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Wednesday, January 17, 2007

White people don't get HIV. Apparently.

Having moved from government (where the predominant culture is African) to a Northern Suburb private practice (predominantly white population), it has been absolutely mind-blowing to witness the the difference in cultural beliefs surrounding HIV.

Forget what LoveLife tells you. Forget what you've talked about with your friends. The truth is far scarier.

Don't get me wrong - I don't think white people ACTUALLY believe that they are immune to the virus - but they have this unbelievable disregard to the rules of "engagement", so to speak. It's baffling.

Why do white people think they can SEE a person who is infected? If a person "looks clean" – it's ok to bang them without using a condom? Argh.

And it is not about education... I have medical friends (who know the most about the disease and its implications) – yet STILL sleep around (one night stands or new relationships) without a condom or a recent negative HIV test.

It's irresponsible. And more frustrating than you could guess.

And then… there are those who are oblivious to the basic facets of human nature. Never underestimate a human's ability to be STUPID. I see a couple who "swings" - and still don't always use condoms. The rationale? They say that they are in a circle of swingers (5-6 couples) that only swing with each other... it's safe! Rule one: NEVER underestimate human nature. Do people not realize that all it takes is ONE to sleep outside the circle and the risk is introduced to ALL of them? What is the matter with people in this country?

HIV can wreck lives.

Case in point - a single episode of infidelity (genders, names and unimportant particulars have been changed to protect the identity of this person). One of my patients came to see me for an unrelated problem - I see him and his children regularly for typical GP stuff. They are the "perfect family" – and he, the near perfect father and husband.

During the consultation he nonchalantly asks whether he should be worried about HIV. Nonchalantly. After much probing it turns out Mr White Right had an extra-marital incident with a work colleague - who is, get this, "perfectly healthy and doesn't look ill".

I did the pre-counseling thing and pulled the bloods. HIV Positive.

It was the worst thing I've ever had to do. Perhaps I saw some of me in his situation? Perhaps I worried some of me would end up in this situation? Perhaps I culturally empathized – I don't know… What I do know – is that this man's whole world was destroyed with a single result.

It gets worse. He had been sleeping with his wife post-incident. Now, not only does he have to tell her about the cheating but also get her tested. If anyone has been in a relationship where they've had to deal with infidelity - they can empathise how truly awful it is... now you add an HIV test to the equation?

HIV can infect ANYONE! For crying in a bucket! You cannot tell who has it and who doesn't, especially in the early stages. In fact, if patients look after themselves – you'll barely know the difference until the last quarter of the disease starts running its course.

White people need to catch a serious wake up. This is NOT a black disease. It's NOT an African disease and it does not only occur in townships. Wear a freakin' condom and have yourself tested.
It makes me sick sometimes.

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18 comments:

Dave said...

Great post albeit very disturbing. Everyone needs to read this!

Andy Hadfield said...

It is hey? I remember SA Doc was devestated when this happened. And we've got so many friends who act in the same way.

Ag ja. Not to get preachy.

Kendall Jack said...

Bru, you are talking such kak. Sure the implications are HIV are horrendous. This is a given. but to assume that the risk faced by White people in LSM 6 - 8 is the same as the risk faced by Black LSM 1 - 5 is #R%#T spurious.

For the last 15 years I have made my living selling Life Insurance to suburban / serial monogamous White and Indian people, that have advanced in age, as I too have aged. Purchasing Life Insurance requires a mandatory HIV test. There simply is no getting out of it. And in 15 Years, thousands and thousands of clients, friends, old school mates, varsity buds, work mates, etc, NOT ONE has turned up Positive ! go figure !

No one is denying the consequences, or how it will bugger up ones life... but this disease simply does not feature on the radar within ENTIRE sections of the SA population. and that is a fact.

As a parent of two teenage children, my HIV / AIDS message to them is...

A B C D

1. Abstain while / where you can
2. Be faithful
3. Condomise
4. Demographic -- Keep to white upper class mates

Hey, it works for me and my clients !

Hazard said...

Racist and stupid. Go figure.

SA Doc said...

ALl my examples ARE white UPPER class people that I see regularly. I hope to God this is not what you are teaching your children.

You are the reason I wrote this article. Call me in 5 years when you start being affected by the virus in your naive subpopulation, and you radar starts beeping!!

SA Doc said...

I am not talking about a numbers game. Sure the percentage of positive "white" people is overshadowed by the numbers of HIV positive in the "black" population. But a statistical risk is still a risk. IT IS A RISK!

The risk of getting HIV from certain needle-stick injuries is less that 0.5%, yet health professionals (and other) will still take prophylactic medication. Why? because if its YOUR life on the line, you don't want to be a statistic!

You would do the same.

Now why shouldn't we treat sex with unknown partners the same. The risk in your "white upper class" population might be 0.01%. But are you willing to risk that odd?

It seems that the nonchalant patients I see are willing. Or maybe they are just ignorant to the risk (however small it might be).

Its still a risk and people - ALL PEOPLE- need to start behaving responsibly!!!

My article is simply meant to be a wake up all.

And whatever it is that you are now experiencing, it is NOTHING like what your children will have to experience and deal with in the future. The "D" in you ABC's can be more dangerous than YOU would want to risk!

kendall jack said...

nah, if you dismiss da argument as racist and stupid, it is clear that you are not thinking this thing out properly.

Firstly the consequences and the risks are different issues, and need to be separated. Secondly, one needs to look at the consequences for different demographic groups. And then the risks...

Mixing up the risks with the consequences confuses the whole business. The risks in my ( and probably your ) demographic are pretty damned low. Of course there are risks. Cheezes Rice, there are all kinds of risks. I face the risk of getting taken out by falling paragliders, getting bitten by radid dogs, being shocked by my toaster. But based on my experience and my understanding, my demographic / income group is simply not at risk from HIV / AIDS. My only experience of people close to my demographic group getting HIV AIDS are a limited amount of Gay Males, most of whom passed away in the late 80's.

The consequences are pretty drastic. HIV does not go away. And HIV leads to AIDS and AIDS will kill ya eventually. But what is to be done ? Take your muti ! The medicine gets better / cheaper by the month, and people who get HIV who follow the treatment regimen experience NO worse lifestyle than their peers, assuming they can keep up the treatment, keep their nutrition, etc. HIV Positive people have a better deal than those with other chronic conditions. It sure beats Chronic Renal Failure, or Insulin Dependent Diabetes ! cripes, if ya got HIV all ya gotta do is take your pills, eat right, don't smoke and follow the programme.

The other part of the consequences of demographically-advantaged groups is that they can INSURE themselves against HIV / AIDS in the same way that one can insure against Cancer / Disability, etc.. you can look forward to a big CASH payout from insurance, the ability to increase your medical cover, cheaper, better medication, and (pie in the sky) maybe a cure sometime in the future ! The at-risk Medical Professional, is nicely insulated from the consequences by his clever Old Mutual Policy !

Simply put, there is a certain part of society that (a) has a minimal risk, and (b) is well protected from the personal consequences.

My real risk is as follows..

I am ( and probably you too ) am at risk in direct proportion to the extent to which I am directly dealing with people who are at risk from HIV AIDS and the extent to which these people do not have coping mechanisms.. Clearly, as a person with some type of regular income, and some kind of asset base, a person like me ( and maybe you ) will be seen as the key part of the coping mechanism of those who don't have the bucks to sort themselves out.

Duh ! so the greater one is exposed to a population that has NO idea as to the risk, and NO method for effectively dealing with this pandemic, the great the risk to you ! That is the risk. and the risk is of being DRAGGED into the problem, attempting to sort out other peoples' problems, coz you are the only person with the means / the transport / the managerial ability. If I had 20 people working for me, and they each had a family of 10, each not in fixed employment... I would be the only person in 200 who could sort out personal HIV AIDS issues. and if out of 200 people, some will die each year, even if only 5% that means I am at risk for 10 HIV AID interventions per annum ! Sure I am at risk, ... But I know what i gotta do...

Champagne Heathen said...

Kendall Jack, please dear god tell me you are saying this all in some weird twisted jest.

Some of the things you said are textbook examples that people like me are doing our best to fight against. You are spreading irresponsible ideas, theories, and false hope behind pseudo-intelligence on a subject you seem ignorant to, because for some so-far-inexplicable reason you remain in denial about the situation.

AIDS is a personal problem. It is not about stats and risk analysis & all that scientific business bullshite. One dumb sexual move by you or someone you trust, & sorry for you; for the rest of your life you are infected with a disease that wreaks havoc in your & your loved ones lives.

I can promise you that ARVs are not one happy experience. There is a degree of truth in all the dissidents' talk about ARVs being like poison. It's just you'd rather be in pain from drugs than from the pain & multiple diseases AIDS wreaks on you. Every person infected with AIDS will tell you they'd rather not have the disease in the 1st place. Read AIDSAFARI by Adam Levin for an excellent explanation of the PERSONAL experience of this disease.

[His story should do well in smacking you in face for making such a ridiculous comment: "HIV Positive people have a better deal than those with other chronic conditions".]

Oh, but wait, he is a gay white man (Surprisingly he didn't die off in the late 80s & take the disease for his demographic with him, as you seem to imply). And we all know that gay men stick to gay men, hetreosexual married men never have homosexual affairs, white people remain in their racial & income sectors & are open about who they slept with & how. No one ever pays for sex from some crack prossie who wants drugs more than she wants a condom. Never ever is the risk daily exposed to your racial & income groups without you being aware! Or so your "insurance-based" theorising seems to lead you to believe.

Go & speak to people at blood clinics about how many people they see from WEALTHY & WHITE/INDIAN homes come in to have their CD4 counts & viral loads checked etc. and then come back & tell me just because YOU have never had a client come back with a HIV-positive result that HIV is not an issue in your clients' sector.

Meanwhile, to talk your stats language:
6% of the white SA population IS KNOWN to be infected with HIV. This is the amount of people who have been wise enough (forced to) take the test through public facilities. As SA Doc says, white people in this country are privileged enough to maintain healthy lifestyles, so not realising until the final AIDS stages that they are infected (and so having infected many other people in their IGNORANT RACIST CHAUVINIST thoughts & behaviour). We have yet to really see the wealthier SA groups dying from AIDS, give it a few more decades.

White people in this country sleep around, and from my experience, the wealthier the individual the more they get off on decadence that involves shagging people from all other sectors - prostitutes, man-to-man sex, single chicks, street kids in Hilbrow, other married people.

Please explain to me, as I deal with HIV facts, where this fact comes from..."but this disease simply does not feature on the radar within ENTIRE sections of the SA population. and that is a fact."

"The risks in my ( and probably your ) demographic are pretty damned low." This means that the risk still exists and so, with HIV not really giving a fck about stats & numbers being such a unpredictable virus, ANY risk is bad & can lead to you dying from a painful death AND our already overstretched health care (and insurance) systems having to foot the bill.

That's all for me for now. I could continue but my head hurts now from frustration & disbelief.

Stii said...

White people can't get AIDS?! They can spot infected people?! Thats the dumbest thing so far in 2.007 I've heard!!

K Jack said...

If you are so clever, answer the following question....

1. How does it come to pass that different groups in society have completely different risks to this illness ?


2. How come different groups in society have completely different coping mechanisms for this illness ?


3. What are my % chances of getting this illness in a two vastly different societal segments.

4. What is my prognosis under two differing societal segments ?

supply me the answers. Intelligent people can see if they are really at risk, based on proper information.


( in the same way that i know that 1100 people will be KILLED on the roads between 1 Dec and 12 Jan each year, I still go on holiday in my car, in the full knowledge of the small - yet horrendous - risk i face )

Gimme the HIV AIDS risk. Not the bloody consequences. the RISK

Champagne Heathen said...

K Jack - less "clever" than I am "informed" & "trained" on this particular subject. I will try to find you comprehensive reports on the web tomorrow.

1. Are all risks completely different between these groups? Nope. Some are shared. And it is those you should be concerned about. If you are exposing yourself to other people's blood and bodily fluids, you are at risk from a disease that could not give a damn of the colour of your skin or money in your wallet.

I think you should also say, rather than "Intelligent people can see if they really at risk...", "EDUCATED people...". Or "Schooled people". People who have been made to think in particular paradigms that seem to sometimes close their minds off from realising human behaviour is not mathematical & predictable. It is not easily analysed or given a percentage. It changes. It adapts. And so to, do factors that threaten humans.

Right now we are being faced with a disease that attacks us through one of our most base instincts; sex. When, how & who we have sex with are based on social & cultural principles as well as our psychological life lessons - healthy or fetish in nature. These principles are flexible and EASILY breakable, and so NOT predictable in a manner that can be scientifically analysed. This allows for the chance for people to have sex in higher risk manners (anal sex, dry sex, unprotected sex, with a person from a higher risk group - like a prostitute, needle-drug-user, or a person who lives in a higher-infection area) AND with people from groups that one's society might not approve of.

There are countless examples of people going against the Apartheid society's ridiculous notion of conducting sexual relations along racial lines. And now, our multicultural society has adapted its principles to accept (and even champion) sex between races and income groups. My generation does not seem to have an issue with interracial relationships, even if the person's just a fck buddy. The next SA generation is going to be even less concerned about race when looking for love or to satisfy their base instinct.

This long winded explanation is to show you that while ECONOMICALLY our society is divided into 1st & 3rd worlds, SOCIALLY we are not abiding, nor ever actually have abided, by this. People fck one another based on desire and need, and so is HIV able to infect A N Y B O D Y where such an active instinct exists.

Let's take the example of some rich white chick going out in Newtown or Melville one night. She meets some cute black guy from Alex or Soweto. She's always held a fetish about screwing a guy from "the wrong side of the tracks" ESPECIALLY if he is of the "wrong" race group. Or hell, possibly cause she is just REALLY attracted to the guy. This guy is infected with HIV. He infects her. She then goes back to her rich white world, and out to Rivonia one night. She meets an ex-private school "nice" white boy. They have a one nighter or get into a relationship. She never mentions her one-nighter with a poor black guy. The white guy meanwhile says that she's rich, she is educated, she LOOKS clean. He is sure he is fine. No condom. He gets infected. He then screws other white chicks and so the multiplying goes WITHIN YOUR DEMOGRAPHIC! SA Doc gave a real example of that right here!

So stop thinking about percentages and numbers! You are not aware of all the factors at play with HIV so doing an adequate-enough risk assesment is beyond difficult.

Yes, people from poorer income groups have further factors outside of those ones they share with you. In order to get money women & children are having to sell their bodies. Sometimes the demand from their clients is for condoms not to be used. Some of their clients are rich whities! Women from certain cultural groups are not allowed basic rights or are faced with discriminatory traditions - such as a man inheriting his brother's widow, even if the brother died of AIDS.

Please do not believe that factors of poverty are the only factors allowing the spread of this disease. Yes, perhaps they have simply intensified its spread FOR NOW through the groups who are at risk from factors of poverty. Behaviour I witness within my country, from personal experience, let alone what I am told, shows me that people from all demographics in SA continue to allow themselves to be placed at risk, to open themselves up to the factors that allow for the transmission of HIV.

One way in which you can actually analyse the risk though is for both of you to go for a HIV test before you shag the person. Which is what I want in the 1st place. So I am happy. And then hope to all hell they don't go and expose themselves to HIV while you are in a trusting sexual relationship.

No one here is saying stop having sex. You did say that you told your teenage kids to be faithful (and hope their partners are in return!)and to wear condoms, which is excellent. But to tell them that HIV exists ONLY in certain demographics is irresponsible and short-sighted. HIV exists in the white/ indian communities already. So what if the number is low at present. It exists & it could be present in the blood of the person you kid next chooses to have sex with. You do not know, no matter what the percentage rate is nationally. Unless white people stop acting so nonchantly about a terrible disease the HI virus will be allowed a field day to spread itself rapidly. Do not allow yourself or your children to be lulled into a idea that taking high risks with this disease (such as unprotected sex with a rich white person when you do not know their status) is ok, just because of external NON-factors in the spread of HIV.

K J said...

You still don't give the stats. you are so hooked up in the possibilities, the consequences, the horror of it all, you can't come up the numbers.

We are all adults.. GIMME the blerry numbers.... I challenge you to enumerate the risk, in some recognizable format eg ( x deaths per y people, in timeframe z, for a given indivual, of specific age / race / gender / income )

We all face many risks. let's see where this thing really sits, then i and other thinking people will allocate appropriate resources towards dealing with it.

THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE
THE NUMBERS PLEASE

thanks

Champagne Heathen said...

Thanks for what? For assisting you to play around with HIV?? I am sorry. I cannot.

I have percentages that are vague. I do not know of any formula yet devised to calculate the risks because there are too many factors at play. It is not simply demographic groups that define your risk.

Honestly, you are being ridiculous. All you want is a number with a percent sign behind it to lull yourself into some sort of denialism that you, your children and loved ones could be at risk?? That a medical risk is based on the colour of skin & on income groups?

I refuse to contribute to your incomprehensible attempt to allow yourself and your children to be put at risk.

Why do you not do a course in HIV training and information. You will find percentages there. You will also read that these are ridiculous to go by. UNISA offers an excellent 4-month Care & Counselling HIV course where you can obtain such information for yourself, while also having it placed in context and reality.

Give me a percentage of the risk of people falling pregnant through unprotected sex. How often do people fall pregnant by mistake. And then realise the miniscule size of the HI Virus cell compared to the size of a sperm cell.

Or why do you not visit Bara or Jo’burg Gen, or even the Lancet clinic in Rosebank and ask those doctors and nurses for AIDS stats and then of the reality of AIDS, which you seem set on toying with.

And while you are there, be sure to get a complete profile on yourself and those people you have had sex with – include your race, your income group, the number of times you have had unprotected sex or been in a high risk situation, the number of times those you have had sex with have had unprotected sex with other people and been in high risk situations, and also drug habits. Include how your & the other person’s immune systems were functioning that day. If they have the virus, where along in the sero-conversion process they were. What sort of sexual activities you engaged in. Where you live in SA & whether this is a higher-prevalence area (some places are known to have a 80% prevalence rate). Your nutritional status, your general health status etc. etc to the MANY other factors involved of which, you a layman to the topic, are not aware.

Go for an AIDS test through a proper Voluntary & Counselling Testing site. These people can give you information applicable to you & tell you about the reality they experience through this disease. Oh, but wait, in general your richer South Africans do not go through public clinics for such tests so the nurse will not be able to offer a proper demographic break down of the many people she has had to inform are HIV positive. So then rather speak to a GP. But wait, this whole post was written by a Northern suburbs GP who is saying to you here and now that she has experienced having to tell a rich white male in denial that he was HIV positive, and so might be his wife, and this disease is having a direct & incredible impact on their family now.

“Adult” is a definition of age, not an idication of intelligence or responsibility. And you are not being responsible by using a number to lull yourself and your loved ones into a false sense of security. I hope that your children always take active precautions against this virus and other STDs. And I hope that neither you nor your wife has extra-marital sexual relations, so putting you at risk to that 1-6% of the white population KNOWN to be HIV-positive. But knowing full well how ridiculously in denial and closed off to reality the white SA population is, I believe that this statistic is under exaggerated.

But you take the risk. Play Russian Roulette for absolutely no logical or intelligent reason. May luck and the percentage sign be on your side.

Read & follow links from these:
http://www.unaids.org/en/Issues/Impact_HIV/Socio_demographic_impact.asp
http://www.unaids.org/en/Issues/Impact_HIV/default.asp
http://www.unaids.org/en/Issues/default.asp
http://www.hst.org.za/healthstats/
http://www.tac.org.za/hivhelp.html
http://www.hst.org.za/healthstats/84/data
http://www.hst.org.za/publications/697
http://data.unaids.org/pub/EpiReport/2006/04-Sub_Saharan_Africa_2006_EpiUpdate_eng.pdf
http://www.unaids.org/en/HIV_data/epi2006/default.asp

(ANC stands for Antenatal Clinics, where most stats are recorded)

K J said...

Thanks for giving nothing useful

RISK = http://en.wikipedia.org/wiki/Risk

Champagne Heathen said...

Pleasure.

And I do actually hope that no incident ever happen to you or your loved ones to prove you wrong in your ignorance, denialism, and narrow mindedness.

It's been a pleasure k j. If ever you are wanting to ignore & fight about researched facts & situations about HIV & the medical world you know where to find us!

Champagne Heathen said...

k j - if we are into sending links to prove our points... http://www.mg.co.za/articlepage.aspx?area=/breaking_news/breaking_news__national/&articleid=297442

It's a Mail&Guardian link to an article titled: Aids rises among SA's rich, say researchers

Anonymous said...

What an idiot! this man should have been castrated before he was able to have kids. The real issue at hand here is not AIDS but the spread of ignorance from dumb parents to their innocent children. People please dont get the kids involved!! please!

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