HIV AIDS in SWAZILAND-GAILS PERSPECTIVE

Hi Again Everyone,

This is a big week of milestones for the Messicks in Swaziland – 1 year ago today we had our Swearing In Ceremony and officially became United States Peace Corps Volunteers assigned to help fight the HIV pandemic in Swaziland. On Thursday 26 Aug 2010 we moved to the Nhlangano area and began our work at the children’s home. And we are scheduled to complete our Peace Corps Service on 22 August 2012—less than a year away. Where did the time go ?? To celebrate our first year in Swaziland I have decided to take a step back and review some of my training materials and see what I could make of this HIV/AIDS crisis in my little part of Swaziland.

So, here it is: HIV/AIDS in Swaziland According to Gail’s Perspective - Part One
Before I arrived in Swaziland, I thought I knew a fair amount of info about HIV. After all, as a hygienist I certainly knew how it was transmitted and how to protect myself. Beyond that, I really didn’t know many details, since it really wasn’t part of my world. Here are some facts I learned, as it helped me gain an understanding of how things got out of hand in Swaziland. HIV is spread by direct contact of body fluids, usually via sexual contact or sharing of needles. What I did not know, is that once the virus has been transmitted, the recipient may show no signs or symptoms, except possibly some mild flu-like symptoms. During the first 3 months the virus replicates relatively unchecked, actually using the CD4 cells (which arrive to fight the virus) for replication. Thus, before one knows they might be infected, their viral load is very high, and they are the most able to spread the virus to others. During that 3 – 6 month timeframe, the immune system becomes amazingly good at trying to contain this virus. By about 6 months time, the immune system has stabilized the virus, and most adults who are carrying the HIV virus will look and act quite healthy and normal. (although they will test positive for HIV and still can pass it on to others) They will be able to remain in this state for perhaps 6 – 10 YEARS! (sometimes even longer). So, unless one voluntarily goes to the clinic to get tested, they might be transmitters and not know it. Only after this 6 – 10 yr. period does one “look sick”, because now the immune system can no longer fight the virus and they develop diseases like Tuberculosis, Pneumonia, etc. A person can have sexual contact with an HIV positive individual and not get HIV – it depends on their viral load, and your health (do you have a sexually transmitted disease, are there any lesions in the area of contact?) Or, a person could have sex only once with an HIV positive person and contract the virus. HIV positive pregnant mothers don’t necessarily pass the virus on to their children at birth – in 2003 the rate was about 40% in Swaziland – again depending on the mother’s viral load. Now there are relatively easy measures to reduce the mother-to-child-transmission (MTCT) – which are to administer the ARV’s (antiretroviral) medication in the late stages of pregnancy to reduce the viral load of the mother. If all pregnant mothers took these precautions, the rate of MTCT could be reduced to 1 – 3% of births. However, denial can be very powerful, and thus far, in 2010 the MTCT here is only down to 20% of all births are now infected. In real numbers, Swaziland has about 27,000 live births annually. We know that about 39% of those women are HIV positive and if 20% of those don’t receive the preventive treatment, about 2,000 babies are born HIV positive each year. That is about 1700 MORE babies born HIV positive, than would be if all pregnant women were to take proper precautions. So, we’ve got a lot of work to do.

That’s all for now – I’ll send Part 2 later – How did HIV fit into the Swazi culture in such a way that they now have the highest incidence in the world.
By the way…all is still good for Mike and I in Swaziland, especially since Spring has arrived and we’re enjoying warmer weather. Gotta go teach the pre-schoolers.
Love To All, Always, Gail and Mike