Wednesday, June 13, 2001

AIDS: Breaking the taboos Prague support center assists patients, but stigma persists for those who carry the virus By Kate Swoger Things are looking up for Monika. The 29-year-old, who is HIV-positive, has to take a handful of pills three times a day to keep her immune system from collapsing under assaults from the virus. She smiles widely and says she feels great. It's been 20 years since the first report of AIDS was published. In the bleak years that followed, it would have been hard to imagine someone like Monika living an active life at Lighthouse (Dum svetla), a support center in Prague 8 for people with HIV. The short, blond woman is one of 511 Czechs who are known to have contracted HIV over the past two decades. "People here help each other a lot. We look after each other," she said of the center, where she has been staying since it opened two years ago. "We're like a community." Before the development of drugs that suppressed the advance of the disease, those diagnosed with AIDS usually died within about a year, said Dr. Marie Bruckova of the National Reference Laboratory on AIDS. "Now ... people are surviving for five, seven, even 10 years," she said. But hopes for a swift cure to the AIDS virus have also faded. Over time, the virus weakens the immune system, leaving the body vulnerable to infections, some cancers and the degeneration of the nerve system. Monika may spend years swallowing a cocktail of pills morning and night, with a course of the protease inhibitor Invirase in the afternoon. Despite the official 511 figure, the United Nations estimates that there were 2,200 Czechs living with HIV or AIDS, the immune-deficiency disease caused by the HIV virus, at the end of 1999. 20 years of AIDS First published report of AIDS: June 1981 Number of deaths worldwide: 21.8 million Number of reported cases of HIV in the Czech Republic: 511 Number of those who have died: 90 UN estimate of cases of HIV in the Czech Republic: 2,200 AIDS: Acquired Immune Deficiency Syndrome, a disease that ravages the immune system HIV: Human Immunodeficiency Virus, the virus that causes AIDS "Very often people won't get tested," said Laszlo Szumegh, a social worker who assists child prostitutes though the city-funded Projekt Sance (Project Chance). The virus is transmitted via body fluids through sexual intercourse or sharing needles. More than 80 percent of the known cases here were transmitted through sexual activity. While Szumegh is heartened to see the stigma that surrounded HIV relaxing, he knows that many people still don't want to face the illness. "They feel bad, but they won't see the doctor for one simple reason -- they say, 'If I don't know what my condition is, I consider myself healthy,'" he explained. Bruckova's "crude estimate" of the actual number of Czech infected is 2,555 -- five times the number registered. And while the number of known cases is low, she said it is increasing, especially among women. If there were more people registered as HIV-positive, the problem would be more visible, said Vaclav Stouhal, head of the foundation that runs Lighthouse. Then, perhaps, the public, especially those older than 35, would more willing to talk about it, he said. The official number of 511 doesn't include 148 HIV-positive foreigners living in the country, Stouhal noted. Over the next five years, Lighthouse plans to add two more floors to the building to accommodate asylum-seekers infected with the virus as part of an agreement with the Interior Ministry. Another Lighthouse resident, Marie, fits into that category. She fled the civil war in her native Democratic Republic of Congo in March and is seeking asylum here. She says she didn't know she was HIV-positive until she arrived in Prague and went to the hospital to give birth to her son. While coping with the virus in a land where she is struggling to learn the language isn't easy, she says her life at the support center is a world apart from the place she left. An estimated 30 percent of adults are infected in sub-Saharan Africa, which saw the bulk of the 3 million AIDS-related deaths in 2000. "There, no one has any money for medicine," Marie said. "If you're sick and you have no money, you are left to die like a dog in the streets." -- Yekaterina Zapletnyuka contributed to this report. Kate Swoger's e-mail address is kswoger@praguepost.cz