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The next patient is in her mid-20s. She sits gracefully on the edge of the chair and looks at me.

"How can I help you today?" I ask.

"It is this," she says, hands clasping her belly, "I look like I am 4 months pregnant!"

"And are you? Have you checked?"

"Oooh! Yes. MANY times - and always negative. I have been talking to my friends and they say it could be the HIV treatment."

"Yes - that is true. You are on one of the older drugs, the one called Stavudine. That can make fat appear in different places on your body, and sometimes disappear from other places. Some people find that it makes their face thin." I suck my cheeks in briefly. She laughs.

"I used to have a VERY round face, now it is thin!"

"I suggest that we change that drug then. We have more drugs available in the public clinics than we did when you started and the one I will use has less side effects. Is that what you would like?" She nods enthusiastically.

As I do the paperwork I ask, "If you don't mind me asking, how do you feel about having HIV among your friends and family. Do you tell them? Do they know?" She grins broadly and pulls off her jumper. Underneath she has a T-shirt, upon which is printed in 6 inch letters 'HIV POSITIVE'.

"Everyone knows. I am not embarressed. It is important that we are not ashamed, then other people will test and get treatment."

"That is brilliant. I used to work in rural South Africa, up in KwaZulu-Natal and there people were very unwilling to be open. There was a lot of stigma about HIV."

"I used to think like that, but when I got my diagnosis I joined a group for people who were HIV positive and when you discover that they are normal people just like you, and that they have been on treatment for 5 years, or 10 years and are well - it makes you realise it is OK! So I make sure everyone knows!"

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Simon said…
Hi Ed. Enjoying your blog. Need your email -- presume you did not get my message just after you left UK... winner.sj@gmail.com

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