To live with HIV

By, ABS-CBN Interactive, November 27, 2006

I know her as Rhina. Though she hides behind aliases and only agrees to be seen as a silhouette—or precisely because of it— she is every woman. And she is positive for the human immunodeficiency virus.

"I came out to impart to fellow OFWs and to everyone—youths and adults—that HIV/AIDS is here and that they should get proper information regarding HIV/AIDS so that they can prevent infection," she explains. The virus is now among the general public. It has gone beyond risk groups such as homosexual men and prostitutes. It is all our concern.

She notes, "It is also because here in the Philippines, there is also discrimination. Affected families still do not fully accept relatives who are HIV positive."

Rhina emphasizes, "Regardless of what I am, I still have purpose. Life, despite sickness, goes on. I want to give an example to those people who still hide that they should not fear or feel ashamed. It was not our intention to be infected with HIV." "Perhaps God has a mission for me. That’s why I’m still here."

Rhina not only survives; she dares live her life.

In the years following her infection, she met, feel in love and married her husband, who like Rhina lives with HIV and works for Positive Action Foundation Philippines Inc., an internationally recognized and supported non-government organization dedicated to people infected and affected by HIV/AIDS and their families and significant others, for which she has been working with for almost six years.

Rhina and her husband even braved willfully having a child of their own, a second for Rhina and the first for the couple. She conceived her eldest daughter before her infection and the child does not carry the virus. Her youngest child, only four months old, has yet to be thoroughly tested for HIV.

"It was our choice as a couple to have a child. My husband has been widowed twice and it is his first child. He’s very happy to have a child. Should the day come that he passes away. . . . My husband has had HIV for 12 years," Rhina explains.

Though there is still no cure or vaccine for HIV and AIDS still kills, current antiretroviral drugs slow down the replication of HIV, allow one’s immune system to recover and allow for a normal life. However, Rhina and other like her need to take ARVs for the rest of their lives and still need to take precaution against transferring the virus. Rhina receives her ARV free from PAFPI for which she has been working with for almost six years. ARVs are available in various hospitals as far away as Cebu and can cost P6,000 a month.

ARVs, when combined with other interventions such as infant formula feeding and cesarean section to prevent transferring the virus through blood or mother’s milk and prophylaxis for the infant after six weeks, can cut the risk of transmission to below 2 percent—this according to the World Health Organization’s "Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants" published in 2004. These facts and more Rhina knows all too well. Still, she declares, "Faith is number one. Hopefully, with all our prayers, my baby tests negative."

Rhina, a provincial woman who attained a junior high-school education in Manila, speaks with many HIV/AIDS advocacy terminologies enriching her highly articulate Tagalog vocabulary. "Discrimination," "affected families," "disclosure" and "indigents" are a few of the English words that she uses as she discusses in the vernacular. She corrects me, clarifying that she does not have AIDS, the end stage of an HIV infection when the immune system has been degraded by the virus to a point where it can no longer fend off opportunistic infections. She and other advocates emphasize that they are not "AIDS victims" or even "AIDS survivors." They are people living with HIV/AIDS.

In person, she is plump, apparently healthy with smooth skin. She recalls weighing several belt sizes thinner when she was still sickly. She credits the support and acceptance of her firstborn daughter as much her treatments for her renewed health. She speaks softly with a measured cadence, yet clearly and directly. This is but a one of many interviews for her. As a volunteer for PAFPI, she testifies for a living. It is now her work to confess her life so that others may learn and live.

Among her kin, only her mother, her husband, her daughter and a few relatives know her condition. "Some in the province know because I had the courage to disclose my status. I need to tell them despite their lack of full understanding because time will come when I will need their help. And they will find out eventually," she confides. If Rhina’s vocabulary is the indicator of her awareness, then the reach and depth of her disclosure is the gauge of society’s acceptance.

"The community has yet to know," she confides.

She admits, "Before I was diagnosed, even I discriminated against persons with HIV. All I knew back then was Sarah Jane [Salazar]. I would say, ‘that person has AIDS. Disgusting. She’s probably a bad woman.’" Salazar was the first person to publicly admit her HIV infection in the Philippines. She died in June of 2000.

"When I first learned about my infection, it was hard to accept. I didn’t know anything about HIV then. I wanted to be alone. I wanted to commit suicide. I felt my soul had already left my body. All my dreams crumbled. I didn’t know where to go or who to talk to or how to tell my family. I was afraid they would be disgusted with me," Rhina recalls.

In the book For Good: Life Stories of Filipino Migrant Workers Living with HIV/AIDS published by Action for Health Initiatives in 2004 before the birth of Rhina’s youngest child, she has told her story through another alias: Sharon. In the book, she narrates her story:

She grew up in the provinces with her two half brothers raised by a single mother who worked as a nightclub entertainer. Her father, a communist insurgent whom her mother fled just before their wedding for his philandering as well as his violent nature, later tracked them down and returned to their lives. For a time, she lived with her mother, her father and his female lover all in the same shanty home. Both parents were physically abusive. Despite her parent’s strict supervision, Rhina dated boys in high school. Her father was later murdered while on assignment in another province. This allowed her mother to move to Manila.

At age 17 while still studying for third year high school, Rhina decided to apply for work abroad as many of her neighbors did. She did so illegally, being under-aged. She gained employment in Qatar with physically and verbally abusive family. During this time she had a series of boyfriends in Manila and upon her return was sexually active.

She gained employment abroad again, this time in Malaysia, where employers were more humane. Rhina also began to enjoy her life, often going to discos though it was forbidden in her contract. She even fell in love with a Malaysian named Steve, yet another violation of her contract. Rhina became pregnant with her first daughter. It was only after conception that Rhina uncovered Steve’s married life. She had to leave her employers as she entered her third trimester; beyond that they would soon find out about her pregnancy—yet another violation of her contract. She moved in with Steve and gave birth to her firstborn in Malaysia in 1997. Following the Asian economic crisis, Steve lost his job and started taking drugs. Six months after the baby was born, Steve disappeared. With no money to pay for rent, electricity, water or a ticket back home, Rhina went hungry. Her friends were able to raise funds to send her home.

Fending off a marriage proposal from a boyfriend in Manila while struggling to make ends meet, Rhina decided to work abroad again, this time as a legal documented OFW in Dubai where she worked for a young couple with a baby. When her female employer went for a trip to Saudi Arabia with her baby, her male employer raped her repeatedly at knifepoint over several days. It was through him that Rhina acquired HIV. Later, Rhina was able to divulge part of the abuse to her male employer’s best friend, who would ask her to do chores for him to distance her from her male employer. When the wife began to suspect her husband’s rape, the man began to beat up his wife as well. With his best friend’s help, Rhina, the wife and her baby later escaped. Her female employer even filed charges against her husband. However, Rhina’s employment agency in Dubai discouraged her from filing a case.

Rhina’s story since has become a continuation of abuse and insensitivity.

She recalls, "The [job placement] agency whisked me away. I didn’t know my rights as an OFW and woman. They immediately dropped me off at my home because they didn’t want me to report the incident. Had I known, I could have filed a case, I would have fought for my rights."

Rhina only discovered she had contracted HIV when she applied for work abroad yet again. She recalls, "I had diarrhea and fever for almost one month starting a week after I arrived. When I tried applying for work abroad again to Malaysia, they took my blood sample at a clinic without any pretest counseling. They didn’t explain that they would run an HIV antibody test. I was just waiting for my medical exam. I already had a visa. They told me they would confirm the findings with a hospital. I didn’t understand it at first. I was offended by their questions.

They asked how many men I’ve had sex with. I was insulted I asked the nurse who accompanied me what my sickness really was. She whispered ‘HIV.’ My best friend [a fellow female OFW] who was with me had to explain it was [the virus for] AIDS. I had to have my counseling in another hospital."

When Rhina applied for indigent status to avail of substantial discounts for her medical expenses, it required an interview with the Department of Social Welfare and Development. There was no privacy during the interview despite Rhina’s entireties for confidentiality. When she did disclose her HIV status, the social worker blurted it out within earshot of her officemates. Rhina felt violated.

Despite such rough treatment, there are also institutions that cared for her. It was PAFPI that provided counseled, supported, informed and later employed Rhina. "I was just a walk-in. A volunteer, a fellow OFW and PLWHAS, had given me her card and told me to come. In June 2002, I traveled to Malaysia upon the invitation of Coordination on Action research on AIDS and Mobility-Asia to make a presentation on HIV Vulnerability of Migrant Workers. During this trip she gained closure from Steve. Rhina has since changed firstborn’s citizenship to Filipino, who was originally registered on her Malaysian birth certificate as belonging to Steve and his wife.

It was also while working with PAFPI that she met her husband. "I met him in the hospital while conducting visits for the NGO," she recalls. "I thought he was my type but back then he had a wife and he looked like a playboy," Rhina confides.

When his wife died due to HIV-related illnesses, her husband later became a volunteer for PAFPI. They became the best of friends and love soon bloomed. After living together for a year they decided to marry in 2003. A Catholic priest wed them regardless of the inadvertent disclosure of their HIV infection. "My husband still had fever from his trial ARV back then. I told the priest he was sick. My husband thought I had told the priest everything. So he made a full disclosure," recalls Rhina.

Today, people who care and who are aware surround Rhina. However, she still experiences prejudice even from health professionals. "I didn’t like the counseling of my first pediatrician," admits Rhina. "What now if you infect your baby?" the doctor asked her in a very judgmental and moralizing manner.

"It is our right, our option to have a baby," declares Rhina. She adds, "As patients, we receive counseling. No parent wants his or her child to have HIV. But doctors have no right to tell us to stop. We have right to live a normal quiet life and kids." Rhina sought another pediatrician. Her current one has been very sensitive to her circumstances, simply offering her options without any moral judgment.

She explains the various considerations they weighed before making the decision to have a child. "We thought of the possibility that the baby would test positive [for HIV]. As a couple we thought we would accept whatever God’s wills.

We saw how other people living with HIV had kids who tested negative. And we took into considerations the medicines now available. In the end I trusted my faith in God."

Despite her faith, Rhina is all too aware of her precarious situation. "This is the difficulty of the volunteer. Work in an NGO will not last a lifetime. What if the organization is no more? What if there’s no more budget? True employment is difficult. With our status, there’s a limit to what we can do. We can’t endure too much hard work or fumes," she explains. "I hope people become more aware. I hope they accept us and not turn us away in disgust," Rhina hopes.

Her thoughts turn to her daughter: "My daughter had a PCR [polymerase chain reaction] test on October 23 and she tested negative. If she tests negative again on the second PCR, she’s free from the virus." PCR tests detect for the genetic material of the virus. Secondary PCR tests on infants are often conducted on the sixth month. Rhina hopes for the best.

Hope is infectious. It travels farther, faster and deeper than any virus. I give Rhina a hug before we part ways. Hope is the one thing everyone carries away with when they witness Rhina lives her life.

Source: http://www.abs-cbnnews.com/storypage.aspx?StoryId=57408