Perspective

Been doing a little reading this morning because the dustmen woke me up at six ("Hey! Stop with all the noise! Can't you see I'm HIV positive? Haven't suffered enough?") so I've managed to depress myself a little bit by looking through aidsnet and ticking my way through their list of countries with restrictions on travel for HIV positive people.

In typical British style, the information for visitors to the UK is contradictory. You will or you won't be tested and if you're positive you will or you won't be deported. However, given that most new cases of HIV in the UK are immigrants, allegedly (although I admit this could be racist nonsense), I'm guessing that whatever controls there are aren't that thoroughly enforced. America, though, are shitty about you trying to get in carrying HIV medication and have had a blanket ban on foreign visitors with HIV entering the country for something like twenty years. More to the point, they stamp your passport with something that declares your HIV status, not something you'd be wanting to have, unless you want bugchaser trophies.

How badly do I want to travel to countries that ban people from entering on the grounds of their HIV status, I wonder. Of course, until I start on medication, it is a simple matter to lie and tick a box on a form that perhaps I shouldn't knowingly tick. They're unlikely to fork out on expensive testing to check if anyone's lying.

Speaking of prognosis, I just found a very interesting article on aidsmap.co.uk about what CD4 count results mean. It's interesting that uninfected women have an average CD4 count 111 points higher than uninfected men and that smokers tend to have a higher CD4 count, too. Maybe it's an argument in favour of taking up the cancer sticks again.

My CD4 count at the initial test was 527. Since the normal range for people without HIV is from 400-1600, I'd assumed this was quite low, but aidsmap tells me that in a US study of people brought into an intensive care unit, the average count was 510. Compared to people with really nasty health problems requiring intensive care, I win by 17 points. I suppose that's a good thing? However, I've got to bear in mind that CD4 count fluctuates all over the shop, so what needs to be looked at is the overarching trend, which may take a year to discover if it's only every three months that it's checked.

They say that the average rate of deterioration of the CD4 count is about 40 a year and each fall of 100 points roughly doubles the chances of upgrading to first class and having "Full-blown!" AIDS. A CD4 count of below 200 is considered the danger zone, so that's when you usually get put into business class and get all the expensive drugs and can't go to America any more, but they'll start talking about it when you hit 350 or so, depending on how healthy you've been, the rate of decline and such like.

However, rate of decline is meant to follow your viral load - 10,000 is low, 100,000 is high. No wonder I scared my friend shitless when I said mine was something like 250,000 because I forgot how many digits were in it. It's 26,351, so it's on the lowish side of things. I can't seem to find the average viral load in people with HIV but it also seems subject to odd fluctuations depending on age, gender and ethnicity, so perhaps I need to look into that some more. Regardless, assuming a 40 point decline in CD4 count per year, that would give me about four and a half years before we talk about combination therapy and about eight years before I'm at 200 and will be forcefed drugs.

Thinking about it, though, the numbers and figures aren't a good guide to what could happen, what interests me really is the social and cultural prognosis, as well as the prospect of better treatments. They say sodium valproate can force the body to release dormant virus cells which can thus help eradicate them - interesting possibility, perhaps I should ask my friend's bipolar boyfriend about that, should we ever meet. They say crocodile blood could cure us and give us all peculiar regenerative powers. Interesting, huh? Sounds like we could go from blotchy zombies to superheroes pretty damn quickly, eh?

I wonder how attitudes will have changed by the time I actually could do with some intervention rather than monitoring? If they introduce ID cards, will they ask for medical information to be stored on those? With the current shift here in the UK towards the kind of police state that I'm sure should be led by a camp Sith in a cheap cloak, with fewer people gaining increasing power in the country, I do worry about the possibilities that this might imply for the socio-cultural prognosis for this country on all kinds of issues which impact on people from minority groups, so the fewer places that have a list saying I'm a gay boy with the plague the better, I say, until the revolution comes!