Health & Wellness

CARE AND TREATMENT OF PATIENTS LIVING WITH HIV IN BERMUDA ‘SECOND TO NONE’

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by VEJAY STEEDE

Once dubbed ‘The Big A’ by citizens whose lifestyles put them at high risk of contracting the HIV/AIDS virus, the incidence and intensity of the epidemic in Bermuda has diminished significantly since the days when it was tearing through our streets with reckless abandon.

Dr Carolyn Armstrong, executive director of STAR (Supportive Therapy for people with AIDS and their Relatives), reflected on how far we’ve come since those harrowing days:

“It is refreshing to muse over the journey of the past 36 years. We have travelled from one evening, during the birthing of STAR, when a tear-provoking story was told of men and women dying alone from a mysterious disease that was ripping through Bermuda. We were told about the families who were being devastated; some by the loss of one family member, while others were losing two and three members of their families. Entire families were affected weekly; the island was in a state of absolute panic!”

In the midst of this tragic environment, STAR became entrenched:

“On Fridays, volunteers from STAR, in partnership with the public health nurses assigned to tackle the mounting health challenge – and socially damaging activities – would faithfully go to Court Street, where many clients would congregate. Some would call out: ‘No need to see me ladies. I don’t have the ‘Big A.’ Others were curious about how some of their friends, who had been hospitalised, were doing. Many had fallen ill, been taken to the hospital and, within mere weeks, had passed away.

“The crew on Court Street would smell us coming. Some walked away. Some would stay to talk, or climb in one van or the other for private conversation. Many trusted our consistency. They were afraid. They feared for their own lives. These were all members of a brotherhood whose common denominator was injection drug use, and other activities used to satisfy addictions. We knew that Friday was a ‘major trigger day’ for drug addicts. We placed ourselves in the thick of it for the sake of the lives of the men and women infected, and their families and significant others. The more that deaths occurred, the more we sensed anxiety, frustration, anger and fear.”

“Those days have passed. Today our friends living with HIV/AIDS infections are in a completely different space.”

This is owing, in no small part, to the determination of STAR and Bermuda’s wider medical community, who dealt with the chaos and destruction that HIV/AIDS visited upon Bermuda in those early days.

Our progress has been well earned, resulting in Bermuda gaining a stellar international reputation for HIV/ AIDS care, Dr Armstrong expounded:

“Bermuda’s teams of ‘medical angels’ from the early 90s, until this season, have invested time, finances and personal sacrifice. Due to their diligence and medical integrity, Bermuda has gained respect and honour in the areas of prevalence and treatment. The number of persons contracting HIV infections have plummeted tremendously.

“According to the official report released in December 2021, the number was 2. We cannot assume that this is absolute, because we are aware that people do travel to be tested and treated. This report can only reflect what is reported to the Ministry of Health, and we trust that all positive tests are reported to Ministry of Health.

“Prevalence is at 0.05 percent. The determined number of persons currently living with HIV is 303. They must continue to be vigilant, in compliance with treatment and self-care.”

“Bermuda’s care and treatment is known throughout other jurisdictions as being ‘second to none.’ With reference to treatment in the late 1980s, from AZT to many different oral medications as treatment measures have progressed. Today a short list of medicinal treatments includes Viktarvy, Triumeq, Cotrimoxazole, Atripla, Juluca and Metoprolol.”

Of course, COVID-19 has had an impact on those living with the immuno-deficiency condition.

“The onset of the Coronavirus put clients on alert. Underlying health issues weigh heavy on those who are immune-compromised. Protocols at Light House (a nine-bed home for men, women and children living with HIV) changed immediately. A sanitizing station was positioned at the home’s entrance. Several masks – huge thank you to the Bermuda Red Cross – were issued to those who left the home at any time. All surfaces are sanitized day and night. Testing is highly respected.”

For all intents and purposes, and due to the dramatically diminished prevalence of the disease, Dr Armstrong said: “From the perspective of Public Health, the AIDS Epidemic is over. This seems to be the calm after the storm.”

Dr Armstrong closed by recounting a heart-warming recent conversation with a Bermudian living with the disease:

“Clearly, years later, we breathe fresh air, with fresh thoughts and attitudes. Upon speaking with a survivor of three Agape’ House admissions, his immediate response was a wide grin. ‘I am so relieved no one plies me with questions anymore. Bermuda has grown up. It was like being under a microscope. Bermuda is so small. Everybody knew my business. I was judged, and I felt judged. I never indulged in the drug culture, but everyone was curious.

“’Today, with all that has been done on my behalf, I walk with my head up. Stigma doesn’t touch me the way it used to. Unfortunately, others are affected differently. Some of my peers are still extremely private, with personal health issues. Not me. I enjoy every day. I volunteered with Agape’ House before Covid-19. I wanted to give back. I am so grateful to the STAR, and Light House Charity, who birthed Agape’ House in the early 90s. I am proud of myself. I share with young people and with anyone who will listen. The only things that remind me about the diagnosis are appointments with the doctor and medication. Although I am challenged with another illness because of having an immune system that is compromised, I am at peace with God, I am supported, and that’s what helps me to thrive. Boy, that was a mouthful.’ And he walked away laughing.”

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