“New treatments and their outcomes changed the disease. The focus shifted to building a stronger mental state to combat the personal struggles with being diagnosed as positive. Finding the roots of mental disorders and various addictions can prevent these issues from interfering with a healthy future as an HIV-positive individual”.
Over 35 years ago a new virus crept into our mindsets and began to impact the lives of millions of people around the world. The human immune system was unable to counteract the invasion and we watched in shock and horror as friends, peers, colleagues and family members began slipping away from us. A variety of ailments that manifested due to the lack of a strong immune system took their devastating toll. We also feared for our own wellbeing as more and more of us also tested positive for HIV. The sexual revolution had hit a brick wall with unforeseen consequences.
Governments were slow to react to the impact until a global epidemic was finally declared. Those who had been working in the shadows were finally given the necessary tools to counteract this deadly disease. Others continued, with more diligence, at raising funds and awareness as a means of support. In the process, significant steps were taken to begin transforming a lethal virus into a manageable disease, always with the intentions of finding a cure.
The search for a cure is still a work in progress but those living with HIV, with proper treatment and care, can now live the same life span as those uninfected with the virus. Through lifestyle changes and the continued use of medications “Undetectable” became a welcoming diagnosis that has given many a new lease on life and the opportunity to think of a future that once wasn’t plausible.
I recently had the privilege to meet with Dr. Adriana Carvalhal who is an Assistant Professor at the Department of Psychiatry at the University of Toronto and Director of Medical Psychiatry Consultation Services at St. Michael’s Hospital. Her research work is in the field of psychiatric disorders in HIV-infected patients, neurocognitive disorders associated with HIV and mental health and service delivery for the HIV population with a specialized interest for HIV-positive women. Her passion for her work includes lecturing around the globe to share her experiences and findings with an openness to continue learning along with other world specialists in the field of HIV.
For over 20 years she has been an active advocate in the battle against HIV. Originally from Brazil, her studies focused on family therapy. During this time a social worker asked for her assistance with a family (husband, wife and child) that was struggling with their newfound HIV status back in 1994. “I had absolutely no regrets and no doubts in helping someone come to terms with their eminent death and in helping them find peace by assisting them in ensuring their child would be well taken care of and loved.” She was an integral part of this woman’s final year of life. “At 27, it shaped me as an adult and as a clinician”. She was greatly affected by the experience and turned her elective into her Masters in HIV.
Her studies brought her to Canada to finish her PhD in 2003, siting our more progressive and better understanding of HIV as opposed to that of Brazil. Her transition to life in Canada included adapting to a new language, culture and time away from her two daughters. She considers her first year here as a total disconnect but persisted in pursuing her goal. Through her one on one work with patients she created a connection that represents how we can all help one another. She helped patients with their issues and they helped her with her adjustments to life in Toronto.
Dr. Carvalhal sites the late 90’s as a turning point with HIV. “New treatments and their outcomes changed the disease. The focus shifted to building a stronger mental state to combat the personal struggles with being diagnosed as positive. Finding the roots of mental disorders and various addictions can prevent these issues from interfering with a healthy future as an HIV-positive individual”.
“Individuals, now positive with the virus have become all the more responsible for their own longevity. One can indeed win their personal battle against HIV with the assistance of a psychological component. Resolving detrimental behavior such as trauma, addiction, depression and violent behavior that are deep rooted requires the assistance of a trained professional”.
At some point in our lives we turn a page and realize that the day has come and that we are indeed the masters of our own destinies. The past can no longer hold us back from moving forward. The blame game changes and the culprit as we age can shift to being ourselves if we don’t come to terms with those demons that had an impact on us. Reaching out for professional help is crucial for many of us to resolve and overcome past issues that can still affect our behavior.
Through Cognitive Psychology and her clinical work she has recognized the steps an individual experiences that she calls an HIV Cascade. They are high risk factors, infection, diagnosis, care and maintenance. “If an individual possesses some form of a serious personal disorder the stronger the challenge in achieving a healthier state of well being with each or all of the steps outlined. It is important to recognize the source of behavioral issues that can be detrimental and then resolve them. These can range from sex addiction, drug or alcohol abuse or to childhood trauma’s that may have triggered detrimental behavior. Some individuals through being diagnosed as HIV Positive naturally end up taking more responsibility and better care of themselves. This is a possibility despite having prior issues that may have led to their infections. It can be a huge wake up call! We all have the capacity to bounce back with the idea of self preservation.”
“Social media has become a tool in helping many come to terms with being positive. Reading about other’s experiences, whether trials or tribulations, creates a more informed awareness. A sense of camaraderie or fellowship that reduces fear and loneliness can be achieved”. Dr. Carvalhal is an active contributor and one of the founders for www. whealthintervention.ca as well as on their Facebook account. The Women’s HIV Empowerment Through Life Tools for Health is a phenomenal source that reaches out to women near and far offering them an excellent variety of information and links. “It’s a forum to inform women and keep them up to date”. Issues, such as stigma, can be marginalized through social media as one can find strength and resilience through a support system that is open and relatable.
Whether it’s assisting in setting up guidelines for the use of PrEP in Canada, her continued research, spearheading new forms of therapy or simply participating locally in Toronto’s annual AIDS Walk, Dr. Carvalhal has a undeniable commitment to her work and to those she comes into contact with. This has also led to her demand around the world in sharing her experiences and inspiring others to develop their own theories that will continue to eradicate the impact of HIV.
The dedication of leaders in their given fields, like Dr. Carvalhal, continues to improve the quality of life of those who are HIV-positive. Significant steps have transformed a life threatening disease into one that is no longer lethal. And like all other manageable diseases, the onus is now up to each and every individual to be accountable for their recovery by utilizing the resources that are currently available. The road of life is filled with many hills and valleys and being “positive” along the journey has an added significance to those “Living with HIV”.