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Reged: 11/30/04
Posts: 113
Loc: United Kingdom.
Re: HIV Care US vs. India and Living in the Mid East
      10/07/11 11:46 AM

Hello, SMARS.

I used to live and work in the Middle East. (I'm from the United Kingdom.) I lived there from the late 1980s, so I know well what difficulties face people who have HIV there, although personally I did not have HIV while living in the Middle East. (I contracted it after leaving.)

Firstly, I second everything that Cublatin has already advised.

Your brother must leave the Middle East. Perhaps this will be hard for him, perhaps he is well set-up there and hoped to live there for many more years, but it is very very far from being the best place for any person who has HIV, including HIV Middle Easterners. As Cublatin has suggested, as soon as officials discover your brother is HIV he may well be deported, although this may vary depending on which state exactly it is in which he is living. Being deported is a most unpleasant business. You are treated like a criminal and escorted from office to office by local police until such time as they have physically loaded you onto a plane.

When I was living in the Middle East, long before the antiretroviral drugs became available, I was introduced to an American citizen who had AIDS, who was working at a hospital, and who was hanging on in the Middle East for as long as he could. He was often too sick to go to work. He had a Western doctor immediately above him and this Western doctor helped protect him, he "covered" for him - although, of course, he was not able to help him with any kind of treatment. But the point is that I used to visit this ill man at his home and I observed the psychological pain he was going through, never mind the physical pains associated with weight loss and loss of appetite that he suffered from. He got no more sympathy or help than that which I and one or two other local acquaintances were able to give him. He was nowhere near an HIV/AIDS support network. This is the point. Your brother now needs to be near such a network. Eventually our ill friend got so ill that he had to resign his job, pack his things while in a sorry state, and fly home to the States. He died shortly afterwards - but that, of course, was in the days when there was no treatment.

So, there is no question about whether your brother should return home. The matter is: how urgently he must do so. This depends upon the date of his infection, how long he has been infected, how soon his CD4 count will drop to dangerous levels. If his CD4 count is currently extremely and unusually HIGH and is viral load is unusually LOW, then he need not panic and he can go about arranging an orderly and "normal" return to his home country, keeping quiet about his condition and not jeopardising documents and references etc. that he may require when he seeks re-employment in the USA. If, however, his viral load and CD4 count are now at levels that would concern an HIV specialist, then he must simply leave the Middle East as quickly as possible and get himself back home and into the hands of a professional HIV clinic in the States.

What if you give your brother's viral load figure and CD4 count to an HIV specialist in the States, or even ask a question of one of the Experts here at The Body, and they advise that he need not start treatment right now? Your brother might then consider that he can hold on, take a test every three months at some clinic outside the Middle East, and postpone departure from the Middle East until his levels indicate he must start treatment. This might sound sensible. However, there are all sorts of reasons why this is NOT wise. For example, he could have a health problem occur in the interim and it could be HIV-related and his Middle East doctors may therefore need to know he is HIV in order to give him an appropriate treatment. But once they find out, they will probably be obligated to document his HIV status and he will be deported while ill. Or he could have an accident, his HIV status might be discovered, perhaps by an enforced blood test, and that is likely to mean immediate, and embarrassing, "deportation". But, most importantly, he could keep his HIV secret for, let's say, three or four years, not manifest any symptoms, and then the next time he takes a test discover that his levels have suddenly fallen dangerously low since the last test. This can happen. It happened to me while I was living here in the UK, and despite living here in the UK it was then a matter of some urgency and panic to get me on a combination of anti-retrovirals IMMEDIATELY before any further damage was done to my immune system. Also, the ARVS I was put on required fortnightly monitoring at the clinic for the first couple of months to ensure that my internal organs were able to cope with them.

So if your brother doesn't need treatment already, he needs to PREPARE for the day when his HIV clinic says it's time for him to go on a combination. He needs to be at home, with a medical support network in place, and, hopefully, with his new home and employment situation at home also sorted out and in place.

If your brother is entertaining the idea of receiving treatment from a clinic outside the Middle East and then passing through Customs at Middle Eastern airports with three months' worth of bottles and bottles of HIV tablets then he is in for some embarrassing trouble, regardless of which country he is from or from which country he acquired the medications! I shall never forget returning to the Middle East after a holiday in India and having every single thing in my suitcase meticulously examined. When the customs official opened my toiletry bag and found a couple of foil-packed sheets of white paracetamol tablets, he popped each tablet out, sniffed them, broke them, and even put them to his tongue. I have never been so insulted in my life. And that was just a dozen paracetamol tablets!

Maybe your brother needs to know that once you are on treatment, you leave a clinic every three months with a BIG bag full of about nine boxes of bottles or foil-sheets containing scores of tablets. Currently I take 4 tablets a day: so that's a bag of 360 tablets once every three months. Clinics usually pop these tablets into a large anonymous-looking brown paper bag to ensure patients' confidentiality: and that's here in the West!

I hope all of the above helps. Good for you for posting your question here. The Body is an invaluable resource for people with HIV from all over the world. It's the best such site on the planet. People in many countries rely on this site. Get your brother to study a little bit of it every day.


Without a dream, life is a broken-winged bird that cannot fly. Keep hold of your dreams.

Post Extras: Remind Me!     Notify Moderator

Entire thread
Subject Posted by Posted on
* HIV Care US vs. India and Living in the Mid East SMARS 10/05/11 06:55 PM
. * Re: HIV Care US vs. India and Living in the Mid East BrokenWingedBird   10/07/11 11:46 AM
. * Re: HIV Care US vs. India and Living in the Mid East SMARS   10/13/11 03:25 PM
. * Re: HIV Care US vs. India and Living in the Mid East cunta_stalwart   10/14/11 04:43 PM
. * Re: HIV Care US vs. India and Living in the Mid East cublatin   10/06/11 07:33 PM

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