“I was afraid when I was diagnosed. Now I encourage others to get tested for HIV (Human Immunodeficiency Virus). With daily antiretroviral therapy (ART), I maintain a healthy lifestyle. I haven’t had many side effects and am very thankful that I got tested,” said the woman when talking to her at my former job at Saint Boniface Hospital in Haiti. I still remember her face, beautiful and bright-eyed with a smile so big you would think she owned the world.
That was not my first encounter with someone living with HIV. In the past, I interacted with patients who tested positive for HIV at Hopital Universitaire de Mirebalais in Haiti, Kibong’oto Infectious Diseases Hospital in Tanzania and at the Centre for the AIDS Programme of Research in South Africa. According to the World Health Organization (WHO), 300,000 HIV deaths occurred among people infected with both tuberculosis and HIV in 2017. In my work in the field of tuberculosis, it has been common to interact with patients who have a positive diagnosis for HIV.
This woman stood out because she is using her positive diagnosis to engage others in her community. By sharing her story, she makes it clear that infected individuals can change the outcome of their life simply by obtaining early testing. Today she is boldly and fearlessly bringing awareness to HIV in Haiti and within her community.
I realize that seeing the woman in Haiti as a community advocate and a colleague normalized the situation for me. It was no longer a disease that inhibited her but rather one that empowered her to advocate for early HIV testing in the community.
As Americans become disproportionately affected by the COVID-19 pandemic, I wonder how we can use the lessons learned during this time to become advocates for others in the world? How can we increase awareness, not just for COVID-19 but also other diseases?
As a child, everything I knew about HIV came from the movie “Philadelphia” in which Tom Hanks’ diagnosis of HIV and his sexual orientation resulted in a significant amount of discrimination. The movie depicts the stigma associated with not just HIV but also with homosexuality and all sexually transmitted diseases (STDs). In the time since HIV was discovered in the 1980s, much has changed. People who are on ART can lead healthy lives if they obtain proper nutrition, exercise and refrain from smoking. As a community, we have learned a great deal about the disease. However, the social stigma persists — especially as the number of STD cases rises.
In the U.S., approximately 37,000 people received an HIV diagnosis in 2018. It is not surprising that the Centers for Disease Control and Prevention (CDC) and the WHO have dedicated resources for disease-associated stigma on their website.
According to the CDC, STDs are on the rise in the U.S., yet there is a lack of awareness about them in our communities. In 2018, syphilis increased by 14% to more than 35,000 cases, gonorrhea increased by 5% to more than 580,000 cases, and chlamydia increased by 3% to more than 1.7 million cases. Congenital syphilis is on the rise, with a tragically high number of newborn deaths. Another common STD is human papillomavirus (HPV) infection. Most sexually active people become infected with HPV at least once in their lifetime. While 90% of the people clear the infection spontaneously and have no associated health problems, those who are not able to clear it could develop genital warts or cancer.
Unfortunately, Americans do not discuss STDs openly, in part due to a puritanical attitude towards sexual activity. According to a piece published by sexual health experts, a fulfilling sex life is an essential part of one’s well-being. Even so, most households, school systems and religious institutions shy away from having open and lengthy discussions about safe sex and the effects of unsafe sex.
A great example of an organization that provides STD testing and counseling in a confidential and respectful manner is Planned Parenthood. The organization, which originally opened in 1916 as a birth control clinic, now has a global presence with partnering organizations in approximately 12 countries. In addition to all the services the organization provides, over the years it has been a leading organization in advocating for the rights of all people to have proper sexual and reproductive health.
An article published by Business Insider indicates that due to an increased focus on the COVID-19 pandemic at this time, fewer people are getting tested for STDs. In some states, public health workers who were focused on caring for patients in the community exposed to STDs, are now working with COVID-19 patients. Therefore, some of the focus from STDs has shifted to COVID-19. Unfortunately, this may lead to a further increase in the rates of STDs, post-pandemic.
While many of us may not personally know individuals who are affected by STDs, COVID-19 is teaching us that awareness and discussions are vital during this time. We are learning that as we hear more about people’s personal experiences with the disease, our perspective of the disease changes. We do not discriminate against people or their families if they are infected with COVID-19. Instead, we empathize with them more. In that light, maybe it is time to encourage our communities to openly discuss STDs, their effects, and ways to mitigate spread.
In the same manner that we have come together to learn more about COVID-19 transmission and take necessary precautions, we can harness the humility and openness to discuss other diseases, in a matter-of-fact way. We can humbly accept that, as living beings, we are susceptible to illnesses and diseases, and by increasing community discussions we will enhance our ability to fight against them. I believe this is a great time for us to focus on diseases that are on the rise in the US and remain a taboo subject. Only then will we, as a community, be better equipped to fight against STDs.