FARAI CHIDEYA, host:
Last week, we spoke with Silvia Glover, the foster mother of 2-year-old Caleb, who has HIV. Earlier this summer, Silvia and her husband were asked to keep their son out of the public pool and showers at an RV park in southern Alabama.
We also spoke with the park's owner, Ken Zadnichek, who says that he just wanted to keep the boy out of the facilities until he got confirmation that it was safe for other patrons.
So from a medical perspective, how should the situation have played out, and what are the myths and realities of HIV transmission?
Dr. Luther Virgil is a physician with Integrated Minority AIDS Network Inc., or IMANI. It's a nonprofit network of doctors who treat HIV patients.
Dr. Virgil, welcome.
Dr. LUTHER VIRGIL (Physician, Integrated Minority AIDS Network, Inc.): Well, thank you. I appreciate being here. How are you doing today?
CHIDEYA: I'm doing absolutely great. And so I mentioned that I spoke last week with the RV park's owner. He asked the Glovers to keep Caleb out of the public pool and showers until he could get assurance from a health official that Caleb, who has HIV, wouldn't put other patrons in danger. So I want to play you a little bit of my conversation with him.
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Mr. KEN ZADNICHEK (RV Park Owner, Mobile, Alabama): The real story to us is child-on-child contact. We weren't sure what we were dealing with. We wanted to protect Caleb's health as well as every other child's health because he's got a suppressed immune system. We didn't know what would happen if a bunch of kids all were in the same place, sharing things that infants do, chewing on toys, diapers, the whole mess.
CHIDEYA: So, Dr. Virgil, how justified were Mr. Zadnichek's fears?
Dr. VIRGIL: Well, his fears most likely came from a lack of knowledge about the disease. In reality, the things that he mentioned such as child-on-child contact, casual, normal, everyday child-on-child contact does not place anyone at risk for the transmission of HIV and also does not place the child with HIV at risk for transmission from someone who has some other illness other than HIV.
CHIDEYA: So run us through bodily fluids: saliva, urine, blood. These are all things that people wonder about in terms of how much of a risk they are.
Dr. VIRGIL: Yes, there are some common misconceptions out there, again, reflecting on our need for more education and understanding about the virus itself. Many individuals are not fully aware of where the virus is actually located and what fluids are the key fluids that we are concerned about in relations to HIV. For example, HIV can be found in blood, naturally, also in the semen of male individuals and the vaginal fluids of female individuals. Those are the bodily fluids that we are most concerned about with the transmission of HIV.
CHIDEYA: And what about saliva?
Dr. VIRGIL: Saliva - not so much a concern about transmission. What a lot of people don't understand is that there's a certain - what we call an inoculum size or certain load or amount of virus that must be present in the transmissible fluid in order for a person to truly get the HIV virus. And the saliva is not a fluid that we look at or consider as one that has a high load in most instances transmit. So kissing an individual on the lips with HIV is not a high-risk situation. Placing your mouth on toys, which children will do, and then sharing with other children is not a high-risk behavior for transmission of HIV.
CHIDEYA: So there are a lot of stories about HIV. You can get it through shared clothing. You can get it through toilet seats, mosquitoes. What are - what do you say to things like that?
Dr. VIRGIL: We run into these types of beliefs even to this day, and they are beliefs which are limiting individuals' abilities to deal with HIV and limiting our overall ability to deal with this illness. We heard stories such as you can get it from toilet seats, you can get it from mosquitoes, you can get it from sharing clothes. These types of beliefs, of course, are not founded. They're not true, but they do exist. And we find it each and every day when we go out to places like high schools or elementary schools and even adult institutions such as churches and talk about the illness.
CHIDEYA: So are there myths that you find are really more prevalent in the African-American community?
Dr. VIRGIL: I think there are myths in all communities but some of the myths that we do find more frequently in the minority community are ones were sent around things like the toilet seats. And also, one of the biggest concerns that we've been having in the minority community, there have been studies, which have shown issues of risk and risk behavior and how people perceive themselves to be at risk.
One of our biggest concerns at this time is that when we look in the population of men who have sex with men, the concepts of what the risks are such as unprotected types of sexual behavior are the true understanding of that is being forgotten. In other words, individuals are not putting as much stock in that and are taking more risks when they are being involved with sexual relationships.
CHIDEYA: Now, what about this. There definitely are theories about AIDS being created, secret cures, things like that. Can you speak to that?
Dr. VIRGIL: Yes. More recently, a study done by the National Institute of Allergy and Infectious Disease showed that about 48 percent of the minority or African-American individuals that they interviewed felt that the HIV virus was created in order to attack certain populations, that it was created by the federal government, whether they believe it was created for a tool of war or created in order to actually attack minority populations. They did have that belief. And that, of course, presents a difficulty when it comes to treatment because if the belief is that HIV was created in order to attack black people or HIV was created by the federal government, then the medicines which come out from studies related to the federal government, the individuals who would best benefit them - benefit from them, we find that they are less likely to take those medications which, again, then sets up those individuals who are HIV positive for spreading the disease because of the issue I talked about before, this inoculum size of viral load.
CHIDEYA: And what about the issue of secret cures, if that has come up?
Dr. VIRGIL: Yes, it has and it is very predominant in the African-American population. And many of the African-American individuals with HIV and those who don't have HIV will give you a classic example and they talk about the case of Irvin "Magic" Johnson, the famous basketball player. They will say, well, Magic Johnson has been cured. And then they look to the issue of the fact that those individuals who have - those individuals with money and power will be able to get the cure and those individuals who are poor, like the large portion of minority population, will not be able to get the cure. That is a difficulty in itself. Magic Johnson, and I've talked with him myself, has not been cured of HIV. He takes the medications the way he's supposed to take the medications and because of that, he gets the best benefit of health.
CHIDEYA: Very quickly, what is your main approach at IMANI to dealing with myths and information?
Dr. VIRGIL: Education, education, education. And some of the best education can come from the people who have the disease themselves. They serve as the best ambassadors for learning. We are continually and constantly trying to find anyone who - will listen and educate them on the issue of HIV disease.
CHIDEYA: Well, Dr. Virgil, thank you so much.
Dr. VIRGIL: I really appreciate you allowing me to talk with you and spread more education about HIV.
CHIDEYA: Dr. Luther Virgil is a physician with Integrated Minority AIDS Network Inc., a nonprofit network for doctors of HIV and AIDS patients.
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I'm Farai Chideya. This is NEWS & NOTES.
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