Response to Rupa Cinai's Article in Times of India

[Guest guest]

Dear Forum members,

Last week we saw a series of 2 articles by Rupa Chinai and the

another by Ms Srivastav about false positive ELISA tests in Times

of India. I am herewith sending the text of the response letter I

wrote to TOI which has not been published as yet. This is for

discussion in the forum. Dr Vinay Kulkarni

______________

To The Editor, TOI

This is in response to the 2-part series by Rupa Chinai (RC) published

25th and 26th May, 2001 in TOI.

As a person also looking at the issue of HIV AIDS for last 15 years

(as claimed by RC) I got interested in the write ups right from the

title. ' Drug therapy may not be the promised panacea for HIV

patients'. I think no one even remotely conscious of the different

facets of this epidemic would ever claim that drug therapy was one.

It is only a promise for a relatively better quality of life as

compared to those who do not or can not avail of or access drugs.

This can be shown from innumerable reports, scientific studies,

individual experiences. If a well-meaning reporter wants to see

it is all there. Apart from the medicines started at an

appropriate time ( not too late), again, there will not be a

single person who will not agree that there is a role for change

in life style. Good food, regular exercise, refrain from harmful

habits, peace of mind ( by whatever means one may get it ),

empathetic counselling and assuring social support - all make

the ultimate difference. Life with HIV is indeed a difficult

life and only medicines will never make it easy.

But if someone starts claiming or hinting at that it is only

a matter of 'toxins' and HIV is all humbug, even if that

someone is RC or a Nobel laureate, is doing a great harm to

the fight against AIDS. All these people Duesburg,

Shantilal Kothari and RC echoing them are in fact helping

the spread of the menace and not its containment.

The scientific and epidemiological arguments against the

contentions have been explained again and again, yet if someone

keeps on feigning 'enlightenment' what can others do? HIV positive

people have definitely a different natural history of health than

millions other who do not have the antibodies and yet have been

exposed to toxins of antibiotics, drugs and anal sex. In families

living in same economic and nutritional settings it is only the

people with antibodies that are developing symptoms, only sexual

partners of these people and their children develop antibodies

and not others in the family or in the neighbourhood, if nutritional

conditions improve the antibodies do not disappear, people with HIV

have more aggressive TB than those without, if people like RC need

to have more evidence they can certainly get it. Raking up the

controversy about what went wrong in 1981, RC is trying to

turn the clock backwards, instead she better cap her pen.

As regards the second part of her series let us understand

that as with any - and by that I mean any- pathological test

there are problems with HIV test also and given the nature of

the disease and stigma attached to it, a wrong test will play

havoc with lives of people. But precisely for this reason we

need to standardise the kits, procedures and protocols. If

technology is used indiscriminately it is bound to have

negative repercussions; but is it not true about everything,

including journalism?

Other issue is about the toxic effects of anti HIV drugs.

Again as with any medicine on the earth there are going to

be some side effects. But our experience of their use in

thousands of patients tells us that they are not as toxic

as they are made out to be. there effects and side effects

can be monitored. The write ups are more toxic, especially

when the drugs are becoming cheaper and more and more people

can now access them.Here again what if they are misused-used?

the answer is that we need appropriate training, well set

protocols and regular monitoring.

Responsible journalism can contribute by writing sensible

articles rather than sensationalising the matter.

Can I ask a few questions?

1) If there were nothing like HIV shall we ask HIV positive

people to continue to have unsafe sex?

2) Shall we stop our programs to promote testing of pregnant

women and providing them with prophylaxis? ( Anecdote about

how a non infected pregnant woman was administered AZT, does

it really prove any point apart from the care needed to be taken?)

3) Should we stop promoting safe sex practices among youth

if they are not injecting drugs and are not having anal sex?

4) Shall we not encourage youngsters to get tested for

HIV before marriage ? ( Almost 40% of new infections are

taking place in girls between age 15 to 25, the infection

is acquired from their husbands - in monogamous, non anal

sexual relations and without any exposure to toxins of

drugs or antibiotics.)

If there are answers to these and so many similarly related

questions there could be some personal questions:

1) Would you have unprotected sex with someone who is HIV

sero-positive?

2) Would you marry your children to someone who is HIV

positive - without discussing the consequences and allowing

them to take an informed decision?

3) As Shantilal Kothari of Nagpur challenges would someone

inject himself or herself with HIV positive blood? Kothari's

challenge is fraudulent as he always asks someone else to

inject him with HIV positive blood.

So I urge RC and all others in her flock to take a saner

view about the situation. let us look at HIV from a broader,

comprehensive, inclusive perspective than taking such

extremist stands.

Extremism of all hues is detrimental to health.

Dr. Vinay Kulkarni

PRAYAS

Amrita Clinic

Karve Road

Pune

E-mail:<prayashealth@...>