Archive for March 13, 2010
Know the Basics
What is HIV and how can I get it?
HIV – the human immunodeficiency virus – is a virus that kills your body’s “CD4 cells.” CD4 cells (also called T-helper cells) help your body fight off infection and disease. HIV can be passed from person to person if someone with HIV infection has sex with or shares drug injection needles with another person. It also can be passed from a mother to her baby when she is pregnant, when she delivers the baby, or if she breastfeeds her baby.
What is AIDS?
AIDS – the acquired immunodeficiency syndrome – is a disease you get when HIV destroys your body’s immune system. Normally, your immune system helps you fight off illness. When your immune system fails you can become very sick and can die.
What do I need to know about HIV?
The first cases of AIDS were identified in the United States in 1981, but AIDS most likely existed here and in other parts of the world for many years before that time. In 1984 scientists proved that HIV causes AIDS.Anyone can get HIV. The most important thing to know is how you can get the virus.You can get HIV:
- By having unprotected sex- sex without a condom- with someone who has HIV. The virus can be in an infected person’s blood, semen, or vaginal secretions and can enter your body through tiny cuts or sores in your skin, or in the lining of your vagina, penis, rectum, or mouth.
- By sharing a needle and syringe to inject drugs or sharing drug equipment used to prepare drugs for injection with someone who has HIV.
- From a blood transfusion or blood clotting factor that you got before 1985. (But today it is unlikely you could get infected that way because all blood in the United States has been tested for HIV since 1985.)
Babies born to women with HIV also can become infected during pregnancy, birth, or breast-feeding.You cannot get HIV:
- By working with or being around someone who has HIV.
- From sweat, spit, tears, clothes, drinking fountains, phones, toilet seats, or through everyday things like sharing a meal.
- From insect bites or stings.
- From donating blood.
- From a closed-mouth kiss (but there is a very small chance of getting it from open-mouthed or “French” kissing with an infected person because of possible blood contact).
How can I protect myself?
KNOW THE Basics
- Don’t share needles and syringes used to inject drugs, steroids, vitamins, or for tattooing or body piercing. Also, don’t share equipment (“works”) used to prepare drugs to be injected. Many people have been infected with HIV, hepatitis, and other germs this way. Germs from an infected person can stay in a needle and then be injected directly into the next person who uses the needle.
- The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual intercourse, or to be in a longterm mutually monogamous relationship with a partner who has been tested and you know is uninfected.
- For persons whose sexual behaviors place them at risk for STDs, correct and consistent use of the male latex condom can reduce the risk of STD transmission. However, no protective method is 100 percent effective, and condom use cannot guarantee absolute protection against any STD. The more sex partners you have, the greater your chances are of getting HIV or other diseases passed through sex.
- Condoms used with a lubricant are less likely to break. However, condoms with the spermicide nonoxynol-9 are not recommended for STD/HIV prevention. Condoms must be used correctly and consistently to be effective and protective. Incorrect use can lead to condom slippage or breakage, thus diminishing the protective effect. Inconsistent use, e.g., failure to use condoms with every act of intercourse, can result in STD transmission because transmission can occur with a single act of intercourse.
- Don’t share razors or toothbrushes because of they may have the blood of another person on them.
- If you are pregnant or think you might be soon, talk to a doctor or your local health department about being tested for HIV. If you share HIV, drug treatments are available to help you and they can reduce the chance of passing HIV to your baby.
How do I know if I have HIV or AIDS?
You might have HIV and still feel perfectly healthy. The only way to know for sure if you are infected or not is to be tested. Talk with a knowledgeable health care provider or counselor both before and after you are tested. You can go to your doctor or health department for testing. To find out where to go in your area for HIV counseling and testing, call your local health department or the CDC INFO, at 1-800-CDC-INFO (232-4636).
Your doctor or health care provider can give you a confidential HIV test. The information on your HIV test and test results are confidential, as is your other medical information. This means it can be shared only with people authorized to see your medical records. You can ask your doctor, health care provider, or HIV counselor at the place you are tested to explain who can obtain this information. For example, you may want to ask whether your insurance company could find out your HIV status if you make a claim for health insurance benefits or apply for life insurance or disability insurance.
CDC recommends that everyone know their HIV status. How often you should an HIV test depends on your circumstances. If you have never been tested for HIV, you should be tested. CDC recommends being tested at least once a year if you do things that can transmit HIV infection, such as:
- injecting drugs or steroids with used injection equipment
- having sex for money or drugs
- having sex with an HIV infected person
- having more than one sex partner since your HIV test
- having a sex partner who has had other sex partners since your last HIV test.
If you have been tested for HIV and the result is negative and you never do things that might transmit
In many states, you can be tested anonymously. These tests are usually given at special places known as anonymous testing sites. When you get an anonymous HIV test, the testing site records only a number or code with the test result, not your name. A counselor gives you this number at the time your blood, saliva, or urine is taken for the test, then you return to the testing site (or perhaps call the testing site, for example with home collection kits) and give them your number or code to learn the results of your test.
If you have been tested for HIV and the result is negative and you never do things that might transmit HIV infection, then you and your health care provider can decide whether you need to get tested again.
You are more likely to test positive for (be infected with) HIV if you
- Have ever shared injection drug needles and syringes or “works.”
- Have ever had sex without a condom with someone who had HIV.
- Have ever had a sexually transmitted disease, like chlamydia or gonorrhea.
- Received a blood transfusion or a blood clotting factor between 1978 and 1985.
- Have ever had sex with someone who has done any of those things
What can I do if the test shows I have HIV?
Although HIV is a very serious infection, many people with HIV and AIDS are living longer, healthier lives today, thanks to new and effective treatments. It is very important to make sure you have a doctor who knows how to treat HIV. If you don’t know which doctor to use, talk with a health care professional or trained HIV counselor. If you are pregnant or are planning to become pregnant, this is especially important.There also are other things you can do for yourself to stay healthy. Here are a few
- Follow your doctor’s instructions. Keep your appointments. Your doctor may prescribe medicine for you. Take the medicine just the way he or she tells you to because taking only some of your medicine gives your HIV infection more chance to grow.
- Get immunizations (shots) to prevent infections such as pneumonia and flu. Your doctor will tell you when to get these shots.
- If you smoke or if you use drugs not prescribed by your doctor, quit.
- Eat healthy foods. This will help keep you strong, keep your energy and weight up, and help your body protect itself.
- Exercise regularly to stay strong and fit.
- Get enough sleep and rest.
How can I find out more about HIV and AIDS?
You can call CDC-INFO at 1-800-CDC-INFO (232-4636); TTY access 1-888-232-6348. CDC-INFO is staffed with people trained to answer your questions about HIV and AIDS in a prompt and confidential manner in English or Spanish, 24 hours per day. Staff at CDC-INFO can offer you a wide variety of written materials and put you in touch with organizations in your area that deal with HIV and AIDS.On the Internet, you can get information on HIV and AIDS from www.AIDS.gov or www.cdc.gov/hiv.
The BBC’s allegations over Ethiopian aid: what is the truth?
by Nicholas Winer
Aid workers must be pragmatic – if food was getting to people, then the money was doing its job.
The food shortage in Ethiopia is still on-going. Photograph: AFP/Getty ImagesI have followed, with a certain incredulity, the recent story put out by the BBC that 95 per cent of the aid to the Tigrayean rebels was diverted. I mean, 95 per cent is a vast amount of money, and why, I ask myself, would any group of self respecting conmen steal it all? Surely they would need to show that enough good was being done, so that the cash cow would come back again and again and again. The cross-border aid process ran from 1984 to the fall of Mengistu’s regime in Addis. This was no one-off smash and grab.
Initially, the TPLF simply sent people from Tigray to Sudan to be fed and housed by the UN and the international NGO community. It seemed a cheap and efficient way to manage a famine in Tigray. But the horrific sight of 300,000 people arriving en masse was overwhelming. The Sudanese camps suddenly turned into a second Korem, until enough aid could be delivered to reduce the death toll. The TPLF consistently deny that this was what they had done. I, and others, couldn’t conceive how such a vast sea of people could have moved through such tightly controlled rebel territory without the active guidance of the TPLF.
What happened next is the crux of the BBC’s story and of Paul Vallely’s refutation in the Independent. There had been a good harvest in western Tigray, but the poor had no money to buy it. The TPLF, through their civilian wing REST, determined sensibly that buying from the producers to feed the consumers was better for all than dumping food aid into the market. Why, they argued, suppress the price of food for the few who had managed to grow enough to sell? This impeccable free trade logic from hardline Marxists won immediate sympathy. And so began the process of meeting merchants, handing out cash, and checking on both food distribution and nutritional levels.
Khartoum, before Sharia law and the “Courts of prompt and Instant Justice”, was a vibrant, dusty and chaotic city. TPLF soldiers swaggered around with gold cigarette lighters, and Johnnie Walker Black Label was their favourite tipple. REST had a large house in an expensive suburb, where rents were too high for us Oxfam types. It was a friendly house, with an endless flow of people coming and going. As foreigners, we never knew who was who, but no one was turned away, and the atmosphere was beguilingly appropriate for beginning a relationship of trust.
The recent angry response to the BBC by aging colleagues that every effort was made to build checks and balances into the purchase and distribution process speaks volumes about their real anxiety that many things could’ve gone wrong. They wanted to be sure that if food or money did go astray, it wouldn’t be because they’d been negligent. On that basis — and the detailed explanations of Paul Vallely — the more extreme claims made by the BBC must be discounted. But for the very same reason, so too must any outright denial that anything did go astray.
The truth, I think, lies somewhere between the two positions. The proud young TPLF fighters in Khartoum and the earnest workers of REST intermingled, working for the same cause, under the same authority. There was much we were never privy to as aid workers (and the same applied to journalists), and so it would be foolish to state anything too categorically. It was in the interests of both REST and the TPLF to ensure a continued supply of resources to them and their people. This they did by providing a satisfactory level of access. That was smart and logical thinking.
Had they not been of a Marxist orientation they would have had an easier time of it from the USA, and perhaps would not have needed to be so accommodating: they could have done with their own Charlie Wilson. As it was, the best they could have hoped for was to be considered the good ‘commies’, as opposed to the bad ones of Mengistu’s regime. The verdict too has to be out on what the CIA in Sudan did and didn’t know. At the time it seemed not enough, given their boringly incessant attempts to question aid workers coming out of Tigray, and yet rather a lot, given their involvement in the highly complex evacuation of Ethiopian Jewry to Israel.
The people they seemed most interested in were often the health workers who travelled widely, witnessed bombing raids by the Ethiopians, and saw where TPLF fighters were based. This was precisely what the spooks wanted to know about. The health workers, on the other hand, weren’t too pleased with these extra attentions, but they were the ones who knew whether the process was working or not. If the people weren’t hungry, then that was what counted. That was, after all, what the grain buying programme was for. That was what determined whether the money was well spent. Counting bags of grain was never going to be a fool-proof process, nor could it have been a guarantee of success. The process did work. The flood of refugees into the border camps slowed to a trickle, and health levels improved in Tigray. That’s what people gave Sir Bob their money for and, by and large, it did what was expected of it.
It was always evident that greater access, and thus greater accountability, was mroe possible with the structures established by the Tigrayeans than with those of the Eritreans. That this was so is still reflected in the different political realities of the two countries. So, I ask myself if the story even has the right focus. What happened to aid to the Eritrean rebels, where accountability was much harder to establish? What of the tales of an underground TPLF political prison in Gondar, to which no aid worker was ever granted access? No surprise there. This wasn’t just famine, but a nasty and brutal war zone. To suggest that the TPLF never pulled a fast one and took their share would be a very foolish and naive assertion.
Today the TPLF — sorry, government of Ethiopia — own vast tracks of sorghum-growing estates on the Sudan border, right next to Western Tigray where this all began. In a land where private property is illegal, these (ad)venture capitalists are a real success story. As ever, someone else is paying the price.
Nicholas Winer is the former director of Oxfam in Sudan and Ethiopia. He is also the author of “The Tethered Goat” a political thriller set in Mengistu’s Ethiopia.
