₦airaland Forum

This post should be in the health section, but....

A. Background.

I'm a medical doctor working in one of the private hospitals in one of the states in Nigeria.

Some time ago, I had a patient. Let's just say a young, married male. I wasn't the doctor that admitted him, my first contact with this person was during one of my ward rounds. He was being treated for a certain condition, and, among other investigations, the admitting doctor also requested for RVS (HIV screening).

This man was very sick, he had a bad cough that had remained for over a month, he had lost weight significantly. He was stooling - passing loosed stools for over 2 weeks. Just before my rounds, the lab results were sent to his folder. He tested positive to HIV (a confirmation test had already been done).

So, according to protocol, the next step was to conduct a post-test counseling where I would break the news to him, encourage him to discuss with his wife, get her tested...and to screen everyone living under the same roof as he is.

B. My Discussion with the Patient.

So, I walked into his ward - he was admitted in a private ward.

He was with his younger brother at the time. I politely requested that the young boy excused us.

After introducing myself and some small talks, we got into the real deal.

I discussed the other results with him; I deliberately left the HIV report for the last.

I eventually broke the news to him, and allowed him some time to process the information I had just dropped. I reassured him, discussed the nature of the disease, discussed its medications, and encouraged him to disclose the news to his wife.

As I did all these, the man remained still, his gaze locked on an imaginary point in space.

Then he reached for his handset.

He rang his wife.

"Sweet, them say na HIV," he said.

They went on to discuss for some 2-3 minutes before he dropped the call.

Following






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C. The Patient's Response.

"Doctor, let me tell you the truth, I already know say I dey positive," he disclosed in a broken voice.

"Really?" I was taken aback, especially considering the fact that he had just spoke with his wife like I had broken a new piece of news to him.

"When were you diagnosed?" I asked him.

"Since 2005," he said.

So, brotherman has been positive for about 20 years.

"Have you been taking your medications?"

"I stopped since 2013," he noted.

I released a silent wow in my head. "Why did you stop?"

"I been say make I try herbal."

I immediately felt sad about his situation. He probably would have been much better if he had stuck with his medications as prescribed, and maintained routine outpatient follow-ups. Sadly, he is now down with an advanced disease most likely because he discontinued his antiretroviral meds.

"How about your wife, sir? Has she been tested?"

He confirmed that they are a concordant couple - his wife is also positive. They have no children.

Concordant couple, meaning what exactly? She, too, was not taking her medications? I hope there are at least no children involved.

A grown man decided to have sex without protection, even after several opportunities to say no, and 20 years later, he is telling fantastical tales trying to make it seem he had no hand or say in the decision to have unprotected sex, over and over again? Na wa ooo! The kain specimens Nigeria still dey raise, ehn!

Anyway, how did he determine that the girl was in fact the genesis of his HIV infection? Or are we simply supposed to believe that the man had not been having sex without protection until that very night in the hotel back in 2005?

Are there any children involved? Is the wife currently also sick or is the man the only one whose needing hospitalization at this point in time?

D. The History

"If I tell you how this whole thing start, you no go believe," he said.

I prepared my mind for a long session (I didn't mind that my rounds was about to be much longer than I had intended).

His story:

Since 2005, my job has been taking me far away from home. In one occasion, my company flew me to Ogun State where I was lodged in a 5-star hotel.

One day, after work, one of my colleagues introduced me to a young, beautiful lady. I didn't really understand the nature of my colleague's relationship with this lady, but it didn't seem like they had anything serious ongoing. We soon got talking, and in no time, she followed me to my room.

I am naturally not a womanizer, I don't keep multiple girlfriends, I don't patronize prostitutes.

All through my initial discussion with this lady, my intention was to start a serious relationship with her, and possibly settle down with her.

So, when we got to my room, one thing lead to the other, and before I could realize what was going on, we had started kissing and all that. As things progressed to penetrative sex, she asked that I used a condom. Sadly, I didn't have anyone with me. I immediately went to the rooms of my other colleagues. None of them had a condom that night, and it was already too late to go out.

I went back to the lady, and despite her initial resistance, we proceeded to have sex, unprotected sex. Interestingly, the next morning, she did not ask for anything from me. She just dressed up and left. This intercourse marked the beginning of several others as it soon became a habit to have her on my bed when I returned to the hotel from work.

E. Still on the History.

As my work at Ogun State approached its end, I realized that I had fallen in love with the state. I decided to rent an apartment, and start life there.

I got an apartment and moved in with this lady. When it was time to travel to another state for work, I left the lady in my house.

Problem started when she called me one day asking for my forgiveness. I was perplexed, I couldn't place my hands on any offence she had committed. I couldn't find a reason why she should be asking for forgiveness. I insisted that I was not angry with her, but she wouldn't let go. After going back and forth for a while, she made a sentence I would never forget in my life.

"Go to a teaching hospital and get tested for HIV. You have been infected, I'm sorry."


To be continued later tonight, got to sort some issues out here.

F. Still on History

I went to a hospital the next day and got tested. It was positive. I was shattered, I saw my well-structured life unfold into a state of hopelessness. I was gripped by fear and rage. We didn't speak for a few days, but as time happened, I found myself forgiving her as I was serious about settling with her. I decided that once married, both of us would find our way through life supporting each other.

I soon proceeded to the new state my company had sent me to. I was to stay there for a month or so. Everything was going just fine until my neighbours began to ring me, one after the other. They all had the same thing to tell me: my lady whom I left in my apartment was bringing different men home, night after night. When I was first told, I couldn't believe the news. But when different people continued calling me for the same thing, I became truly worried. A relative of mine confirmed the news. With further investigations, I came to the complete realization that this lady was actually a prostitute. Truth was that all through my dealings with her, in my subconscious, I used to consider this kind of possibility especially because at Ogun State, she was always around the hotel. But I do not know why I didn't give this much thought, and I didn't confront her with it.

After my job in the other state, I returned home, and immediately, I asked her to leave my home. She begged, cried, but I wasn't having any of it. I sent her out.

About 2 weeks before pathing ways with this lady, I met a young girl online, she was barely 18/19 years old at the time, she was pursuing university admission in a South-Eastern state. Nothing much, we were basically chatting and calling each other on phone, but no serious commitment.

So, my girlfriend was now my ex, I was done with her, and she had left. All through this time, I was taking my medications, life was essentially fine and OK with me.

G. My New Girlfriend.

The young lady got admitted that year. She proceeded to her school for resumption. As she was now away from her parents' house, we began planning a visit. Somewhere around this time, we metamorphosed from being mere friends to being lovers. In a few weeks, we perfected our plans and she left her school for my house. Sir, I honestly didn't know what came into me. From the very first night of her visit, I began having unprotected sex with her. I totally did not consider my HIV status, neither did I consider the impact of my actions on this young girl's life. We had sex a number of times until she left. We continued to arrange for visitations, and in all these times, we had sex, with and without condoms.

One day, my conscience hit me. I couldn't take it anymore. I rang her and broke the news of my status to her.

The weeks and months that followed are memories I would rather forget than recall. She got tested, and it was positive. She almost took my life. It was a big catastrophe, and I never believed I would survive it. At the end of the day, I made a vow that I must get married to her.

I continued to support her through school and life. About 2 years after her graduation, we got married.

OP, talk true, is this story fake? A whole human being, knowing how devastated he was when he discovered he was HIV positive, decided the best he could do was end the life of a 19-year-old girl by having unprotected sex with her, too?

So, marrying someone whose life he literally ended by his own hands— HIV is literally a life sentence—, makes him what? A better person than the monster he truly is?

If accessing drugs was hard for him, what about for the girl he now calls his wife? See wetin people dey do their fellow humans?

H. The Current Ailment.

So, about 12 years ago, I got tired of the medications. Beyond this, accessing the drugs became more difficult that it used to. I was not attending the clinic, I had someone supply me the medications in privacy (for my girlfriend and I). As time went by, our supplier was increasingly finding it difficult to provide us with the medications. I too was tired. Someone talked to me about herbal alternatives, and I decided to exploit this option.

A few years after this time, I noticed that my health was deteriorating. I was becoming weaker. I was almost always having cough problems. In some episodes, I would cough for up to 2 months before finding relief. I developed unexplainable rashes on my skin. I was fast losing weight. My company gave me some time to sort myself out, but I never really did much. I just rest, take my herbs, take some other medications for my cough, get a bit better, then return to work....only to fall sick again....say a month later or so.

Things didn't get better. The reason I came for this admission was that this time around, things became worse, an all-time low. I'm scared for my life, my wife is scared too. She thinks I may die soon if nothing is done. She begged me to present myself to a hospital for professional review and management.

I. The Last Post before Concluding.

As I stood and listened to my patient's story, I felt goose pimples break out of my skin. The story was too wild to imagine. I felt like I was watching a Nollywood drama. I didn't interrupt him through his story, I remained still, paying full attention to every word his weak voice uttered.

As I looked at him, I saw regret emblazoned on his face. I saw fear in his eyes. This man was scared...scared for himself and for his wife. I saw guilt rise with his voice. I could tell he was feeling guilty again, like he felt the period he infected his wife.

"So, did you hear from the prostitute again?" I asked.

"Yes, I did. She never really let me go. She kept on calling me from time to time. When she realized that I had indeed moved on, she stopped begging to come back to my life. She only called to check on me and see how I was doing. She never requested money or anything from me."

"When last did you hear from her?"

"It's been over 2 years now. She took ill and was admitted. The last time we spoke on phone, her voice was frail. She kept on asking for my forgiveness. I told her I had since forgiven her, that if I were close, I would have visited her in the hospital. Her voice was very frail."

"About two weeks after speaking with her, a mutual friend called me to announce her passing. She did not survive her ailment," he disclosed.

"I'm so sorry about that," I said. I said this because I could still tell that he really loved the lady.

I further counseled him. I told him that he now had an advanced disease with a possible tuberculosis coinfection. I told him he would be needing a thorough medical care, one that will best be delivered in a tertiary centre. In my clinical note after my rounds, I recommended that he should be referred to a tertiary centre for expert management. The next day when I returned to work, I saw that he had left. I asked for his folder to confirm that he was referred to a higher centre for better care.

Sadly, this wasn't the case.

In the documentation of the doctor that took over from me, it was noted that he requested for discharge against medical advice (what we call DAMA).

I doubt he proceeded to a tertiary centre.

NB: Ironically, his chest x-ray came out to be normal, not suggestive of tuberculosis.

[b][/b]

J. Lessons.

1. Main lesson here is to ensure safe sex practices. Abstinence is the gold-standard recommendation. If this is not practical, sticking to a sexual partner and using condoms is advised.

2. Routinely present yourself for screening for retroviral disease and other STDs.

3. Being positive is not the end of life. As a matter of fact, I know A LOT OF POSITIVE PATIENTS that are very healthy, and are living normal lives. Many would grow to a ripe old age. Note, in Africa, malaria claims more lives than HIV.

4. Stigmatization is senseless, wicked, and childish. Stigmatization is likely the reason why this patient didn't go to the source to access his antiretroviral medications. If he had been duly enrolled, he would have gone through adherence counseling and he would have been followed up. This may have prevented a lot of things.

5. Be responsible. Open up to your sexual partners before having sex. If you are positive, protect your partners by ensuring you take your medications as prescribed so that your viral load is suppressed...and by using condoms as indicated.

TONYE001:
4. Stigmatization is senseless, wicked, and childish. Stigmatization is likely the reason why this patient didn't go to the source to access his antiretroviral medications. If he had been duly enrolled, he would have gone through adherence counseling and he would have been followed up. This may have prevented a lot of things.

What source? He was already married to the woman he infected, so what stigma would he have been worried about again?🥱🥱

K. Conclusion/Why I Shared this Story.

The events described above happened, and are true. As doctors, in the course of our jobs, we come across some cases that stick in our heads for life. This is one of such cases for me.

There is one small reason why I was reluctant to take and swallow every detail of this story. I've come to realize that most newly-diagnosed patients deny having multiple sexual partners. True, the disease can be transmitted through other routes like sharing of sharp objects, birth, and blood transfusion. This notwithstanding, transmission through having unprotected sexual contacts with an infected person remains the most common route. Rather than confirm having multiple sexual partners, some patients may fabricate lies to protect their image.

Somehow, I believe this man's story. Most of it (or, perhaps, all of it). It may sound weird, but it is possible.

May God help us all.

Be safe.

End of Story.

Please, note: the location and dates of this story have been altered. This is to protect the identity of the patient and his family.

Kobojunkie:
Concordant couple, meaning what exactly? She, too, was not taking her medications? I hope there are at least no children involved.

A grown man decided to have sex without protection, even after several opportunities to say no, and 20 years later, he is telling fantastical tales trying to make it seem he had no hand or say in the decision to have unprotected sex, over and over again? Na wa ooo! The kain specimens Nigeria still dey raise, ehn!

Anyway, how did he determine that the girl was in fact the genesis of his HIV infection? Or are we simply supposed to believe that the man had not been having sex without protection until that very night in the hotel back in 2005?

Are there any children involved? Is the wife currently also sick or is the man the only one whose needing hospitalization at this point in time?

I understand your point, but as far as evidence goes, the lady is the only confirmed positive he had had sex with.

The have no children.

I never saw his wife, but from our discussion, it didn't seem like she was very bad. What I know is that she too stopped taking her medications.

Kobojunkie:
OP, talk true, is this story fake? A whole human being, knowing how devastated he was when he discovered he was HIV positive, decided the best he could do was end the life of a 19-year-old girl by having unprotected sex with her, too?

So, marrying someone whose life he literally ended by his own hands— HIV is literally a life sentence—, makes him what? A better person than the monster he truly is?

If accessing drugs was hard for him, what about for the girl he now calls his wife? See wetin people dey do their fellow humans?

The story is very true. I'm a very busy man, I neither have the time nor patience to come online to fabricate tales.

Immediately this happened, I knew I would share it online someday....main reason is to sensitize the general public. The only things I changed are the location (actual event wasn't in Ogun State) and the year/dates. I did this to ensure the identity of my patient is protected.

Though I didn't ask him why he went on to infect his girlfriend...now wife, he kept on saying that he didn't know what entered into his head. It was like an unseen force enveloped him or something.

My hypothesis - he did it to secure her, to ensure she married him...he was probably scared she won't accept a marriage proposal if he disclosed his status. I may be wrong.

Kobojunkie:
What source? He was already married to the woman he infected, so what stigma would he have been worried about again?🥱🥱

Source = A hospital proving care to people living with HIV (PLHIVs). Going to these hospitals to enroll and receive care would expose him to the public. Hospitals are public platforms...he may run into someone he knows...if there were not stigmatization, he wouldn't have worried about this...but because of stigmatization, he didn't want anyone to discover his situation.

Many years ago, while I was working with an international NGO that was involved in HIV care delivery services, I was approached by a man after work at a facility. He was seeking a possibility of me supplying him with his medications. I politely refused...and made a fair attempt to counsel him.

Another reason people work out personal arrangements is because of the crowd. Some people end up spending the entire day there.

Again, there are numerous private hospitals that work with NGOs in providing care for PLHIVs. In these hospitals, the crowd is minimal, or nonexistent. Those that cannot deal with the crowd of public hospitals should use private facilities...the drugs there are free too.

TONYE001:
➜The story is very true. I'm a very busy man, I neither have the time nor patience to come online to fabricate tales.
Immediately this happened, I knew I would share it online someday....main reason is to sensitize the general public. The only things I changed are the location (actual event wasn't in Ogun State) and the year/dates. I did this to ensure the identity of my patient is protected.
➜ Though I didn't ask him why he went on to infect his girlfriend...now wife, he kept on saying that he didn't know what entered into his head. It was like an unseen force enveloped him or something.
My hypothesis - he did it to secure her, to ensure she married him...he was probably scared she won't accept a marriage proposal if he disclosed his status. I may be wrong.

People in Nigeria have been made terrified of AIDS since the 1980s/1990s when we saw pictures of humans existing as skeletons not by choice but because of a virus invisible to the naked eye that spread through sexual intercourse and blood, of course. The fact that he met his now wife— a 19-year-old at the time— around 2005 tells me this man must have been at least in his 20s to mid-20s around the time in question, meaning he had knowledge of AIDS and HIV prevention before all this happened to him.

2. Not secure, but trap her in the same nightmare that he had now come to know as his life, so she would have nowhere else to go but to spend her life taking care of him in his illness. The same way a lot of men out there baby trap women with baby after baby to keep them from pursuing their dreams and goals.... this man literally infected that young girl to trap her and give her no other option but himself.

Some gomba will come out claiming it was love... love does not hurt or wish hurt on the one who is loved. This man literally wished that girl hurt and delivered the blow against her himself.

---

You mentioned that stigma was the reason why he went off his medication. What stigma would that be?

Fear catch me oo

TONYE001:
➜Source = A hospital proving care to people living with HIV (PLHIVs). Going to these hospitals to enroll and receive care would expose him to the public. Hospitals are public platforms...he may run into someone he knows...if there were not stigmatization, he wouldn't have worried about this...but because of stigmatization, he didn't want anyone to discover his situation.
Many years ago, while I was working with an international NGO that was involved in HIV care delivery services, I was approached by a man after work at a facility. He was seeking a possibility of me supplying him with his medications. I politely refused...and made a fair attempt to counsel him.
Another reason people work out personal arrangements is because of the crowd. Some people end up spending the entire day there.
Again, there are numerous private hospitals that work with NGOs in providing care for PLHIVs. In these hospitals, the crowd is minimal, or nonexistent. Those that cannot deal with the crowd of public hospitals should use private facilities... the drugs there are free too.

Oh! The drugs are free, too? I thought affordability was a particular issue from the story the man told. Interesting!

Kobojunkie:
People in Nigeria have been made terrified of AIDS since the 1980s/1990s when we saw pictures of humans existing as skeletons not by choice but because of a virus invisible to the naked eye that spread through sexual intercourse and blood, of course. The fact that he met his now wife— a 19-year-old at the time— around 2005 tells me this man must have been at least in his 20s to mid-20s around the time in question, meaning he had knowledge of AIDS and HIV prevention before all this happened to him.

2. Not secure, but trap her in the same nightmare that he had now come to know as his life, so she would have nowhere else to go but to spend her life taking care of him in his illness. The same way a lot of men out there baby trap women with baby after baby to keep them from pursuing their dreams and goals.... this man literally infected that young girl to trap her and give her no other option but himself.

Some gomba will come out claiming it was love... love does not hurt or wish hurt on the one who is loved. This man literally wished that girl hurt and delivered the blow against her himself.

---

You mentioned that stigma was the reason why he went off his medication. What stigma would that be?

I totally agree with you!! Absolutely. I, however, believe he now regrets his actions...though it's obviously too late.

Yeah, stigmatization contributed to his withdrawal from ART care.

Stigmatization made him make a private arrangement to get medications for himself and his wife. At some point, his private source was no longer delivering the drugs as he should be taking. Naturally, at this point, he should have gone to a hospital for proper care...but, again, stigmatization may have hindered this...he basically didn't want anyone he may know see him in a department of a hospital responsible for caring for PLHIVs.

How do I know that this is likely the case? None of his siblings know about his situation. I forgot to add this part. He is yet to disclose his situation to his brothers, sisters, and parents. It's that bad.

Kobojunkie:
Oh! The drugs are free, too? I thought affordability was a particular issue from the story the man told. Interesting!

The drugs are totally free. Affordability was never an issue. This man is working in a big organization...he is actually financially comfortable.

TONYE001:
➜I totally agree with you!! Absolutely. I, however, believe he now regrets his actions...though it's obviously too late.
Yeah, stigmatization contributed to his withdrawal from ART care.
Stigmatization made him make a private arrangement to get medications for himself and his wife. At some point, his private source was no longer delivering the drugs as he should be taking. Naturally, at this point, he should have gone to a hospital for proper care...but, again, stigmatization may have hindered this...he basically didn't want anyone he may know see him in a department of a hospital responsible for caring for PLHIVs.
➜How do I know that this is likely the case? None of his siblings know about his situation. I forgot to add this part. He is yet to disclose his situation to his brothers, sisters, and parents. It's that bad.

1. I no longer believe in sob stories, abeg! Nigerian politicians and pastors regularly put on the same show, like literally every week... I am all sob-storied out. People are just wicked at their core. 🥱🥱🥱

2. And probably his in-laws are not aware that their daughter is also HIV positive, no thanks to the man whom they later married her off to. 🥱🥱🥱

Kobojunkie:
1. I no longer believe in sob stories, abeg! Nigerian politicians and pastors regularly put on the same show, like literally every week... I am all sob-storied out. People are just wicked at their core. 🥱🥱🥱

2. And probably his in-laws are not aware that their daughter is also HIV positive, no thanks to the man whom they later married her off to. 🥱🥱🥱

It's honestly a sad story. A lot of things would have been done differently.

Yeah, his in-laws probably don't know....;

TONYE001:
➜The drugs are totally free. Affordability was never an issue. This man is working in a big organization...he is actually financially comfortable.

Could it instead be depression that got him to abandon his treatment? I mean no matter how bad things get, the human survival instinct usually kicks in unless someone has become suicidal, right? 🥱🥱

Kobojunkie:
Could it instead be depression that got him to abandon his treatment? I mean no matter how bad things get, the human survival instinct usually kicks in unless someone has become suicidal, right? 🥱🥱

Possible, but not quite.

He didn't just abandon his medications. He switched to herbs. He has probably been brainwashed to believing that herbs are curative/better than routine antiretroviral medications.

So, switching to herbs is a survival maneuvre, for him, at least.

This is how I see it.

Not ruling out depression though...he's most likely depressed, but I doubt this is the reason behind his decision to discontinue medical care.

TONYE001:
➜Possible, but not quite.
He didn't just abandon his medications. He switched to herbs. He has probably been brainwashed to believing that herbs are curative/better than routine antiretroviral medications.
So, switching to herbs is a survival maneuvre, for him, at least. This is how I see it.Not ruling out depression though...he's most likely depressed, but I doubt this is the reason behind his decision to discontinue medical care.

I see! But your story suggests that over time, he got weaker, meaning he did realize the herbs were not working. I feel pity for the 19-year-old girl who was dragged into this nightmare without experiencing adulthood fully for herself. 🥱🥱

In this world... what I know is that evil is man and man is evil.

Kobojunkie:
I see! But your story suggests that over time, he got weaker, meaning he did realize the herbs were not working. I feel pity for the 19-year-old girl who was dragged into this nightmare without experiencing adulthood fully for herself. 🥱🥱

In this world... what I know is that evil is man and man is evil.

True sha. True

Lots of possibilities here.

Front page for broader views, please.

Cc: Farano, Dominique, Rocktation.

Sex once and get hiv lol. Cooked up stories. Unless he an anal god

Memberclub:
Sex once and get hiv lol. Cooked up stories. Unless he an anal god

Actually, a single penetrative, unprotected vaginal intercourse with an infected female can do the job.