Fifteen years ago, to be diagnosed with HIV/AIDS was akin to a death sentence as persons simply waited to die. Today, with increased accessibility to more affordable drugs and earlier diagnosis, infected persons are living longer.

But now health professionals are faced with a new problem, as children infected at birth who are now in their teen years have begun expressing sexual desires.

It’s an issue which no contingency plans were put in place to deal with.

Ian McKnight, former director of Jamaica AIDS support, says there is at least one case here in Jamaica where a child born with the disease have lived to be 18 years old.

“Somehow in our minds we never figured he would still be alive…now wanting to have girlfriends and to date and these are things we never thought about,” he said “At first it was that we were very happy that he has survived two years and by the time you look around he is a teenager and now it is a whole different discussion, one we had just never thought through,” he added.

He said the same is true for some schools who enrolled HIV infected children and now see them becoming teenagers and getting interested in the opposite sex.

“Now, some of the principals are looking at Peter checking out girls and not knowing what to do and these are some of the shifts we never planned for,” McKnight pointed out.

He explained that 15 years ago when persons were diagnosed with the disease, they could not afford the $40,000 for a month’s supply of the antiretroviral drugs, which now cost $1,000 for the generic brand. As such he said many of those who died could still be alive if they were on medication.

Ministry of Health statistics revealed that 6,032 persons have died from the disease since it was first discovered in Jamaica in 1982.

One member of JNPlus, a network of HIV-positive persons, while agreeing that increased access to medication is a contributing factor, pointed out that the formation of various support groups does play a role.

She explained that in 1997 when she was first diagnosed it took her two years to pull herself together as there was no support system in place.

“When I went back to the doctor for my result the first thing she asked is how could I allow this to happen to me..I just could not believe that the doctor could think I willingly allowed this,” she said.

Now, she says, persons have access to counselling before they take the HIV test, while they wait on the result and after. “With this preparation they already know what to expect and how to manage themselves if the result comes back positive,” she argued.

Faith Hamer of the National HIV/STI Control programme in the Ministry of Health, in addressing a group at a Panos Caribbean workshop in Ocho Rios last weekend, also agrees that the affordability and accessibility to antiretroviral drugs have contributed to infected persons living longer.

“This is largely due to collaboration of public and private companies such as Lasco to provide the drugs,” she explained, adding that the Global Fund, which provides some US$23 million, has enabled the process.

Discrimination and stigma she said, however, remain a major deterrent for persons wishing to access the medication.

“The accessibility and the affordability are affected by the rate of discrimination and stigma in the society as some persons do not even want to visit the health centres for fear that people will know their status,” she explained.

This point was supported by a member of the Jamaica Forum for Lesbians All Sexuals and Gays (JFLAG) who argued that HIV and AIDS infected persons were timid about seeking medical services because of the questions that will be asked, as well as society’s perception that AIDS is a gay disease.

But Patricia Russell, also of the National HIV/STI control programme, argued that there are more services now available to people with the disease, and there are social workers who will visit those who can’t go out.

She said families have also become more accepting of the disease and are better at assisting their loved ones to live positive lives.

“People were giving up on life quicker then a couple years ago because they did not have the support system in place, but now they realise they are not in it alone and that has helped them to want to live longer,” she said.

One young man who was diagnosed with the disease nearly 10 years ago supported the argument that the medication does prolong life. He however noted that persons have to be prepared for the side effects that come in the first stages of taking the drugs.

“When I first went on the drug I had side effects where I saw all sorts of things such as creatures crawling on the wall, and I began walking in my sleep; a whole lot of things happening,” he explained.

McKnight agreed that this is true, as the drugs are highly toxic and in the initial stage people suffer various side effects.

“Some people put on a lot of weight in some very obvious areas, so 15 years ago you are talking about physical manifestation such as slimming down, now you are talking about this uncontrolled weight gain that is unexplainable.”

McKnight noted that while the medicine has its advantages, it could be seen almost like a cure with no further research being done to improve on it.

“Some companies have made billions of dollars out of these drugs and because the generics are available on the market they have pulled out the research component out of it,” he said.

He questioned what will happen in the long term when the research is not updated and the drug no longer has the desired effect.

“We are going to be at a standstill and a lot of these companies have just backed off because they have made a lot of money out of it.”

He said that now with earlier diagnosis people are learning to better deal with the disease, as they are able to start getting treatment before showing symptoms of the disease.

“In the earlier years it was some physical manifestation which prompted them to go and get tested, but now people are getting tested earlier for different reasons,” he said.

And even as the drug is more affordable, he said there are persons who are still unable to find the transportation cost to travel to the health centre to get the medication. There are also others who are unable to afford a balanced diet which is needed for the drugs to have the desired effect.

McKnight also noted that in many instances persons have not been able to maintain a consistency in taking the medication on schedule.

There is a greater need, he said, for persons to be more sensitised on the importance of taking the drugs continuously, even after they begin to feel better.

“What is happening to people is that they feel good, they are going back to work and they stop taking the drug and then they regress,” McKnight explained.