Many people are fond of saying that HIV is a chronic disease these days -- comparable to diabetes. Do you agree with this statement? Why or why not?
I was recently asked this question, and it made us both start thinking. What with the medical advances of the past decade, and the miracle of antiretrovirals (at least those of us who are blessed to be able to get them), we HIVers are living these days. I've heard of people who have been alive for the full 30 years of the known epidemic. Through my work, this blog, and reading I've been doing from people living with other chronic diagnoses, it seems that there are a lot of comparisons to be made. And yet ...
In terms of disease process, I have been reading lots of articles lately about the effects of long-term inflammation (caused by the HIV virus) on the body. I have experienced, myself, a slow and steady decline in my personal energy and stamina, and I've started to notice that when I get sick, it isn't really just a cold anymore. Often, other little buggies help themselves to my body at the same time. It seems that I have perhaps come to a place through faithfully taking my medications as prescribed where I am okay -- but slowly getting worse?
People I know who have diabetes describe their diagnosis in a similar way. I have heard it described as a "slow death," a falling apart of the body in little pieces. I hear people describe the depression that comes from dealing with all the little, sometimes imperceptibly small changes in health. The struggle of daily taking medications, of fighting with insurance companies, of attempting some kind of life. I have heard from people who deal with the financial difficulties a chronic health problem causes. Like HIV, diabetes left untreated is fatal. Really, we can all relate to one another. Our stories share a common thread -- we speak the same "language" of the sick. In these ways I think that HIV is just like any other disease.
And yet, it is still very difficult to tell people that we have HIV. People assume things about me based solely upon my diagnosis -- things that are not true. I did contract this virus as a consequence of my own choices. But these same things can also be said about people who live with diabetes. The difference is that with HIV we are dealing with more morally charged choices than those that lead to diabetes or heart disease. Or are we?? And really, does it matter how we got sick? Do we have to blame the sick people?
It seems to me that in some ways we WANT HIV to be different. Historically this epidemic has carried with it political fights, human rights issues, and great stigma. Being of the age, sex, and geographical place I am in, I know I do not fully appreciate these realities (although I do try through listening to others, reading, etc., to gain some understanding). I know that we walk a thin line -- trying to educate others to make smart choices and thus stop the epidemic, while at the same time trying to create compassion for people who are truly sick, suffering, and dying. Perhaps that is the challenge in attempting to prevent ANY disease.