Will future SEE let Freddie Mercury express his HIV-status & sexuality?

“Mamaaaaa, ooohh. I don’t wanna die”. I think most of us will recognise the lyrics of this song by the famous and magnificent lead singer of Queen, Freddie Mercury. Freddy died in November 1991 and almost 30 years later, ‘Bohemian Rhapsody’ still plays on the radio nonstop. Besides his musical talents, his cause of death will continue to inspire people today and in the future. Freddie died of HIV/AIDS which he only publicly announced a few days earlier.

Last week we spoke about alcohol related to mental health, now we will further discuss the double burden of HIV/AIDS as a communicable disease and mental health in SEE. You can find previous posts on our blog. If this is of your interest, I would recommend reading them for a broader context.

The human immunodeficiency virus (HIV) is an infectious disease. For an explanation on how HIV is transmitted and how transmission can be minimised, watch this short video (1.35min)

https://www.youtube.com/watch?v=aHVgXacACj8&feature=youtu.be

HIV affects the immune system which is responsible for the protection of diseases to occur in your body. Therefore, people infected with HIV are more susceptible to all kinds of infections, cancers and other diseases, whereas people with healthy immune systems can generally fight these off. Symptoms people can experience depend on the stage of infection. Usually HIV-infection starts off with mild, feverish symptoms and in a later stage symptoms such as diarrhoea, weight loss, cough and swollen lymph nodes can appear. If treatment is lacking, even more severe and long term diseases can develop, like tuberculosis, meningitis and some cancers. This latter stage is the most advanced stage which we also know as AIDS. Depending on how the body can combat these diseases, death is a possible consequence.

But how is HIV/AIDS related to mental health?

HIV and mental health have a bi-directional relationship according to UN AIDS.

Firstly, people infected with HIV have an increased risk of developing mental health disorders as a consequence of neurological effects of the virus in the brain and psychological stress due to ill-health, stigma and discrimination. This concerns ‘common’ mental health problems such as depression, persistent depressive disorder, anxiety disorders and substance abuse. Consequences of alcohol abuse can be found in our previous post.

Secondly, an American study stated that HIV is almost four times more prevalent in people with severe mental health disorders such as schizophrenia and bipolar disorder. This is as a result of the characteristics of these psychiatric disorders causing more risky behaviour including unprotected sex, sex with multiple partners, sexual victimisation and injection drug use.

What is the state of HIV in SEE?

To find out what the actual state of HIV is in SEE, is very difficult. Some sources say that countries like Albania and Bosnia & Herzegovina have the lowest prevalence of HIV worldwide (<0.01%). Other sources claim that Albania and Bosnia & Herzegovina have the highest percentages of people diagnosed with very few immune cells which are specifically affected by HIV. Even though availability of data on HIV is questionable, I think we cán safely conclude that HIV is a major public health threat and it affects thousands of people (and counting) in SEE alone.

As mentioned in a previous post, most SEE countries belonged to a communist regime. This may have influenced the current high levels of stigmatisation and discrimination. Even today gay rights are not yet completely adopted in countries such as Armenia, Bulgaria, Croatia and Moldova. Therefore, gay people (who are more at risk for getting HIV) can suffer from social exclusion. Moreover, knowledge of HIV remains low for example in Albania, especially women do not know much about prevention or where to find treatment. Also knowledge and education is limitedly provided in schools as sex used to be a huge taboo subject.

As symptoms are difficult to recognise, people are unaware and diagnosis is often late which increases the risk of HIV developing into AIDS and death. Also, access to diagnosis, treatment, condoms and care (in combination with mental health care) are physical, social and economic barriers. Therefore, direct diagnosis, treatment and knowledge are needed to slow down progression and prevent HIV from further spread.

Will future SEE let Freddie Mercury express his HIV-status & sexuality? Let them be no longer “Under Pressure”.

Next week you can read more on personal stories of HIV patients under pressure or what the WHO recommends.