IS THE HONEYMOON OVER?Going
on to HAART (Highly Active Anti-Retroviral Therapy) is rather like entering into a marriage. Not only is it a lifetime commitment, and one which requires a lot of thought before “taking the plunge”, but also it has its “ups and downs”, and rather like the partner you choose, you take it “for better or for worse”. No-one would disagree that a good marriage takes a lot of hard work. So does HAART. Learning to live with the every day problems that such a close relationship brings is difficult. Changing your daily routines, coping with adjusting to a new way of life. And it also brings great joy, especially at the beginning when you find there are suddenly lots of things you can do that you didn’t do before. Sound familiar?
Those first few years are often blissful, give or take the minor adjustments. But what happens after the honeymoon is over? That’s when the real work begins. Settling into a daily routine. You begin to become complacent. You expect everything to be as good as it was in those early days. But they’re not. Not by a long chalk. You begin to wonder if it is all worth it. And the cracks begin to appear.
The difference between marriage and HAART? With marriage there are lots of other people who have “been there” before you. Lots of people who can help you cope with this deteriorating situation and help straighten things out...people understand. And HAART. well, it’s not quite the same. The whole thing is so new that we have to just hope for the best. No-one really understands...except perhaps other people taking HAART.
Positive Lives is beginning to hear from people who are not as happy as they used to be, both physically and mentally. Cracks are beginning to appear. Unfortunately, the medics are so preoccupied with good viral loads and CD4 counts that they may be missing problems that come with time. Being well is about feeling well. And some people are beginning to feel unwell.
Lots of anecdotal reports (especially in London) are beginning to show that long term use of HAART is producing symptoms which were not anticipated (and are often ignored) by the medical profession. Mood swings, loss of libido, muscle wastage, weight loss, mental heath problems and much more. There is currently a feeling among some HAART patients that these effects are being dismissed in the light of high CD4 counts and low viral loads. It is true to say that opportunist infections and the number of deaths from HIV & AIDS has been dramatically reduced. People are living longer.
But, rather like a shaky marriage, things are not so solid under the surface.
Successful marriages are few and far between. The ones that work are the ones that look at all the problems facing them, not just the ones that the outside world sees. It involves a continuous reassessment and readjustment of the relationship, without an air of complacency.
With the new reports coming through, could it be that the honeymoon is over? Could we and the medical and health professions be ignoring the long-term consequences?
This marriage with HAART has the potential of being a long-term survivor. It also has the potential to be a marital nightmare. We are already seeing “separations”, with people coming off their therapies. Divorce is the ultimate option, a procedure which traditionally carries casualties, heartache and pain.
Let us try and maintain this marriage so that we can be celebrating our silver wedding in the next century. |