the PLHIV prone to opportunistic infections that may be fatal.   

So, PLHIV need to take ARVs for life, at exactly the same time each day, to keep the virus within the container. A missed or late dosage can cause the virus to replicate and damage CD4 cells. Worse, if this happens frequently, the virus may become resistant to the drugs, and get out of the container despite intake of ARV. If the virus becomes resistant to all known ARVs, guess what happens? 

That's how crucial timely ARV is. I believe those people from Customs are ignorant, and outright stupid for not knowing this, which reportedly caused the delayed release of medicines from the port. You guys are putting our lives to danger!  

Of course, this could happen again in the future. I guess I better start finding out if I can go to Bangkok or India as a last resort, to buy ARV in case something like this happens again.  

Anyway, the good news is, PLHIV  have been ecstatic. After the push from HIV advocates, ARVs have already been delivered to various HIV hubs. And one more good news. The 3-in-1 drug (combining lamivudine, tenofovir, and efavirenz in 1 tablet) is now available in the country. I got mine last Friday. If before, I had to take 1 lamivudine and 1 tenofovir at 9am, 1 lamivudine at 9pm, and 1 efavirenz at 11pm, now I only have to take 1 combo drug at 11pm! Less risk of forgetting to take the pills.

Less chance of delayed intake. And, since most of my friends don't know I'm positive, it's now easier to conceal my drug intake, especially if I travel with them. I can just say, it's time for my nightly vitamins. I can't use that reason at 9AM, 9PM and 11 PM! Who takes vitamins 3 times a day? :) And, one more thing, I checked the manufacturer. The new drug is no longer from Ranbaxy. Ranbaxy is the manufacturer of my Lamivudine and Tenofovir. And according to this article, Ranbaxy pleaded guilty to felony charges and paid a USD 500M fine last year. This is a relief. 

But dude, the new pill is HUGE!! It's 3 in 1, what do you expect? hehe. It's bigger than Kirkland Multivitamins by 1/6. Indeed, it's a giant pill! But this is still a lot better than 4 tablets taken at 3 different times a day :) So... rejoice! 

It's Valentine's Day

 Oh! It’s Valentine’s weekend.  

Back in college, it meant nothing to me, as I didn’t have a partner at that time. To me, it was just an ordinary day. The only difference is I get to see “other” people giving and receiving flowers. That’s it.

When I had a partner, my Valentine’s days changed. But still, we celebrated it in an unconventional way. As we were not a “normal” straight couple, we could not openly have a Valentine dinner in a cozy restaurant. What would people think if they saw us romantically having dinner on a Valentine's night?  In some years, we even just practically skipped having dinner on the day itself, and just celebrated it on the 13^th or 15^th. That’s fine… we’re not out and we don’t want to be the topic of gossip. The bonus is, we avoided monstrous traffic jams and crowded restaurants.

This year is another milestone. I still can’t openly date my partner on a Valentine’s day as we are still not out. But the main difference is I can’t have dinner out with him on this occasion, not on the 13^th, 14^th, nor 15^th, nor a week before or after Valentine’s Day. Why? Because my CD4 is still low. My partner doesn't want me to risk going to crowded places and catch people’s viruses and microbes.

So my Valentine’s Day this year is just like my Valentine’s Day during my college years. It was a normal day, except that I saw my workmates displaying bouquets of flowers on their desks. 

But, that’s fine. I'm not complaining because I know this “college” Valentine is only temporary…. up until my immune system recovers.  Next year, I’m sure we’ll be back to having a dinner on the 13^th or 15^th. Still not on the 14^th… because I still have the closet. As they say it… this too shall pass. Happy Valentine’s Day everyone! 

Oh, before I forget, thanks to my iPhone’s Waze app! I discovered a new route from work to home. Surprisingly, this route only took me 35 minutes to get home on a Valentine’s night. So, I was still able to do a dumbell work out when I got home, before dinner. Amazing! 

Would You Rather Have Cancer or HIV?

This question popped into my mind when I was diagnosed as positive. Cancer and HIV have similarities. They are serious and dreaded. And people fear them. Cancer, if diagnosed at a late stage, can be fatal, and may even cause so much pain to the patient. On the other hand, HIV at an advanced stage, may or may not be fatal. Many PLHIV even with advanced AIDS cases do recover, thanks to ARVs.  

But why does it seem like people are more fearful of HIV? Simple... due to ignorance. To most people, including myself before my diagnosis, AIDS is death. They don't know and refuse to know how modern HIV medicines have advanced. Another reason is stigma. HIV doesn't always kill. Stigma does. Stigma makes HIV bigger than the virus itself. 

What do people with cancer get upon diagnosis? Sympathy! Friends, family, and relatives suddenly show utmost care and empathy. They openly offer prayers, love and support.  

On the contrary, what do PLHIV get? Disgrace! They become objects of gossips. People look at PLHIV as immoral, equating them to prostitutes and sex maniacs. People look at them with sodomy, disgust, and prejudice in mind. 

As a result, PLHIV hide in closets. They camouflage their illnesses, opportunistic infections, changes in skin conditions, and physical appearances. Having pneumonia for "normal" people is difficult enough. But what is worse is to fight pneumonia, TB, and other AIDS opportunistic infections while pretending to your friends and work mates that you are just on an extended vacation. PLHIV are in constant stress to keep their illness in their security vaults. Worse, some PLHIV even commit suicide. Some family members disown them. And a number fall into depression. 

Stigma! This magnifies the suffering of PLHIV. Unfortunately, I don't see this ending soon.  No, at least not in this generation.  

Going back to my question, Cancer or HIV? Many will definitely not choose HIV, all because of stigma. That's quite easy to understand. It's difficult to fight stigma. It's difficult to live in the closet, fighting for your life without your dear friends and loved ones. 

As for myself, would I rather have cancer or HIV? Knowing the facts, I'd choose the latter. I value life more. I want to live, and HIV offers a higher probability of having a normal life. PLHIV can recover and re-live their lives. I can endure stigma. I can hide my virus from my friends. I can endure not getting their support during my difficult times in the hospital. I can discreetly take my ARVs at exactly 8pm daily for the rest of my life. I can always make reasons on why I no longer drink beer. I can forever invent reasons whenever I go to my HIV hub to get my supply of HIV drugs and CD4 test. I can forever lie on why I suddenly stopped eating sashimi and medium rare steak. I can forego traveling to HIV-phobic countries like UAE, China, Singapore and Malaysia. Yes, I can forever hide in my ARV closet. I can live with that. If at the end of my battle, I will regain my life back, I would consider stigma as a little sacrifice to pay. But can you image how much easier the battle would have been had there been no stigma? In any case, I'm still lucky to be living in the era of ARVs. 

Someday, there will be a cure for HIV. But before that momentous day happens, I hope people will look at PLHIV just like people with hypertension or diabetes - no stigma. Stopping stigma starts with me.