So there you are — not yourself, perpetually tired, sleeping badly, getting repeated sniffles, coughing, maybe losing weight or putting on weight in all the wrong places, suffering various joint pains, headaches, maybe even the odd bout of eczema, boils, warts, mouth sores, shingles, thrush and the like. High blood pressure or low blood pressure, pre-diabetic or full-blown.

If you are in South Africa, the last thing you do is check in at the outpatient clinic of your local government hospital. Why? Because you will be pressured into taking an HIV test. If you resist, you will be given short shrift and sent on your way. If you do take the test and it’s positive, your life is over. It’s Bactrim or antibiotics until your CD4 count (a measure of you immune system) drops below 200, and then it’s antiretrovirals (ARVs).

LETTER FROM SOUTH AFRICA
Events of the past two weeks combined to put the AIDS debate back into the headlines and provided an opportunity to assess progress. I am happy to report that since my entry into the debate in 1999, I have not been more optimistic the war is being won. This relates not to the world situation, where government idiocy still reigns, but to my country, where there are now clear signals of a new direction in AIDS business.

NEWS COMMENTARY

You have to hand it to drug PROs; they can always come up with a new strategy to push their wares. The latest is to move antiretrovirals (ARVs) from the morning-after treatment to the morning-before — to be blithely popped out the medicine cabinet in anticipation of unsafe sex.

"To an extent that undermines classical standards of science,” the late Serge Lang, a renowned Yale professor, wrote in a letter to the Council of the National Academy of Sciences, “the scientific establishment has handled purported scientific results concerning AIDS by press release rather than by scientific exchange, thereby manipulating the media at large."

Front-page news in the U.S. this week included an upcoming recommendation from the Centers for Disease Control and Prevention that Americans automatically be tested for HIV at the same time they undergo routine blood tests. The implementation of this plan portends self-perpetuating, medically caused disaster, as false positives inherent in HIV-testing techniques are rampant. These false positives come from the non-specificity of all testing techniques designed to detect HIV antibodies, antigens or RNA copies.

It's a point I've made often in these letters — South Africa is a small country. Little happens that is not nationally known. Any news is national news. No matter the field, few experts exist and they are incessantly quoted.

Headlines here, on radio and television, have been dominated by one subject when it comes to the AIDS debate. Microbicides. Thanks to an international conference that received unprecedented media attention, the nation is vastly better informed on the subject.

All those words, confined in yesteryear to obscure medical and science journals, repeated over and over again with never a blush. Gone are the days when the topic of sex in all its unmentionable detail was just not embalmed in ink and amplified over airwaves and the small screen.