Love in a time of HIV: medical man tracks his family's journey

There is hope for those with HIV, but testing is vital, says a doctor who is on ARVs, Stephan Gerke

I am a doctor. I am HIV-positive. I have been on antiretrovirals since 1999. My CD4 count on diagnosis was 57 - stage 4, because I had abdominal, or extrapulmonary, TB the same year.

I am an "import". I came here voluntarily to do my internship in medicine and fell in love with this country and with a woman, too.

We had a child and we took out life insurance in 1991. We were both HIV-negative then.

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Our second child was born in 1993 and it was time for us to upgrade our insurance policy.

HIV testing was a requirement back then. I tested positive. My wife was fine. Our baby was fine, too.

Then came 1994 - a new government, finally! A free, democratically elected South African parliament. God blessed this beautiful country.

It may sound stupid, but I am not someone who is unfaithful and neither was my wife.

How on earth could I have contracted HIV?

Then again, I was working at the busiest trauma unit in our beloved South Africa: Baragwanath Hospital. In fact, I was on call the day Chris Hani was assassinated. That very same hospital - at which I was a registrar - was later renamed Chris Hani Baragwanath Hospital.

At the time, resources were scarce: no gowns, no appropriate gloves, no face masks, no whatever.

Worst of all, there were no proper HIV test kits in the public sector - only in the private sector.

HIV tests are available in abundance these days, but health resources are still as scarce as they were back then. In fact, they are worse.

And then, of course, there was total denial from higher up: health minister Manto Tshabalala-Msimang didn't acknowledge the disease, selling beetroot and stuff instead.

The second president of this republic, Thabo Mbeki, was a business-oriented person: there was just no way that this country could afford in real terms to pay for life-saving ARVs without destroying any viable economy there was.

Let me leave it at that; pointing fingers is easy. Coming up with answers? Very difficult.

I wanted to live: after all, I had two children born in South Africa, one from a previous marriage and a stepson from my new wife.

Solution? Skip the country. We left for the UK.

HIV in the UK was rare at that time. I felt embarrassed to tell anyone, but then I got sick. Really sick. They thought cancer and all sorts of other things. HIV was not on their list of priorities.

block_quotes_start Our little baby girl turned two a few months ago, and she is HIV-negative. It is all about compliance block_quotes_end

Subsequently, I got diagnosed with abdominal TB. That is, by definition, already stage 4 of the World Health Organisation classification of HIV/Aids.

Since I knew that I was positive beforehand, I used one of those "no name" clinics they have in the UK. Called myself "Frikkie".

Two days later I was put on ARVs. Free. No cost.

Two months later, they took bloods and my CD4 was almost back to normal.

I felt great. My nasty skin rashes had all disappeared. No more TB. I felt normal, fit as a fiddle, ready to take on the world.

My family and I came back to South Africa in 2006.

I had read that things weren't looking as bleak as they had when we left. And that was and is true.

For the first year or two after re-registering with the Health Professions Council of South Africa, I didn't tell anyone at my workplace that I was positive. That stigma just sucked.

Then I thought about it.

Bugger them all!

Doctors and other healthcare practitioners die from occupational diseases a lot: hepatitis, cholera, Ebola, Marburg, H1N1, and whatnot.

I guess if it's my turn, it's my turn.

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My marriage faltered and I am now remarried.

My wife's parents died in the 1990s. It is clear to us in retrospect that they both died of Aids.

And it is clear to not just us. There have been many deaths in my wife's family. Some as young as 17. Why?

My wife and I are both positive and we have a child.

Our respective CD4 counts and viral loads when we conceived were favourable: CD4 above 350 and viral load undetectable.

Our little baby girl turned two a few months ago, and she is HIV-negative. It is all about compliance.

I have three teenage stepchildren. I took them for testing and they asked me why.

That was a few years ago, and I told them that they should get tested every three months or so.

The threat is still there and there is still no cure for the disease.

Early detection is vital and saves lives.

These days, my teenagers are telling me: "Take me to a testing station!"

In my family, there is no stigma. The place I am working at knows about my status.

I transferred my HIV care to a government facility. It was hard, initially, but I am damn proud of it. I am one of many.

Have you tested?

• Gerke is a medical practitioner in government service at KwaMagwaza Hospital in KwaZulu-Natal