Most people who are educated understand that AIDS is spread through transmission of bodily fluids (vaginal fluid, semen, and blood). Most Americans are also aware that AIDS is a crisis in Africa, in fact, many people instantly associate the word”AIDS” with word “Africa”. And rightfully so- conservative estimates place Africans suffering from AIDS at between 26 and 30 million people. Because of this exorbitant infected population, it seems as though many Americans also consider the crisis as a lost cause, lumping every person together in a collective group doomed for steadfast misery and suffering.
In her 28 Stories of AIDS in Africa, Stephanie Nolen attempts to scrap up some dignity for the suffering Africans by putting actual names, faces, and personal stories to the epidemic. She chose 28 people- one to represent each million (taking an average of the estimated 26-30 million) to interview, explaining how they are affected by the disease, how they contracted it, and how they feel this epidemic will affect their homeland in the future.
Through her presentation of her interviews and her experiences, Nolen effectively provides several recurring themes that are both insightful and informative. In doing so, she eradicates some commonly held beliefs about the AIDS crisis in Africa, including the following:
- AIDS evenly affects all parts of Africa: Many people speak of “Africa” as though it is itself a country. Because of this habit, people tend to forget that the continent of Africa is actually comprised of 53 countries, all of which are affected differently by the disease. Within the continent, there are deserts, forests, villages, urban cities, and everything in between. Therefore, it is not conducive to look at the crisis from a continental standpoint, but rather better addressed on an area by area basis.
- AIDS is a disease of the poor: Yes, AIDS affects many poor people. However, studies have shown that in various parts of Africa, the wealthy class is afflicted much more than the poor. This is as a result of the extra expendable income. By having extra money to spend, a man can solicit prostitutes while away from his village, or even have a girlfriend in a different city which he pays for her education or a cell phone in return for sex. He will then bring this home to his wife, who may spread it to her lover while her husband is away, and so forth, leading to widespread contamination within those with larger incomes.
- Africans get AIDS because they are so promiscuous: Again, there is some truth to this. But, studies have shown that Africans do not have sex any more or less than people in America. However, there are two main differences between Africans and Americans: 1. Africans widely do not have access to condoms, nor do they understand the point of using them, 2. Many Africans still do not understand how HIV is transmitted. Also, many African women are subjected to rape or forcible sex in exchange for food. So, the option for them is die today of starvation or die a few years from now from HIV. For many African women, sex is something they have to do to stay alive…far from something considered intimate or pleasurable. Nolen shows that if close enough to starvation, some women will sell sex for less than $1 an encounter.
- Africans won’t change their lifestyle, so there is no point to try and help: This is one of the greatest myths that Nolen dispels in this book. Although she does show some stories just for the emotional effect, she also shows stories of those who contracted HIV and successfully joined the fight against the disease. One soldier contracted it after having sex with a fat woman, because all soldiers believed that fat women could not have the disease. He has since then spent his life traveling to hundreds of army camps to expose this myth and to demonstrate how to use condoms (something many Africans have never seen before). A nurse who contracted the disease from her cheating husband runs a clinic that teaches about the effectiveness of ARV (anti-retro viral…used to halt the progression of HIV) treatment, and has successfully distributed the medication to hundreds of people. A man in South Africa refused to take any medication until ARVs were offered in public clinics, and in a surprising turn of events the government decided to succumb to his demands days before he would have died. Through individual efforts and hugely through education, there has been small yet incredibly effective measures to reduce the transmission of this virus…further proving that attempts to help, especially through education, can be anything but futile.
- HIV is a death sentence, so money and time should not be wasted on those who already have it: Despite my love for medicine, even I did not have as great of an understanding of ARV treatment as I have now. For those who have AIDS, even end-stage, ARV treatment can be life-changing. It does not get rid of the virus by any means- but it stops it in it’s place and does not allow it to take over any more cells or reproduce. This allows the immune system to nearly completely regenerate, making it able to fight off infections that having HIV usually does not allow. Nolen shows many stories of those who were literally on their death bed- infected with skin cancer, lesions, thrush, etc, and so thin that you could literally count the bones on their body. Once treated with ARVs, they turned around in just days. Within about a month, most people who take their medication the right way will gain back enough weight to be healthy, will have normal amounts of energy, and will be able to live life the way they used to before they were sick. Although this medication does not eradicate the virus, it allows those who have HIV to live full, nearly normal, healthy lives. Most Africans want the medications, but can’t afford the dollars (literally dollars…some even only $2 a month) it takes to stay on the medications. If these medications were more widely available, millions of lives could take a turn for the better in just a few days.
Initially, I believed this book would provide 28 sad stories….and it did. But it also provided stories of hope, promise, and the ability for change. By reading this, I really got a lot of insight into the disease and how it affects not only the individual emotionally, but also how it affects the economy, the government, etc. Nolen’s writing style is perfect for the purpose of this book- simple so everyone can understand, yet simultaneously highly informative. I would recommend this book to anyone who would like to better understand the immense global impact HIV holds while being inspired and encouraged to make an active effort to change it.