‘Tired of diagnosing HIV in women faithful to their husband’, says infectologist – 08/26/2021

“Men, if you’re going to gore your wives, at least cover your f… of the dick when you go to eat someone. I’m tired of giving an HIV diagnosis to a young pregnant woman, married for years and who is faithful to her husband. If you go f… with someone’s life, f… just yours, brother.”

I am an infectious disease doctor in Santarém, Pará, and I published this outburst, which went viral on Twitter. I work at the Treatment and Reception Center (CTA) in the city and every day we have new cases of HIV.

On the day of this outburst on social networks, I saw a pregnant woman, I believe she was seven or eight weeks pregnant. It was her first child and she was accompanied by her mother, a woman in her late 70s.

I saw this very distressed woman in the clinic. As it was her first appointment, we always tried to receive the most. We ask her how she is, how she thinks she got the virus, who she’s going to tell and so on.
During the conversation, I found out that she was a teacher, in her 30s, married for five years and that she never had an extramarital relationship. It was a very open patient.

She discovered HIV that day. She had gone to the health post to start prenatal care, and with a positive rapid test, they sent her to the referral center to confirm. We repeated the exam and confirmed. She still hadn’t even come home to talk to her husband.

I graduated six years ago from the State University of Pará (UEPA) and, since I graduated, I have the opportunity to work with people living with HIV, before as a generalist, and for almost two years as a specialist. During this time, stories like this are repeated and revolt me.

Unfortunately, it is a type of diagnosis that still happens a lot: that of a woman who has been with a man who has unprotected extramarital relations for a long time.

Eduarda Prestes, 30 years old, has been working for two years in Santarém, Pará - personal archive - personal archive

Eduarda Prestes, 30, has been working for two years in Santarém, Pará.

Image: personal archive

There are patterns of discovery of the infection. The one of those who discover when their husband is already very sick, in the stage of AIDS, and who often dies. And those who test positive in the prenatal period of pregnancy. Few find out through routine exams, which raises the alarm for how we are doing as health professionals in Primary Care or in Gynecology offices, for these women.

Lack of information hinders rapid diagnosis and initiation of treatment

The top representative of the current government blames those who get infected and attributes the HIV epidemic in Brazil to those who have “different sexual behavior”. It treats our patients as an expense to the SUS (Unified Health System), and completely takes away the focus of investments in prevention and awareness campaigns. Meanwhile, “family fathers” infect their wives based on the false moralism prevailing in our society.

It is 2021 and there are still people who strongly believe in the myth that they cannot sit in the same place, use the same bathroom or share the cutlery with a person living with HIV.

We are failing as human beings by not fighting this, we are failing as health professionals by not diagnosing and providing guidance on this, we are failing by not fighting for mandatory sex education in schools, which would be so much more valid for us than persevering in the culture of keeping sex as a taboo in society.
‘We end up putting ourselves in place’

It is impossible not to put yourself in these diagnosed women’s shoes. I’ve seen a 17-year-old girl die after three months in hospital for fungal meningitis and AIDS complications. How was she infected? Being raped by her own neighbor since she was 10 years old. That girl could have been me, my daughter, my friend. It’s closer than we think because HIV doesn’t have a face, it doesn’t have a face and it’s not written on anyone’s forehead.

I really want to work with just that, especially in a line of research on HIV in cis and trans women. The science on this subject is still more aimed at the male audience and studies on women are still scarce. It is absurd that, for example, we have to adapt male prevention methods when it comes to sex between women; that we are doomed to be shadow and be On the sidelines of what is meant for men.

My job currently has been to try to bring information in the way that I can reach as many people as possible, through social media. With this interaction, I can visualize the demands of these women. We talk, exchange experiences, sometimes become close. They make me want to move on, to study more and, one day, to be able to do more than I have done so far.

It’s controversial, painful, and bad to say this, but I tell my female patients not to trust anyone. Take care, be on the safe side, take rapid tests for HIV, viral hepatitis and syphilis at least every six months. Prioritize yourselves. We are together in this fight.” Eduarda Prestes, 30 years old, an infectious disease physician.