"Africa is, indeed, coming into fashion." - Horace Walpole (1774)


teens & HIV

Stephan Faris writes about Ugandan teenagers living with HIV/AIDS:
Yet the teenage years, when not-yet-mature patients begin to take responsibility for themselves, are perilous for bearers of a chronic disease...

...Once firmly established on a treatment regimen, they can check its progress with their doctor as seldom as twice a year. But for HIV-positive people in places like Uganda, there are also a lot more reasons therapy is likely to fall apart. Shattered families, poor education, or the lack of bus fare to the clinic can come between a patient and the medication. "Many of those who fail on their treatment have poor social support," said Kitaka. "They have multiple caregivers. They are in boarding school."

...Among adolescents--prone, the world over, to easily mix judgment, hypocrisy, and naïveté--these sentiments seem particularly sharp. And for those who slip up in their treatment, the consequences can be unforgiving. "You don't get many chances in Africa with medication," said Yuka Manabe, head of research at the Mulago Hospital's Infectious Disease Institute and a professor at Johns Hopkins University. Whereas in the United States, 24 different drugs can be combined into many different types of therapies, options in the developing world are limited. "You get a first-line regimen, and you might get a second-line regimen if you're lucky," Manabe said. In a region where finances form the barrier to the availability of drugs, allowing the virus to build up resistance has dire consequences. "For every person that goes on second-line therapy here, nine people will [have to be denied] first-line therapy," Manabe explained--the alternate treatment is that much more expensive. "These are tough decisions. Is your first allegiance to the people who have been on? Or should it be on trying to give as many people access as possible? And if you blow it, 'Sorry'?"
I found this to be a particularly well-written piece for several reasons. First, it doesn't exoticize its subjects. Yes, the teenagers live in Uganda and deal with a disease that most readers of the Atlantic will never contract. But, like all teenagers everywhere, they are sometimes prone to making unwise or poorly thought-out decisions. Not treating these teenagers as exotic creatures in a faraway land makes it possible for readers to more fully consider the complexities of the issues surrounding their treatment without distraction.

Finally, it's always nice to see reporters follow good standards of ethical journalism for reporting on children and youth. There's rarely a reason to disclose the identity of an HIV+ child - especially one whose parent or guardian may not really understand the implications of consenting to do so.


Blogger mipoulin said...

I agree, the article is nicely done. I'd emphasize, though, that the teen years are a period when belonging, and friends, are particularly important, in Africa and elsewhere. So, when a teen doesn't adhere to treatment, the rationale behind this decision likely comes from a place of naivete and poor judgment, but also from a prioritization of the desire to be like one's friends--in this case, not HIV positive, and not having to deal with all of the requisite tasks of managing the disease.

Tuesday, June 01, 2010 9:05:00 AM

Blogger texasinafrica said...

That's a great point, and one with which I don't think the author would disagree.

Tuesday, June 01, 2010 1:05:00 PM


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