It's World AIDS Day.

Before moving to Africa HIV/AIDS was a disease I knew of academically but that was it. I'd never met anyone who suffered with this disease and aside from a few celebrities who had passed away from AIDS or who were living with HIV and the occasional article I would read, it was largely a 3rd world problem in my mind--a widow and orphan creating disease. 

Now that I've lived in Africa for nearly nine years I have come up close and personal to this pandemic. It is a brutal and devastating disease. It isn't even so much that it is a deadly disease with no cure but the psychological effect of HIV/AIDS is the worst part. 

There is still so much stigma attached to an HIV diagnosis. I think a big part of this is the prevention campaigns. As well-intentioned as they are, when all the posters say, "Stay Faithful and You'll be Safe", then the flip side is: If you're infected you were Unfaithful! This causes people to stay away from testing. They don't want their neighbors to perceive them as a philanderer.--Even if they are and everyone knows it, the HIV positive result means there is no room for doubt. 

In Africa, sadly, most HIV is passed through heterosexual relations. This means that if a woman tests positive her integrity is called into question even if she was the faithful one and her cheating husband is the one who infected her. As long as he is not tested she is the one everyone points fingers at. 

Getting people to the testing center for VCT (Voluntary Counseling and Testing) is only the first step. After that, a person living in Africa with HIV has a long, hard road ahead of them. 

First they have to summon the courage to get on a program where they receive the medicine that they need. This can mean having to go to the clinic in full view of the village where everyone knows that those with HIV visit the clinic on a certain day.

Next, they have to be diligent to take their medicine at exactly the same time every day. In a culture where things go by the flow and time is fluid, this can be a real challenge. But, it is so incredibly important. Their life hangs in the balance.

Finally, they have to eat better and do more to stay healthy. The African diet in the villages is not well-rounded or extra nutritious. Those with HIV need more protein and vegetables in order to keep their immune systems up. African diets tend to be more starch-heavy because people focus on the energy foods--those with greater immediate benefits.

This is the reality of HIV/AIDS in Africa. It has come a long ,long way from when we first got here. People are going for testing now. Medicine is available. And the information is out there. When I met with my staff yesterday for our regular meeting, I took advantage of my captive audience and discussed HIV with them. And, amazingly, they all knew the right answers--to nearly every fact or question I threw out there. There were a couple things they got wrong but they were minor--they knew the important stuff. But, at least three or four of them are stubbornly refusing to get tested. I could tell that some of the others know their status but are not following the best treatment plan because of the difficulties in confidentiality in a village setting.

The crazy thing is that the fear of HIV permeates people's lives. They all know it exists, they have the information, the see the posters everywhere and they fear it. Those that haven't gone for testing worry constantly about possibly having it. So, even if they are not infected it affects their life. I feel like shouting from the rooftops: The truth will set you free! 

When we lose a sweet employee who dies because she refuses to damage her reputation and get tested for HIV or when we see another valued employee fail to get the necessary treatment 'because she doesn't want anyone to see her entering the clinic, or when a baby is denied the right to medicine because her parents are afraid to know their status it breaks our heart.

How can you help? Pray for those working in communities with high HIV rates. Pray that strong, Christian examples can come forward to show what living a positive (HIV infected) life looks like. When we can move HIV out of the shadows and into the light where it is just a disease that we have to prevent and treat and not a social stigma then we will finally make real progress in helping people stay healthy.

Exactly One Year Ago: No One Told Me  (get to know my teenagers)