Living with AIDS

Radio 4's Living with AIDS series focuses on disparate experiences of the HIV pandemic. In the first programme, Blood Brothers, we are reminded of the men with haemophilia who contracted HIV in the early 1980s through factor VIII. In the United Kingdom 25% of patients receiving factor VIII were infected with HIV before doctors fully understood the problem.

We hear from Mick, who realised that he was infected with HIV only when instructions for a special diet for people with AIDS arrived in the post. He was told he had two years to live, and recalls receiving little support or advice beyond “Go out and enjoy yourself ... but don't have sex!”

While gay men had close social networks and a legacy of rights activism from which to draw strength, men with haemophilia were geographically dispersed, and did not naturally identify with one another. The onset of HIV left many feeling isolated. Eventually, a support group emerged—Birch Grove, named after a pub in Cardiff, where founding members met. It soon gained national membership, and helped launch compensation claims. And now a real birch grove exists—a poignant “living memorial” with a sapling planted for each of the 800 plus people with haemophilia who have died from the NHS's “greatest medical disaster.”

The next three programmes, The Global Challenge, turn to sub-Saharan Africa, where over 60% of the 40 million people currently living with HIV reside. Uganda is often hailed as a success story in reducing prevalence rates, and the programme traces the development of the ABC prevention approach—Abstinence, Being Faithful, Condoms—exploring the current controversy over the appropriateness of this message.

Religious leaders suggest that abstaining before marriage and monogamy within it are the only sustainable means of slowing the virus's spread, while condoms promote promiscuity. Others advocate a more balanced view that considers women's limited ability to control sexual activity and relationships. “ABC does not work for women,” states Beatrice, who was infected by her husband.

This series goes beyond grim statistics, and privileges the voices of those personally affected by the disease, using their recollections and explanations rather than relying on doctors and other “experts.” Formal narration is kept to a minimum. The programme uses excerpts from the “Living Stories” archives set up to document the feelings and experiences of men with haemophilia and HIV. The episode from Uganda records one young woman's giggling attempt to purchase a packet of condoms—it's more daunting than she expects.

Another strength of the programmes is how they deal with the increasing availability of antiretroviral treatment. While the drugs are shown to offer real hope to people who previously believed they carried a “death sentence,” they are not without their own complications. In Uganda, young people now talk complacently about HIV being as innocuous as the common cold, while some people with haemophilia who believed that they had just a year or so to live have found it difficult to adjust to planning long term futures. The programmes strike a good balance in showing how far we've come since the confusion and panic of the early days, yet how complex and difficult the challenges of the HIV pandemic continue to be.