Rights to Confidentiality and Privacy – The Law

Dear Alan,

Please accept my apology for missing the group, I really wanted to attend but sometimes the best planned events still get hijacked.

I need some advice that you might be able to help me with.

I’m separated at the moment from my spouse and divorce proceedings are about to start (I’m all fine with that) but my lovely husband has been making gentle and other very clear statements that he will disclose my + status to all my clients and ruin my life if I do anything to upset him. He is a registered 

Dr with the AHPCSA but when I contacted them to ask about Dr/patient confidentiality I was told that it doesn’t extend to spouses and that the law becomes very grey in this matter.

Today he stated that if he finds out I’m having sex he will inform the person that I’m HIV+ and trying to kill them knowingly.

I’m not stupid and know that most of his claims are tactics to keep control over me but we both know that should he go ahead, even if I can prove the contrary, the damage would have been done.

He told his sister about my status as she sent me a SMS today to say she will make it public knowledge should I go against her brother in any way, so the ship has sailed as far as him disclosing my status goes.

I can lose my business and everything if he discloses my status in this way.

Is there any legal protection to stop him...no point in legal action afterwards, I need something that will stop him from disclosing to anyone else.

Sorry for the long message but I think you get the idea of what I mean and need.

If you know of anything or could direct me to a link or anything I will be forever grateful to you.

Kind regards,

P

Dear P, I look forward to seeing you at one of the support meetings again soon.  It is totally against the law and our constitution to disclose the HIV status of another person without their consent.  The Allied Health Professions Council of South Africa (AHPCSA) is incorrect it is not a grey matter as the rights of people with HIV are clearly defined by the South African constitution, as well as their own guidelines. It is very clear based on the law that even a threat to disclose another person’s status is illegal for the purposes that your ex-partner is threatening to do so. 

I recommend you contact the AIDS Legal Network on 0214478435 or visit their website for more details on www.aln.org.za also the AIDS Law project now called + Section 27 would be able to assist you. Visit www.section27.org.za contact details are 011 356-4100.

Also you can contact the Section27 advice centre on 011 356-4117

By doing this now they could assist you to notify your ex that if he continues to threaten you or breaches your right to privacy he will and can face litigation.

To better understand your rights let’s look at what the Laws in South Africa have to say about HIV and confidentiality/privacy;

The South African Constitution

The Constitution of South Africa protects the rights of people living with HIV. It doesn't allow discrimination and protects people’s right to privacy and confidentiality. In South Africa, there aren't any laws that force people to tell others about their HIV status. People who do test positive should tell their partner, so that they can be protected and also have an HIV test. People with HIV/AIDS in South Africa are protected by the Bill of Rights and have the same rights which protect all citizens.

• There can be no discrimination against anyone who has HIV/AIDS.
• Test results cannot be shown to anyone else without the permission of the person who had the test.

The Basic Rights of people living with HIV/AIDS

• People living with HIV infection and AIDS should have the same basic rights and responsibilities as those which apply to all citizens of the country.
• People with HIV infection or AIDS are entitled to make their own decisions about matters that affect their marriage and having children. Counselling about the consequences of their decisions should be provided.
• People with HIV and AIDS have the right to confidentiality and privacy about their health and HIV status.
• Information about a person’s HIV status may not be disclosed to anybody without that person’s fully informed consent.
• After death, the HIV status of the deceased person may not be disclosed to anybody without the consent of his or her family or partner – except when required by law.
• Medical schemes may not discriminate against any person on the basis of his or her state of health.
• People have a moral and legal obligation to tell their sex partners if they are HIV positive.
• Insurance companies may not unfairly refuse to provide an insurance policy to any person solely on the basis of HIV/AIDS status.
•  All people have the right to proper education and full information about HIV and AIDS and how to prevent it.

The Basic Rights of people living with HIV/AIDS at Workplace

• Employers may not discriminate against HIV-positive employees or victimise them in any way.
• No person may unfairly discriminate against an employee in any employment policy or practice (e.g. recruitment, appointment, remuneration, training and development, promotion, transfer and dismissal) on the grounds of his or her HIV status.
• No HIV-positive employee has to disclose his/her HIV status to his/her employer.
• Information and education on HIV and AIDS, as well as access to counselling and referral, should be provided in the workplace.

HPCSA guidelines on patients’ HIV status

Sharing information within the healthcare team about a patient’s HIV status is only permissible if the patient has given consent or if it is clinically indicated.

• Ethics, the South African Constitution (Act 108 of 1996) and the law recognise the importance of maintaining the confidentiality of the HIV status of a patient.
• The test results of HIV positive patients should be treated with the highest possible level of confidentiality.
• Confidentiality regarding a patient’s HIV status extends to other health care practitioners. Other health care professionals may not be informed of a patient’s HIV status without that patient’s consent unless the disclosure is clinically indicated. For treatment and care to be in the best interests of the patient, the need for disclosure of clinical data (including HIV and related test results), to health care practitioners directly involved in the care of the patient, should be discussed with the patient.
•  The decision to divulge information relating to the HIV status of a patient must always be done in consultation with the patient.

The HPCSA states: “In the management of an HIV positive patient it is important that the health care practitioner gives due consideration to other health care professionals who are also involved in the management of the same patient (eg where necessary, and with the patient’s consent, informing them of the HIV status of the patient).”

HPCSA - Disclosure in the public interest

• The National Health Act makes an exception to the rule of confidentiality if non-disclosure of a patient’s personal health information would pose a serious threat to public health.
• HPCSA guidance states that, for disclosure to be justified, the risk of harm to others must be serious enough to outweigh the patient’s right to confidentiality. If you judge that this is the case, you should attempt (if it is safe and appropriate) to obtain the patient’s consent first, but should go ahead with disclosure to the appropriate authorities if this is not forthcoming.
• Carefully document the reasoning beside your decision to disclose, together with details about any discussions you may have had with colleagues in the course of your decision-making

It is hence clear from all of the above that your ex-partner may not disclose or breach your rights to confidentiality and hence disclose your HIV status to 3^rd parties, even if he is a medical practitioner, when the intent or purpose of so doing has but one aim aimed and that is to destroy your rights to privacy and confidentiality. 

He may not disclose your HIV status to persons he suspects you might be engaging with even if the relationship is of a sexual nature unless he has proof that you are engaging sexually without having taken precaution to protect the person from exposure and/or based on the assumption that you are placing the person at risk. He can only do so from a medical practitioner’s responsibility to protect 3^rd parties point of view, if he knows for a fact and has evidence that you are not protecting the 3^rd party (sexual partner). 

He still can only do that after having discussed the matter with you first and attempted to provide you with counselling aimed at correcting your behaviour and only after providing such counselling, if you still refuse to protect 3^rd parties, may he warn you that he has an obligation to breach protect 3^rd parties and hence is considering disclosing your HIV status to the 3^rd party that he knows, for a fact you are placing at risk. Clearly this is not his intent and hence he is simply doing this, not in his medical capacity, but as an avenging ex-lover/partner. And this is against the law.  

It is also important to always remember that one’s right to privacy does not give one the right to place others at risk and hence, keep secrets or tell lies. Informing your sexual partners of your HIV status is your responsibility and you should always insist on taking precautions not to transmit HIV to your sexual partners.         

Love and light

Alan Brand

Employee Wellness Consultant and Specialist HIV and Employee Wellness Training Provider

www.positivelyalive.co.za

A question about PrEP

What is PrEP? PrEP stands for Pre-Exposure Prophylaxis. The word “prophylaxis” means to prevent or control the spread of an infection or disease. The goal of PrEP is to prevent HIV infection from taking hold if you are exposed to the virus. This is done by taking one pill every day. 

These are some of the same medicines used to keep the virus under control in people who are already living with HIV (called Anti-retrovirals). PrEP is meant to be used consistently, as a pill taken every day, and to be used with other prevention options such as condoms.

In several studies of PrEP, the risk of getting HIV infection was much lower—up to 92% lower—for those who took the medicines consistently than for those who didn’t take the medicines.

Dear Alan. Right now, I’m still battling to get my head around the whole I am positive idea... I started seeing a guy a few weeks back, had amazing time together and connected amazingly...

Unfortunately, it seems there are still many people who are not educated about HIV, therefore when we eventually had the discussion around HIV... He ran miles... He does not know about it at all, nor what it means to be undetectable etc...

We have stayed in touch as friends subsequently and I have slowly but surely tried to educate him and talk to him about it and shared a few links with him through your support network however, he is still very scared and sticks to the "stigma" of the past...

I tried to explain to him around using PrEP as well, explaining the significantly reduced risks. But he is now so scared because and his words "I would never have thought you were HIV Positive"... And says he doesn’t want to be with anyone because he doesn’t know anymore. Hopefully in time I can educate him and in general people around the world will become a little bit more educated about HIV and the risks and how to mitigate these risks.  

The questions he asked me, for someone who is 31, were quite scary and clearly showing how little information and knowledge about HIV he has.

But, hopefully when I meet someone special one day and if they are Negative I will be able to have the skills to be better able to discuss the same issues any guidance would be greatly appreciated.

Dear M, thanks for your comments and indeed it is so sad that for over 34 years HIV continues to been an issue of humanity and although we have had to deal this yet still so much ignorance, shame, stigma and denial continues to exist. But before I was diagnosed HIV+ back in 1997 (18 years ago) I too was caught up in ignorance, intolerance and denial. Hence I will continue to remind myself of my own ignorance and denial not to mention my feelings of stigma and lack of knowledge towards those infected back then. This always helps me to remember that people only are interested in education about something when they feel the issue is of benefit to them or will affect them in some way. 

Sadly many simply remain like ostriches with their heads so deep in the sand and notion; "It is not my problem" that one can but only be compassionate and sympathetic at their attitude. It is a protection mechanism of sorts, “what I don't know about I don't have to deal with” mentality. Silly as it might sound perhaps but that the biggest barrier to HIV awareness.

I commend you on taking the stand to make a difference and if only all HIV+ individuals could do that we would be much further down the road to making a real change and getting people to realise that it can happen to anyone and nobody is immune to the HIV virus. If anything the very stance of "It cannot happen to me" is what places most people at highest risk.

Fear is a very real experience and unfortunately for far too long fear has been the only way HIV awareness has been used to no effect. It is simply human nature when presented with fear and no other alternatives but fear to shut down and fall into the trap of ignorance and denial. In 2015 we now have such a better position with so much more at our disposal. We can speak about real ways to prevent transmission such as PreP, and all other treatment as prevention methods (TaSP), condoms, water based lube, undetectable viral loads etc etc etc.

I’m assuming that somebody is going to take the lead in getting the PrEP conversation started. Here are some steps to kicking it off and keeping it moving forward: 

Start with a reminder: I love you. When you’re having a conversation about your relationship, start with reconfirming your foundation. After all, you’re together because you love each other. 

State your intention: This isn’t the time to be a wimp about why you’re starting this conversation. But that also doesn’t mean you’re here to lay down the law. So how about making it clear that this is a decision for you and your partner to make together? You might say something like: “I’ve been thinking about PrEP and what it might mean for us. I want to talk to you about your thoughts. Is that OK?” If your partner isn’t ready to have the discussion, you may need to drop it for now and bring it up again when he/she is ready.

Let your partner talk first: You might already be aware of your partner’s feelings about PrEP, or maybe not. Either way, give your partner a chance to express their opinion first. This approach can help your partner to feel like this really is a conversation and not only an opportunity for you to express your opinion or state the decision you have already made on your own. “I’m really interested to know what you think about PrEP.” 

Listen: Early and often. Conversations are an interchange between two people. You take turns talking and listening. So when your partner talks, really listen to what they’re saying — instead of thinking about what you want to say next and waiting for them to take a breath so you can jump in. If you aren’t feeling listened to, gently ask your partner to do the same. It might help to state what you just heard your partner say, in your own words, to make sure you understand: “So you are saying ______.” Listening is one of the best ways to honour another person.       

Offer to team up on getting informed: Make this an opportunity to look for information together. Share what you learn. Make a list of questions to get more information on. You might also want to meet as a couple with your doctor to talk about PrEP. To kick off the information-gathering: “How about if we get on the Internet and do some research? Where do you want to start?” 

Get to the why question: OK, here goes what might be the hard part. At some point in the discussion, you’re going to need to clearly state why you want to consider going on PrEP, why you want your partner to, or why you won’t. Since you kicked off the conversation, your partner will at some point ask you the “why” question. Again, this is no time for talking around the issue. “Here’s why I think PrEP would be a good idea for me/you/us.” Or, “here’s why I don’t think it’s a good idea.” And then state why. 

Keep listening: The conversation may go smoothly. Your partner may also have been thinking about PrEP and welcome the opportunity to talk about it. On the other hand, some elephants may have been wandering around your living room (one of them named “Trust”) that needs to be identified and discussed. This could get uncomfortable. If so, listen with an open mind. Try to understand your partner’s concerns without being defensive: “I really want to know how you are feeling about this.” Again, it might help to restate what you think you just heard: “So what I think you are saying is _________.” Keep your head in the game even when you’d rather tune out.    

Get clear on life with PrEP: PrEP may not make much of a difference at all beyond providing an additional barrier against HIV exposure. But it may also mean renegotiating some boundaries, or at least being up-front about boundaries that you have kind of been avoiding talking about. As the saying goes, put your cards on the table. Get specific with each other about what your relationship would be like with PrEP. 

Consider this conversation a work in progress: You may need to consider the PrEP decision from a variety of angles before you come to a decision that you can both be comfortable with. Remember: Patience is a virtue. Give your partner time and space to work through his/her concerns on their own as well as with you. Keep the conversation going. 

This may be one of the most important conversations you and your partner have had so far. Approach the PrEP conversation with honesty and with an open mind. Hear each other out. Share information. Try to understand each other’s concerns and expectations. Be patient and kind. Keep talking.

On a personal level let’s consider the HIV partners role in all of this discussion

Do not lose hope as what I have found is the more I became willing to be open about my status, coming to a slow acceptance of the reality myself, I found myself surrounded by love and acceptance from others. Daily I dedicated my life to making a difference in the attitudes and experiences of others towards the realities of HIV and AIDS. On this path for the one or two people that I discovered that rejected me or turned away in fear many more came towards me with love, embracing the ability to gain knowledge and hence have become part of the solution rather than through ignorance continuing to contribute to the problem.

Learning to again love myself and accept the virus through the tools I gained I found others embracing these tools too for issues in their own lives. For me the major lesson I had to learn and continue to learn afresh every day was that "Forgiveness is the path to self-love, and self-love is the key to inner healing". Forgiving myself for getting infected, forgiving the person that passed the virus on to me (I was not raped I went and through my own decisions and actions I got infected, so I take responsibility fully for that decision but that acceptance has given me the ability to forgive myself), forgiving the virus for entering my life as I never invited it into my body in the first place. 

All of this has released within me the ability to look myself in the mirror and I am able to say to myself, "Alan I forgive you and I love you, you are not a bad person". So I have learnt to love myself again. Through that love and my own acceptance of myself I was able to reach out and ask for help and guidance and have learnt from so many wonderful teachers along the path. As my light of acceptance and love shone bright I believe that it too has attracted others in pain and denial to me. What a blessing! And I do not give HIV the credit for any of this it was the teachers and myself that decided to rise up and be different. I did not sit on a pile of sand and say, “oh poor me, I am going to die”. I chose life and every day I am grateful just for today, for today I have the choice to make this day the best it can ever be.

I wish you too the ability to continue to shine as you already do and I know through your path you too will find the love and acceptance from a person like I have. I met my life partner in November of 1997 and disclosed my status to him, yes he needed his own time to learn and come to acceptance of the situation. Together we have walked different paths at times but always hand in hand. What a blessing that has been. My daughters and family too have had to deal with my status in their own time and in their own way and I am blessed again with love and acceptance.

Start with your own journey of acceptance and learn again to embrace yourself as a unique, special and wonderful person and without a doubt people will be drawn to you and the love you have to share and give. 

Nobody ever said this path is easy but my word, has it been a wonderful experience, I wish the same for you

Alan Brand

Employee Wellness Consultant and Specialist HIV and Employee Wellness Training Provider

www.positivelyalive.co.za

Alan Brand Living Positively with HIV An Inspirational Story - Interview for Doctors Orders SABC TV3

Stigma and Discrimination - Obstacles to an Effective HIV and AIDS Response - World AIDS Day Message 2013

By Alan Brand 

Introduction

“Getting to Zero", I am of the opinion that Stigma is the final battle front in the war on HIV and AIDS. We have made unbelievable strides in care and treatment. Treatment as prevention (TASP) is in our hands, used correctly we can achieve the objective of "Zero New Infections" and soon "Zero AIDS Related Deaths" will become a reality, it is not impossible to have a vision of an AIDS free future! However, all these efforts will fail if we do not overcome stigma and discrimination. Getting to an 'AIDS Free Future' will require strong political will, effort and commitment from all if we wish to succeed and reach the target of "Getting to Zero Stigma and Discrimination". This final frontier must be overcome now! We cannot afford not to! Without wiping out stigma ....HIV and AIDS will continue to spread and the AIDS related deaths will continue unabated!  

             

Let us first reflect back on the past.

Acquired Immune Deficiency Syndrome (AIDS). I first heard those words more than 25 years ago. But it wasn't until eight years later; when I heard the following words from my doctor “your HIV test has come back positive”, that the reality of what it meant really hit me. By that time more than 4million South African’s had contracted HIV, and many thousands had died of AIDS. The disease had become real for me and for my colleagues in virtually every corner of the country.

So much about HIV/AIDS and the epidemic has changed since then. Yet one thing has not changed nearly enough -- HIV is now, as it was in 1980’s, the most stigmatised disease in South African society.

In the 1980’s, the stigma attached to HIV, while undeserved, was at least a little more understandable. We knew very little about the disease then. Fears of being infected from kissing, holding hands or sharing a cup with someone with HIV was still common.

Doctors and patients were scrambling to stir up scientific research programs that in many ways had been slow to respond. Despite a rapidly expanding caseload, there was very little reliable medical or scientific information about the virus, how it was transmitted, or what could be done to treat it.

In fact, effective HIV treatments were virtually non-existent at that time. The few medicines that were being used were no match for the virus,  treatments quickly became ineffective as resistance to these drugs occured. The treatment regimens often involved so many pills and such severe side effects that many people felt that taking their medicines every day was as difficult as the disease itself.

Too often, being HIV positive meant having to cope on your own. It wasn't uncommon for doctors and other healthcare workers to refuse to see patients who they knew were HIV positive. Social workers, lay counsellors and activists around the country responded at that time, and services for many people began, gradually, to improve.

The situation today is very different. We now know how HIV is transmitted, and we know how to prevent infection. Scientists have learned how HIV attacks the body's immune system, what its weaknesses are and how to exploit them. They've even mapped out the virus's genetic structure.

HIV treatments have also improved dramatically in recent years. With the introduction of powerful new drugs in the mid-1990s, HIV/AIDS death rates began to drop for the first time since the start of the epidemic. More recently, treatments that require fewer pills and cause fewer side effects have begun to help people with HIV/AIDS live longer, healthier and fulfilled lives. Thanks to these advances in care, HIV is well established as a chronic but medically manageable condition.

Support services for people with HIV have also improved. In practically every city across the country you will find community organisations and groups dedicated to helping ensure that HIV positive individuals get the care and support they need and deserve.

Yet, despite all this progress, the terrible stigma associated with HIV and AIDS continues unabated. Isolation, fear and shame continue to cloud this diagnosis of an HIV status for many.

What's worse is that the stigma surrounding HIV actually helps to perpetuate the epidemic. Most of the over six million South African’s estimated to be infected with HIV don't even know they have the virus. The cause of this reality is not ignorance as much as it is fear of rejection and discrimination. Each year, thousands of people who have contracted HIV do not get tested out of fear that an HIV positive diagnosis will mean a life of isolation and discrimination.

Misinformation accelerates the spread of HIV in communities across the Southern Africa, particularly among minority and poorer populations that already suffer more than their share of prejudice and discrimination. Despite progress in so many other areas, HIV infection rates continue to grow.

We can't afford to let another 20 years go by before we separate the myths surrounding HIV and AIDS from the reality. It's time we started seeing the disease for what it is: a serious communicable disease that is both avoidable and although still incurable has become very treatable and manageable. We need more open and frank education and more community leadership to address this epidemic. We must also target resources to address the changing demographics of the disease, so that information and education programs can be tailored to the audiences that need them most.

Finally, people living with HIV/AIDS must have access to the medical care, prevention and treatment information they need. Research advances have meant that more and more people with HIV are living full, normal lives. It's time that the human progress in how we handle HIV/AIDS in our community begins to match the advances being made in the research lab.

Give the following questions some thought:

Question 1:

Has the message about HIV/AIDS over the past 30 years helped or increased stigma and discrimination around HIV/AIDS? Consider the following:

• Today, people with HIV are still stigmatised and continue to face many forms of discrimination.
• Some people are refused employment or membership of employee benefit schemes.
• Some people are refused proper health care and equal membership of medical schemes, or their children are victimised at schools. 
• Many people are tested for HIV in our hospitals without giving informed consent, or are told about their HIV status without receiving proper counselling.
• Breaches (breaking of) of confidentiality and privacy happen almost every day.

Questions 2:

Why does stigma and discrimination help spread HIV? Consider the following: 

• Is it who and what you are that puts you at high risk of contracting HIV, or 
• Is it behaviour that puts you at greater risk          

Questions 3:

How do we stop discrimination? Consider the following:

• Can the law help?
• Does having a constitution help?
• Does having knowledge help?

Today, we know that stigma and discrimination has helped the spread of HIV. Discrimination has made it easy for people to blame others without protecting themselves. Instead of campaigns that educate everyone in our society, people have been taught to believe that HIV infection only happens to gay people, prostitutes and ‘people who sleep around’. If you are not gay, a prostitute, or promiscuous you are ‘safe’. This is not true.

Key points:

• Types of behaviour, not groups of people, put you at risk of HIV infection. 
• For as long as people with HIV continue to face discrimination, people will be afraid to volunteer for an HIV test,
• This means that it will be more likely that they will unknowingly pass HIV on to other people.
• Unless people are encourages to come forward freely to tell others about their HIV status, ignorance and misunderstanding about HIV and who is affected by it will continue.

Discrimination is prejudice in action!

The non-legal definition of prejudice is “Preconceived judgments or decision; unreasonable predilection or objection; esp. an opinion or leaning adverse to anything without just grounds or before sufficient knowledge.”

Now that is a bit complicated so I am going to simplify it down to “illogical reaction to fears of anything outside ourselves”.   And, yes, people often have prejudices even when they have been presented with the facts that point to the fears being groundless.

The list of prejudices dreamed up by the public and especially public figures, educators, clerics, generals, and politicians is almost endless. Just about any complaint that has been thought of has soon had its associated prejudice.

In the First and Second World War hatred of Germans was considered national pride, even though a great percentage of the people who founded the United States were German.  In fact, In the USA, English as the national language won over German by just a few votes!

In the Second World War hatred of Japanese was even more irrational.  Driven by movies and the press, that hatred came to a fever pitch during the WW11.  Those of Japanese descent and Japanese on American soil were rounded up, thrown into concentration camps, and deprived of their land and possessions.  Amazingly enough, this did not happen to those of German descent!  Talk about irrational.

Now people in the United States can’t get enough of Japanese cars, computers, electronics, etc.  And they admire the German people for their cars, military, clean living, etc.  Talk about irrational.  But there it is: once the threat is past, all the bad things we perceived about the “enemy” are forgotten.

Prejudice and fear?

The best example of how prejudices, fuelled by fear creates myths and illogical reactions is the story of “Juliana’s cloth disease” of Tanzania.

The story goes as follows:

A handsome Ugandan trader arrived selling cloth for women’s kangas with a sort after patterned named Juliana. A village girl with no money traded sex for a kanga, as did several other women who converted the beautiful Juliana patterned cloth into a wrap or kanga. Some months later the first girl became sick: she had no appetite, could hold down no food, and had constant diarrhoea, which filled her with shame. In a few weeks she wasted away, grey and weak, and had to be carried everywhere. Before she died, two other women, also adorned in Juliana’s cloth, came down with the same strange disease. The people of Lukunya decided that the Ugandan was a witch, and that the Juliana cloth had evil powers. To conquer Juliana’s disease, traditional healers toiled to lift the stranger’s curse. But the curse was too powerful and the death toll continued to rise. Within a year the curse had spread to the neighbouring villages. Rumours of widespread witchcraft spread through the Kagera region, and traditional healers felt compelled to solve the Juliana mystery. (Garrett, 1995:334-335)

In 1995 doctors identified that the reported cases of wasting disease (“Juliana’s disease”) in Kagera, Tanzania as AIDS cases, based on comparisons with published symptoms in the medical journals in the U.S.

However the story does illustrate how people can experience the world in a unique and very specific way that is different from the way in which others experience it. Understanding these beliefs and not simply laughing them off as silly prejudices that result from ignorance is critical to our ability to address HIV and AIDS prevention messages in Africa.

---

Below is an exert taken from Alan’s recently published book called, “Positively Alive” published by Jacana, 2005 which is available at Exclusive Books.

Positively Alive

I remember the first World AIDS Day celebration that I attended in 1998. A number of HIV/AIDS organisation rallied together to commemorate the event at Zoo Lake in Johannesburg. It was only a small gathering of people but the event made a huge impact on me at the time. Beautiful, haunting music was being played from a car radio. The event was more a memorial ceremony than a celebration. As the sun set, a prayer was said and everyone was given the opportunity to light floating candles. These were then placed on the lake in memory of loved ones that had died of AIDS. As I watched, I was struck by an overwhelming sense of the hopelessness and loss that each candle represented. To make matters worse a gentle breeze was blowing and as each candle was placed on the water it would simply flicker and die. Hands reach out to try and keep them protected from the breeze. A few managed to be re-lit only to quickly fade and sink beneath the water. The entire event reflected the hopelessness and lack of ability to do anything for those infected at that point in time.

In this time of despair, I was forced to consider the purpose of my life. As I began to examine my belief structures I entered into a holistic approach to health through the crisis of this terminal illness. I have learnt so much and become a far more spiritually mature person.

So much has changed since 1998. HIV is now classified as a chronic manageable disease with continuing improvements in the availability of medical treatment. Much more is known about the effects of balanced nutrition in relation to maintaining a healthy immune system. The effect that stress has on the individuals’ ability to heal is well documented.

The HI virus, however, continues to affect millions of people throughout the world. The traumas experienced by so many people infected by HIV and AIDS indicates that health is generated by a balance of the emotional, psychological and spiritual aspects that form the core of who we are.  In the same way that my being HIV-positive has brought a crisis into my family so the planetary family is facing the same crisis of HIV. We will never be able to overcome this epidemic by individual responses. By begin to think of ourselves as united in our efforts – firstly healing ourselves – and then our relationship to each other; we can embrace the reality of healing our planet. If it is true that, “AIDS is, indeed a virus that thrives on “victim” consciousness, fear responses and isolation” - Caroline M. Myss then surely love with compassion and acceptance will go along way in helping those affected by HIV and AIDS to remain ‘Positively Alive’.

---

Contact Alan Brand from Positively Alive should you wish to inquire about a quotation to host the accredited workplace related employee wellness and training modules at your workplace, these courses are facilitated by Alan Brand from Positively Alive, and   include amongst others the highly successful: “Mitigation of HIV and AIDS related stigma & discrimination in the workplace – Training Module”.

---

Alan Brand

POSITIVELY ALIVE ^cc

Employee Wellness Consultant and Specialist Trainer

Website: www.positivelyalive.co.za

Love Hurts, Love Scars, Love Wounds and Marks …!

Valentine's Message 14 Feb 2013 - STI and Condom Awareness Week 10 - 16 February 2013

Love hurts, love scars

Love wounds, and marks

Any heart, not tough

Or strong enough

To take a lot of pain

Take a lot of pain

Love is like a cloud

Holds a lot of rain….

The above lyrics come from the famous song “Love Hurts", written and composed by Boudleaux Bryant and first recorded by “The Everly Brothers” in July 1960.

Love is that intense feeling of deep affection for someone and expressed through a deep romantic or sexual attachment. So does love hurt?

Alicia Keys reminds that “Love is blind”. So many songs have been written about the emotions, feelings and realities of being in love.  Is love blind?

A simple quick answer would not be sufficient to satisfy all that the mystery of love brings with it. This article by no means aims to do that. “When love comes knocking at your door, just open up and let it in” …. Oh my, I am in a singing mood as I contemplate the topic of love. When love enters the front door of ones heart it seems that all common sense departs through the back door of our minds.

All caution to the wind. Yet a key issue as one begins to fall in love and before one is overcome by a deep desire to be intimate, one should contemplate firstly with wisdom, mutual respect and understanding the risks involved. Using those wonderful days of intense love to build a foundation of trust and respect based on honesty and the ability to communicate about all things, not only the wonderful matters of the heart, are key to developing a loving relationship which will be able to prevent and protect one from the harm. This is the first step towards a love that will stand the test of time.

Sexually transmitted infections (also known as STIs or STDs for "sexually transmitted diseases") are infectious diseases that spread from person to person through intimate contact. STIs can affect guys and girls of all ages and backgrounds who are having sex.

Unfortunately, STIs have become very common among teens. Because teens become sexually active earlier than before they too are at risk for getting some STIs, hence it is important that they learn what they can do to protect themselves.

STIs are more than just an embarrassment. They are a serious health problem. When an STI is untreated, some can cause permanent damage, such as infertility (the inability to have a baby) and even death (in the case of HIV/AIDS).

One reason STIs spread is because people think they can only be infected if they have sexual intercourse. That is wrong. A person can get some STIs, like herpes or genital warts, through skin-to-skin contact with an infected area or sore.

Another myth about STIs is that you cannot get them if you have oral or anal sex. That is also wrong because the viruses or bacteria that cause STIs can enter the body through tiny cuts or a tear in the mouth and anus, as well as the genitals.

STIs also spread easily because you cannot tell whether someone has an infection if the infection is in the asymptomatic stage. In fact, some people with STIs don't even know that they have them (being asymptomatic). These people are in danger of passing an infection on to their sex partners without even realising it.

Some of the things that increase a person's chances of getting an STI are:

• Sexual activity at a young age. The younger a person starts having sex, the greater his or her chances of becoming infected with an STI.
• Lots of sex partners. People who have sexual contact, not just intercourse, but any form of intimate activity, with many different partners are more at risk than those who stay with the same partner.
• Unprotected sex. Latex condoms are the only form of birth control that reduce your risk of getting an STI, and must be used every time. Spermicides, diaphragms, and other birth control methods may help prevent pregnancy, but they do not protect a person against STIs.

Preventing and Treating STIs

As with many other diseases, prevention of STIs is the key. It is much easier to prevent STIs than to treat them. The only way to completely prevent STIs is to abstain from all types of sexual contact. If someone is going to have sex, the best way to reduce the chance of getting an STI is by using a condom every time.

People who are considering having sex should get regular gynaecological or male genital examinations. There are two reasons for this. Firstly, these exams give doctors a chance to teach people about STIs and protecting themselves. And secondly, regular exams give doctors more opportunities to check for STIs while they are still in their earliest, most treatable stage.

In order for these exams and visits to the doctor to be helpful, people need to tell their doctors if they are thinking about having sex or if they have already started having sex. This is true for all types of sex; oral, vaginal, and anal. Let the doctor know if you have ever had any type of sexual contact, even if it was in the past.

Do not let embarrassment at the thought of having an STI keep you from seeking medical attention. Waiting to see a doctor may allow a disease to progress and cause more damage. If you think you may have an STI, or if you have had a partner who may have an STI, you should see a doctor right away.

If you do not have a doctor or prefer not to see your family doctor, you may be able to find a local clinic in your area where you can get an exam confidentially.

Not all infections in the genitals are caused by STIs. Sometimes people can get symptoms that seem very like those of STIs, even though they have never had sex. For girls, a yeast infection can easily be confused with an STI. Guys may worry about bumps on the penis that turn out to be pimples or irritated hair follicles. That is why it is important to see a doctor if you ever have questions about your sexual health.

Talking about Condoms and Safe Sex

It is much smarter to talk about condoms before having sex, but that doesn't make it easy. Some people, even those who are already having sex, are embarrassed by the topic of condoms. But not talking about condoms affects a person's safety. Using condoms properly every time is the best protection against sexually transmitted diseases (STIs), even if you are using another form of birth control like the Pill.

So how can you overcome your embarrassment about talking about condoms? Well, for starters it can help to know what a condom looks like, how it works, and what it's like to handle one. Buy a box of condoms so you can familiarise yourself.

The next thing to get comfortable with is bringing up the topic of condoms with a partner. Practice opening lines. If you think your partner will object, work out your response ahead of time. Here are some possibilities:

Your partner says: "It's uncomfortable."

You might answer this by suggesting a different brand or size. Wearing a condom may also  take some getting used to.

Your partner says: "It puts me right out of the mood."

Say that having unsafe sex puts you right out of the mood. Permanently!

Your partner says: "If we really love each other, we should trust each other."

Say that it's because you love each other so much that you want to be sure you're both safe and protect each other.

Your partner says: "Are you nervous about catching something?"

The natural response: "Sometimes people don't even know when they have infections, so it is better to be safe."

Your partner says: "I won't enjoy sex if we use a condom."

Say you can't enjoy sex unless it's safe.

Conclusion:

Let me continue to use the theme of love songs; is it possible to be “safe in the arms of love”? Only by knowing ones risks and engaging in a loving and responsible relationship with someone that you can feel safe and comfortable with. Loving someone with whom you are able to communicate effectively and openly with.  Being able to initiate discussions that are related to all issues of health and safe sexual practices without fear or judgement will enable you and your partner to develop a trusting and the intimate relationship and it will protect you both. Do not play the blame game, rather be responsible and have clearly defined actions in the event of one of the partners testing positive with a STI. Getting tested together and ensure that both receive treatment in the event of an STI is also important to effective treatment. 

Yes it is possible to be, “safe in the arms of your love”.

I need somebody who really cares

So tired of livin' solitaire

Someday I'm gonna be

Safe in the arms of love…

Sung by Martina McBride

Alan Brand

POSITIVELY ALIVE ^cc

Employee Wellness Consultant and Specialist Trainer

E-mail: albrand@iafrica.com

Website: www.positivelyalive.co.za

Images from Zwagain Graphics http://zwangaingraphics.co.za/pages/posters.html