Thursday 20 October 2016

HIV sufferers get all the sympathy - while smokers are lectured

Published 07/12/2015 | 02:30

'If you develop a condition triggered by smoking, you are likely to be reprimanded for your habit'
'If you develop a condition triggered by smoking, you are likely to be reprimanded for your habit'

About four years ago, I was diagnosed with a pulmonary condition in the category known as chronic obstructive pulmonary disorder (COPD). The form it took was bronchiectasis, whereby the airways of the lungs were damaged, causing breathlessness, mucus and a tendency to pick up chest infections during winter.

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And yes, it is all too evident what prompts many forms of COPD: the dreaded cigarette habit. From the age of 17, I puffed away on these aptly named coffin nails, often consuming two or three packets a day.

And, as a member of the "nation of extremists", as Diarmuid Ferriter has dubbed the Irish people, I had to smoke the fags with the strongest levels of nicotine, tar and all the rest.

Predictably, when this bronchial condition was diagnosed, I received a bit of a scolding from the consultant about the Wages of Sin.

I could have been sitting in Dr James Reilly's own surgery in regard to the finger-wagging that went on. Not only that, but the chest consultant added that he didn't feel inclined to treat me while I was overweight. A smoker (well, an ex-smoker by now) who was also on the tubby side - two modern sins in one go. He recommended that I lose a stone in weight, first off.

I did the sensible thing: I asked for a second opinion. I got a consultant who didn't scold - not overmuch, anyway - and set about addressing the COPD condition.

But here's an interesting aspect of modern diseases that arise out of what they call lifestyle choices: if you develop a condition triggered by smoking, you are likely to be reprimanded for your habit.

But if you develop a condition that occurs because of sexual choices made, you will be supported by many compassionate voices that reiterate that this illness should never be stigmatised.

Last week it was announced that HIV cases in Ireland had "soared" between November 2014 and November 2015, with 427 new diagnoses of HIV, which can lead to AIDS (though fortunately nowadays need not). This represents an increase of 85 cases over the same period the previous year.

Chief executive of HIV Ireland Niall Mulligan said that part of the increase was because of increased testing, yet many people still didn't know that they had the illness.

Half of the cases over the past 12 months, he said, was among men who had sex with men.

There should be more widespread free testing for HIV, and most importantly, there should be no stigma attached to the condition. Stigma, he lamented, "was institutionalised in Ireland".

HIV Ireland works to support people with HIV, some of whom may have even unfairly lost their jobs because of the condition.

Anyone who works for the reduction of any disease is admirable; and, as it happens, religious texts often urge us to embrace and love anyone afflicted with any illness.

St Catherine of Sienna is said to have drank a cup of leper's pus to show her Christ-like attitude to infection (and I draw no parallel here between leprosy and any other disease).

Mother Teresa of Calcutta was one of the first to say that the best treatment for those with AIDS was love and care.

Yet it is striking that some health conditions are now stigmatised, and officially so: not only smoking-related illnesses, but, increasingly, any form of obesity that arises from the consumption of junk food - and, let's face it, pure gluttony - is also subject to stigma.

In London recently, overweight people travelling on the Underground, were handed cards about how hateful fat people are. Stigma, for sure.

But while the stigma on smokers and the portly seems to be increasing, every campaign to combat HIV/AIDS denounces stigma as wrong, wicked and always to be avoided.

Both smoking-related illness and HIV/AIDS (in most cases, and with the emphatic exception of children) arise out of 'lifestyle choice'. You may get a COPD if you smoke, and are more likely to do so if you have a vulnerable genetic predisposition. You may get HIV/AIDS because you have many different sexual partners and don't use protection - and there is also the probability that there is genetic vulnerability.

Of course, some people are lucky and suffer no consequences of such lifestyle choices: there's a famous textbook case of a Canadian air steward who slept with 3,000 men and emerged hale and hearty - just as there are those who smoke away ferociously into their 90s.

Rightly, those fighting AIDS and HIV want to encourage potential patients to come forward, get tested, and get treated, without fearing stigma.

This is excellent health advice. But we must all face the consequences of the choices we have made.

And if prevention is better than cure, then surely it's rational to explain that HIV/AIDS arises because of a choice made, just as lung cancer or COPD may be the penalty for a similar form of recklessness.


Irish Independent

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