I have been away for a little while. There are reasons for that. Including lots and lots of self care. I do after all, do this all by myself. Of course, with the support of incredible people around me. So that fact, and all the work I am currently doing and the weird situation we are all in at the moment has made it quite difficult to maintain the podcast momentum. I am not complaining though. Having said that…today is the 1st of December. It is the day that the world commemorates the World AIDS Day. We have one more month left in what has been a rather interesting year 2020. And we have quite a bit to talk about. So…here we go…
First, let us get some statistics out of the way.
According to UNAIDS, as of 2019 38.0 million people globally were living with HIV. Of these, 1.8 million were children aged 0 – 14 years. 1.7 million people became newly infected with HIV. 690 000 people died from AIDS-related illnesses. Since the start of the epidemic and ending in 2019, 75.7 million people have become infected with HIV and 32.7 million people have died from AIDS-related illnesses. 81% of all people living with HIV knew their HIV status. About 7.1 million people did not know that they were living with HIV. The risk of acquiring HIV is 26 times higher among gay men and other men who have sex with men. 29 times higher among people who inject drugs. 30 times higher for sex workers and 13 times higher for transgender people.
Find the full fact sheet here.
Yes. We are going to be talking about HIV today. It is World AIDS Day after all. Every year, on 1st December, people around the world unite to show support for people living with and affected by HIV. They also unite to remember those who lost their lives to AIDS.
At Padded Cell Podcast, I focus on matters mental health. So today, I want to talk about HIV and Mental Health for gay men in Africa. Specifically, I want to talk about three things. Mental Health on Diagnosis, The Trauma of Stigma and this year’s theme for World AIDS Day, Global solidarity, shared responsibility.
Earlier, when I was giving the HIV statistics, I mentioned that the risk of acquiring HIV is 26 times higher among gay men and other men who have sex with men. It should come as no surprise therefore that, the world over, HIV has often been referred to as a “gay” disease. The “gay plague”. It did kill hundreds of thousands of gay men at the beginning of the epidemic in the 80s and it continues to disproportionately kill many gay men today. Now, in a continent where most states criminalize same-sex conduct, one where society largely deems homosexuality a western import and considers gay men an abomination, it is easy to see why the numbers for gay men are higher.
It is also the reason why an HIV diagnosis for a gay man in Africa is an incredibly difficult thing to deal with. A gay man in Africa is already dealing with the fact that his loving another man is a crime. He is dealing with a society that is so fixated with and disgusted by the way in which he engages in the very personal act of sex. He is dealing with the fact that his family has disowned him. He is dealing with the loss of a job because his sexual orientation was disclosed. He is dealing with religious leaders constantly telling him that he is going to hell. He is dealing with societal pressure to marry a woman and sire children to maintain his family’s bloodline. He is dealing with the fear of losing everything and everyone if his love for a fellow man is known to anyone.
An HIV diagnosis therefore will come as a shock. It will be a burden, not only to the gay man, but presumably, his family and friends. It will be a disappointment. A disappointment on himself for allowing himself to contract the gay disease and become a statistic. A disappointment on people close to him for catching a disease that will kill him. There will be fear. Fear of living with the disease. Fear of losing weight and dying. Fear of having to take medicine daily. Fear of his family finding out. There will be anger. At the world for allowing this to happen. At himself for being so careless. He will feel disgusted and not worthy of love. He will feel sad. He will be depressed. He will feel heartbroken and miserable. On diagnosis, a gay man in Africa will be broken.
Which brings me to the second thing I want to talk about. The trauma of stigma. It is the anticipated stigma that causes most if not all the emotional reaction I just described. Not too long ago, warnings on billboards and in news paper headlines said, “Don’t Die of Ignorance” and “AIDS: The Beubonic Plague of the 21st Century”. Today, in some parts of Africa, some people still believe that HIV is a death sentence. Some believe that if you share a spoon or a cup or a toilet with someone who is HIV positive, you too will contract HIV. Some countries in Africa still criminalize HIV. Some yet still don’t have laws preventing discrimination on the grounds of HIV status and even for those that do, the fear of disclosing one’s HIV status prevents people from seeking redress in case of any such discrimination.
Despite the stigma gay people already face, within the community, there still exists stigma towards people living with HIV. You still find dating sites and apps with profiles that use the word “clean” to mean HIV negative. You have people within the community shunning anyone that is positive just because they have the virus. Even with the advancement of the science around HIV, we still have people explicitly stating that they would never date a person who is HIV positive because they do not want to die. This stigma faced by gay people living with HIV can be and is incredibly traumatic.
And yet with all of this at play, there are men out there, gay men, living positively with HIV, making a difference in their communities in Africa. David Deo in Kenya. Reverend Jide Macaulay from Nigeria, Bisi Alimi from Nigeria, Cameron Kakande from Uganda and countless other beautiful people shining a light in an otherwise dark and dreary world.
This year, the world’s attention has been focused on another pandemic. One that, much like the HIV pandemic, has its own stigma attached to it. COVID-19. It has shown, once again, how health is interlinked with other crucial issues including mental health. A gay man in Africa, who is HIV positive who then contracts COVID-19 has a lot of hurdles to jump. Which is why the theme for this year’s World AIDS Day is “Global solidarity, shared responsibility”. To me, this means that as human beings, we need to learn more. Read more. Understand more. Not only about what HIV is, but also what it means to those who live with it every day of their lives. Science has proven that if one is HIV positive and is adhering to his medication, his viral load will be undetectable which means that they have a zero chance of transmitting the virus. This in turn means that you have a higher chance of contracting HIV from someone who does not know their status than from someone who does and is taking care of themselves.
We share the responsibility of educating our friends and family about the fact that HIV positive people live long healthy lives. Lives that can be full of love and light and laughter and purpose. Lives not defined by the virus but by the good deeds done in the world. We share the responsibility of ending the stigma attached to homosexuality and HIV. We share the responsibility of ensuring that we all know our status. Get tested. If you do test positive, there is a world of support for you wherever you are. Adhere to your medication and you will live a long, beautiful, wholesome life. If you test negative, there are ways in which you can reduce your chances of contracting the virus. One of which is PrEP. Science is amazing! Together, we can end this epidemic. But first, we must end the stigma.
Today as we unite with people living with or affected by HIV, as we remember the millions who have died from the virus, let us also keep in mind the impact of our actions, individual and collective, on the lives of those of us who are here. Listening to the words you say. Watching the things you do.
My guests this month will share their personal stories on the impact HIV had on their mental health. Watch out for those episodes in the coming weeks. Do check out the podcast website www.paddedcellpodcast.life where you will find previous episodes and links to the podcast social media accounts. If you would like to share your story or simply chat about mental health. Feel free to contact me.
As always, don’t forget to be kind, to yourself and others.