So I came across this video and remembered the story from a couple of friends who are coping with HIV. Janne, not only do I dare to touch you, I hope to touch your heart and I pray God gives you strength. You are loved.

To everyone living with HIV, the road may be tough at times but don't be discouraged. Live your life to the fullest, you are entitled to it. Do not let HIV define who you are, leave it as a condition that you have to leave with.

To the friends and families that are aware of their own friends and families that is dealing with HIV, your support means the world to them. You are the biggest person, thank you.

For those who has lost loved ones from HIV, AIDS or complications that are related to it, Life is for the living. We grief, we regret, we move on. Occasional we reminisce, the memories of loved ones will never be forgotten.

And to the rest of the world, HIV is a condition. It does not define any one person. It is not easy, but when you think about it there is none too many that differentiates. We breathe the same air, walk the same earth, so learn and love each other unconditionally. 

Following up on my recent post on addressing the social stigma of HIV/AIDS, I would like to talk about syphilis - one of the lesser evils in the family of sexually transmitted diseases (STI). This, after coming along with a friend to a clinic to get a second dose injection for its treatment by which I was informed rather painful. 

Before I even begin to talk about syphilis, I'd like to emphasize on the awareness of STI in general, and how we should all play a part in dissolving the social stigma concerning STI. 

1. Wherever you go, you should not be judged by your sexual behaviour.
2. Give advice willingly, and you owe it to yourself to be informed.
3. Ask as many questions as you need to - do not assume. And make sure you get answers that you understand.

What is syphilis and what causes it?

Syphilis is an infectious disease classified under sexually transmitted disease. It is caused by a germ called Treponema pallidum. While the symptoms of a syphilis is difficult to diagnose, untreated for a long time it can cause complications to the brain, the cardiovascular system and even death. 

Syphilis can infect both men and women, and they both can pass it on. An interesting fact about syphilis is that it is known with another name: The Great Imitator. This, because it has so many symptoms, many of which look like symptoms for other diseases. (This was how I was told by this friend of mine: "I have the great imitator." I didn't know anything about syphilis back then so I just gave him a blank stare!)

Speaking of passing it on, how is it spread?

As mentioned earlier, syphilis is a sexually transmitted disease, therefore any man or women who leads an active sexual lifestyle is at risk. However, sex is not the only way syphilis is passed on. 

• It can be passed on unknowingly from the infected person as the symptoms are difficult to differentiate from other disease. An infected person may not know he/she is infected for years and continue to live a healthy life.
• Direct skin contact with the syphilis sore or syphilis rash can lead to infection. 
• Direct blood transfusion can also pass on the germ that causes syphilis. 
• It is also possible for a pregnant mother to pass on the disease to her unborn baby. 

You cannot catch syphilis from kissing, hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery. Just as the HIV virus, saliva and urine do contain the germ that causes syphilis, but not in enough number for it to become an infecting agent. 

What are the signs and symptoms?

As aforementioned, it is difficult to diagnose syphilis from symptom alone. My friend found out by chance doing an annual medical checkup in a specialist hospital. I was later informed - and this is important information - that there is no exact way to test how long has the infection been there. 

However, syphilis can develop in three stages:

1. the first stage: called primary syphilis
2. the second stage: called secondary syphilis
3. the third or latent stage: called tertiary syphilis.

Primary Syphilis

This is the earliest stage and generally occurs from 10 days to 3 months after infection. It typically causes a painless ulcer on the genitals.

Secondary Syphilis

This is the second stage of syphilis. Many different symptoms can occur (see later) but usually last several weeks. They can, however, come and go for up to two years.

Tertiary Syphilis

This is the final stage of syphilis. Untreated after many years, it may start to cause very serious damage to the heart, brain, eyes, other internal organs, bones and nervous system.

Arguably, there is another stage between secondary and tertiary syphilis called latent syphilis. Latent means 'hidden'. This occurs after the symptoms of secondary syphilis have cleared. With latent syphilis there are no symptoms. Latent syphilis can last for many many years. It is divided into two types:

• Early latent syphilis: This lasts for a year or so and the infected persons are still infectious - that is, they can pass syphilis on to other people.
• Late latent syphilis: About two years after secondary syphilis has cleared the infected person can become non-infectious and are no longer able to pass syphilis on to others.

If the symptoms are difficult to diagnose, then how will I know if I am infected?

The only way to be certain is to be tested for syphilis. Most government hospitals and clinics do run these tests, and - get this - they don't mind running the tests for you even if you look and feel healthy as a bell! So go ahead, if:

• you, or a partner, think you might have symptoms
• you have recently had unprotected sex with a new partner
• you, or a partner, have had unprotected sex with other partners
• a sexual partner tells you they have a sexually transmitted infection
• you have another sexually transmitted infection
• you are pregnant or planning a pregnancy

go get tested. 

What happens during the test?

• The doctor or nurse will ask you to give a blood sample. 
• They will do a genital examination. 
• For women this may include an internal examination of the vagina and; 
• For men an examination of the penis, foreskin and urethral opening (where urine comes out). 
• Both men and women may have the anus examined internally and externally. 
• The doctor or nurse will also check the body generally for any rashes or warty growths. They may check the mouth and throat area. 
• They will use a swab to collect a sample of fluid from any sores. 

This only takes a few seconds and is not painful, though it may be uncomfortable for a moment. 

If I have syphilis, how will I be treated?

Just like another human being, generally speaking. Medically though, because syphilis is a germ infection, it can be readily treated with antibiotics. Antibiotic injections are the usual treatment. Benzylpenicillin is the antibiotic usually used. This kills the germs (bacteria) and prevents the disease from progressing any further. The injections are given intramuscularly (IM), usually into the buttock (this may explain why my friend adamantly asked me to drive >.<) . A single dose can be given for primary and secondary syphilis. Later stages may need a course of three injections, at weekly intervals. Neurosyphilis usually requires more frequent, daily doses for a couple of weeks.

What if I am allergic to penicillin?

Well, you're screwed. Or rather, mother nature screwed you. I'm kidding, of course. Other antibiotics are sometimes used if you are allergic to penicillin. Azithromycin is often used in this situation.

What if I am pregnant?

Well your husband must've screwed you up well, didn't he? OMG hahaha! I'm kidding again. If syphilis is found during your pregnancy, you can be given treatment safely. This can help prevent the baby from becoming infected and there is no risk of the treatment harming the baby. If the syphilis is untreated you may pass the infection to your baby in the uterus. This can lead to miscarriage or stillbirth, or the baby being born with syphilis.

Wrap up

Something to keep in mind if you have an active sexual lifestyle, especially with multiple partners, do keep safe. Abstinence from sex is the surest way to not contract any STIs, however in cases where sex just cannot be avoided use protections, and use them correctly. 

If you are diagnosed with syphilis or any other STIs, don't fret. It's not the end of the world yet. You just have to live it a little differently. And I'd like to keep thinking that the possibilities of sex is not completely and entirely shut - just take it to inform your engaging partner of your condition, and only go forth with mutual consent. Again, abstinence from sex is probably the best, but in situations where sex just can't be avoided and must be done, do use protection and use them correctly. 

Another note to be highlighted is that just because you were once cured of syphilis does not mean you cannot catch it again. Be safe, use protection. On a final note, I want to adopt a new slogan for anyone living with STD:

You're not sick, you just have a condition. 

Until next time, ciao!

I made a note to come to Merdeka Plaza today and have a look at #hivkuchingawarenessday campaign. It's high time that awareness campaigns like this be held more and more - and to add a value to it so that it achieve its intended purpose. For me, personally, this time, this campaign, is just like any other campaigns is well organised, well coordinated and well executed. I just wished our audience would be more of an active participator even if just cheering for the DJ and emcee, rather than passive onlookers. 

The Event

In the effort to raise awareness of HIV as well as other STD, #HIVKCHAWARENESSDAY is a community event supported by Sarawak AIDS Concern Society (SACS). According to the project manager of the society Rahmah Nicholls, discrimination against AIDS patient did not come from the government, but rather from the society as a whole. She further stated that "Due to the stigma placed on them, those reputed don’t go to the government hospital. This is a difficult area for surveillance" (BorneoPost Online, Feb 21, 2014)

The Sarawak AIDS Concern Society was initially set up in 1998. As a non-profit organisation, its main objective is to address AIDS related issues in Sarawak through the dissemination of information on the disease. It also aims to protect the rights of those living with AIDS as well as to support the families of those affected by AIDS.  

The Objective

1. To reject myths and misconceptions and fight HIV/AIDS related discrimination.
2. To raise awareness on sexually transmitted diseases and help young people to understand the dangers of the disease better
3. To change the “passive cultural’ through education on social environment. 

Perhaps to aid the first objective, I wish to enlighten those not in the know that HIV and AIDS are, in fact, two different conditions related to one another. HIV, or Human Immunodeficiency Virus, is a virus that infects a human through close contact with HIV infected body fluids - blood, semen and vaginal secretion are some of the examples of such body fluids. It does not, however, infect through saliva and sweat. Persons who has HIV are referred to HIV positive, and without is referred to as HIV negative. According to statistics, 169 cases of HIV positive cases has been reported in Sarawak in 2011. The number decreases to 147 cases in the following year, while in 2013, just last year, the number jumps to 190 reported cases. Do remember that these are reported cases. In many instances, persons who are HIV positive shows no particular symptom and live a healthy life until diagnosed.

AIDS, on the other hand, is a classification of the persons who are HIV positive with their CD4 count falling below 200. CD4 is a type of protein that is found on the surface of immune cells - the lower the count, the lower the body's resistance to infection and diseases, and the slower the body recovers from them. AIDS patients can also be classified when they acquire HIV-related infection such as tuberculosis (TB) as well as other various infections (honestly, the scientific names just escapes me).

In short, while the terms HIV/AIDS are commonly used together, a person may be HIV positive but never developed AIDS even towards the end of his life, but if a person is classified as an AIDS patient, his is therefore HIV positive. 

The Social Stigma

It has always been a society ruling that persons living with HIV/AIDS are sinners by default. Such prejudice against them is so thick in the society that we live in that it's almost tangible. Added with the singular knowledge that this is a "gay's disease", the persons living with the condition is condemned for the rest of his life, and even after his passing. 

This is not completely true, though. In fact, it is completely false. Numbers of new HIV/AIDS cases involving heterosexual sex is increasing in the United States. Closer to home, in Sarawak, state Health Director Datu Dr Zulkifli Jantan told The Borneo Post that most of the reported cases are male and transmission was from a heterosexual relationship. Such stigma and prejudice is unjust and barbaric, and should be purged from the society. 

Community Awareness and Support

Events such as these: #hivkchawarenessday, small as it may be, is a great start and provides continuity in the support of persons living with HIV/AIDS and those affected by it. It might be a small move, but I've always been a believer in the saying Rome wasn't built in a day. It makes me sad to admit that I am one of those few affected by HIV/AIDS, having made privy to the secret that the community believes should be kept between four walls and closed doors.

It was also the missing element in the campaign that was organised by SACS. No, I am not asking for those living with the condition and those affected by it to come forth and announce to the world - though I am not against that as well if it's to raise awareness. The campaign only showcased one side of the story - prevention. It is better than cure, but to those already living with it and to those affected by it, their input and contribution is just as valuable.

We all have a story to tell, and theirs are extraordinary. Once made privy, instead of pity or sorry, you suddenly gain a higher sense of understanding and a totally different perspective of life. The value that visitors take home with them even after just being a passive bystander is what I would like to see.

How? is the question to ask. In this era where communication is supported by technology, I am quite surprised to find that the event did not have it's own Facebook page. But that's on the promotion side. I believe Plaza Merdeka has very good and diverse traffic. Like I said earlier, the value that the community can take home is much more worthwhile in achieving the objective of the awareness campaign.

I look forward to an awareness campaign whereby visitors can engage with the persons living with HIV/AIDS and the persons affected by it through multimedia interaction should there be a need to protect the identities. Audio and visual recordings, two way interaction through multimedia applications, or even a creative representation of the daily life of persons living with HIV/AIDS can effectively show how their lives are no different than ours. That way, perhaps we can address the social stigma that was imposed to them, and remove the stone hard prejudice against them once and for all. 

Here are some of the photos I managed to snap during the event.