ISKCON's position on HIV/AIDS
Reposted April 19, 2005
Firstly, thanks for all your support- you know who you are. Secondly, its not all doom and gloom inside ISKCON. Its a lot of reading but here's some interesting stuff I found whilst browsing the net today. This is from CHAKRA's archive:-
"ISKCON Law Book Error
HIV testing not required
There is an error in the present version of the ISKCON law book. It states:
8.5.2 AIDS Test
1. The GBC Body requires that all devotees living and/or serving in our temples should take an AIDS test, local laws permitting. All new devotees, as they join, should also take an AIDS test.
2. The GBC Health and Welfare Committee advises that temples should not allow persons who are HIV positive to engage in services within our temples, which involve the preparation or serving of bhoga or prasadam.
This 1993 GBC resolution was overturned during the 1994 Mayapur meetings because the resolution was based on inadequate information about the best way to prevent HIV virus transmission. This section of the law book will therefore be removed in the next edition.
Along with this article CHAKRA is publishing a paper providing basic information for devotees about HIV/AIDS. The paper includes definitions of common terms and reviews routes of transmission, prevention strategies, information about the HIV antibody test, and it explains from various perspectives what it means to test positive."
and part 2 follows:
"Basic information about HIV/AIDS for ISKCON devotees
by Madhusudani Radha devi dasi
(Maria Ekstrand, Ph.D.)
Center for AIDS Prevention Studies
University of California, San Francisco
While I wish that information on AIDS could be irrelevant to the lives of ISKCON devotees, this is unfortunately not the case. We have already lost several members to this disease and many more are infected or care for devotees with AIDS.
In addition, the World Health Organization estimates that India currently has more HIV positive individuals than any other country in the world and the epidemic is spreading rapidly there. Approximately 70-80% of injection drug users in Manipur are infected and the figures are high for other groups too. Commercial sex workers have been hard hit (up to 60% depending on the study), as have STD clinic patients (30-40%), and even women with no risk factors who simply come to the hospital to give birth have a rate of infection many times what you find in the West (3-4% in a recent Mumbai study).
Since devotees frequently travel to India, this situation has implications for us too. The only silver lining with this horrible disease is that it is completely preventable. I hope this paper will shed some light on how this virus is and is not transmitted, and how you can prevent infection.
I. HIV and AIDS
Many people, including some members of the press, frequently use the terms HIV and AIDS interchangeably. While the two terms are certainly related, they are also different in some important ways.
1. Human Immunodeficiency Virus (HIV)
- HIV is a virus that attacks some of the white blood cells, which are crucial to a properly functioning immune system. Once the virus enters the body, it continues to replicate and, during this process, destroys the body's immune system. Thus, you don't get sick from HIV itself, but rather because your body can no longer defend itself against infections and diseases.
2. Acquired immune deficiency syndrome (AIDS)
- AIDS is what is called a "syndrome," i.e. it is not one disease but rather a cluster of symptoms and diseases. Being diagnosed with AIDS usually indicates that your body has been attacked by some typically fatal infection, such as pneumonia or cancer. The definition of AIDS also includes individuals whose immune system has become so weakened that the body is unable to effectively fight off any of these conditions, (i.e. has less than 200 CD4 cells). The reason for this addition is that it has become impossible to list all the various ailments that afflict people with AIDS, and some people felt the earlier definition did not include enough symptoms experienced by women.
- AIDS has a very long incubation period compared to many other diseases. Ten years after becoming infected with HIV, approximately 50% of all people have developed full blown AIDS and another 30% suffer from less serious HIV-related symptoms. We don't yet know if everyone who is HIV infected will eventually develop AIDS. The earliest HIV infections we know of in the US happened in or around 1978 and some of those men are still alive today. It is thus possible that a very small percent of HIV infected individuals will never develop symptoms and many researchers are now interested in studying those people to find out what makes them unique. Some recent data suggest that this may be due to both individual factors (such as having a certain protective genetic "defect") and viral factors (e.g. possibly having been infected with a less virulent strain of the virus)
In spite of recent treatment advances (such as the much publicized "protease inhibitor" drugs), AIDS is typically fatal. It is therefore not surprising that people have become very fearful of HIV infection. Many theories and myths about transmission have been proposed.
The good news is that compared to many other diseases such as colds, measles, and chicken pox, HIV is a fairly difficult virus to transmit. The routes of transmission are listed below, followed by a section describing ways in which the virus is not transmitted. These are typically referred to as "casual contact" and have never been implicated in any HIV infection cases since the beginning of this epidemic.
1. Transmission routes
The routes of transmission have been remarkably consistent ever since the epidemic was first discovered. That means:
- You can become HIV infected if you have unprotected anal, vaginal, or oral sex with an infected individual.
- You can also become infected if you are exposed to infected blood, e.g. by sharing needles, or by going to a street barber who does not disinfect his knives between customers.
- Infants can become infected during pregnancy or delivery if their mother is HIV infected. They can also become infected through breast feeding.
- You can become infected by receiving blood transfusions in countries that do not test all donated blood and plasma. Most West European countries and the United States have been testing their blood supply since 1984/85. However, you may be at risk if you received a blood transfusion in any country prior to this time, or if you received one since then in a country that does not routinely test all donated blood. Although some parts of India mandate blood screening, there is some evidence that this is not done consistently, and the Indian blood supply in general can therefore not be considered safe. Devotees who need blood transfusions while in India should look into the possibility of using friends with compatible blood types as designated donors. Devotees hospitalised in India may also be wise to inquire regarding the use of sterile needles. Finally, there have been some reports of use of discarded syringes to squirt colored water during Holi. At least some of these syringes have apparently been obtained from hospital waste dumps.
2. Safe behavior
There is no evidence that HIV can be casually transmitted. You cannot get it by talking to someone who is HIV infected, by hugging them, by touching the same doorknob etc. You cannot even get it by having them cough on you or by drinking out of the same glass. Donating blood and being tested for HIV is also completely safe in most countries since new sterile needles are always used and are discarded immediately. If you are in doubt about the infection control and sterilization procedures used in your country, ask the health care workers there!
A few years ago a large study was conducted in New York among families of HIV infected haemophiliacs. For many years, these families had not known that their children were infected and had thus continued behaving as most families do. All of them had eaten off the same plates and drunk out of the same glasses. Many had even used each other's toothbrushes and licked the same ice cream. In spite of this intimacy, not a single family member tested HIV positive.
Another important point to remember is that during the past few years, researchers have stopped talking about risk groups and are instead focusing on risk behaviors, since these are really what transmit the virus. Thus it doesn't matter whether you consider yourself a drug addict, a gay man, a straight woman, or a devotee, the important thing is whether you have engaged in one of the previously mentioned behaviors and whether you might have been exposed to infected fluids.
III. THE HIV TEST
It is important to know that the HIV test was designed to detect antibodies to HIV, rather than the virus itself. These antibodies do not develop immediately in the body, but usually take anywhere up to 6 months before they are present in a sufficient quantity to be detected by the test. If you know that you have recently engaged in a risk behavior, you should probably get re-tested even if your HIV antibody test is negative. To be safe, the second test should be obtained at least six months after you last practiced the risk behavior.
Since AIDS is usually fatal, some people wonder why anyone should bother taking the test. It is true that early on in the epidemic this was a pretty controversial topic. The only reason back then was that by knowing that you were positive, you could avoid infecting other people.
Even though there still is no cure for AIDS, many advances have been made in the treatment of HIV infected individuals. For example:
- We now have new therapies consisting of a combination of anti- retroviral medications and protease inhibitors. Taken together, these drugs can slow down the rate of virus replication in your body and even remove virus already there. This means that people can live longer periods with less risk of contracting deadly infections and other diseases. Controlled trials using motivated samples that followed an extremely complex regimen over a long period of time, showed that these drugs can reduce the amount of virus in your blood stream to virtually undetectable levels. Unfortunately, most people find it very difficult to take up to 20 pills per day on complicated schedules, making the real-life success rates of these drugs more modest (53% in one recent study). Another factor to be considered is the very high cost of obtaining these drugs. A year's supply can easily run $15,000 and this is not always covered by private and government insurance, especially in the developing world.
- Other treatment options available include medications that can prevent the onset of some of the specific opportunistic infections that people living with HIV frequently get. These include the prevention of PCP, a rare form of pneumonia, as well as CMV retinitis, a type of blindness that often occurs in HIV infected individuals. Some of these procedures involve clinic-administered treatments, while others can be self-administered at home.
- New treatments are being developed constantly, some of which are available through physicians, in drug trials, or through "compassionate use" programs. There are also many people who decide to try alternative, non-Western therapies. Although no results are yet available, there have been several recent efforts to test some of these alternative treatments in rigorous clinical trials. Those who are interested in this approach can get more information either from their regular health-care providers, from alternative medicine clinics, or from various self-help groups. The choice of whether or not to undergo any HIV-related therapy and, if so, which type of regimen to try, is obviously a very personal decision. By learning your antibody status you have a better chance of hooking into the community of AIDS service providers and learning about the latest developments.
IV. TESTING POSITIVE
What does it mean medically to test positive?
- As mentioned earlier, a positive result basically means that the
test (Elisa &/or Western blot) detected antibodies to HIV in your
blood. These antibodies typically develop within weeks, and almost
always within 6 months. However, no medical test is foolproof.
1. If you test positive, but know that you have not engaged in any risk behaviors since around 1980, go and have the test redone.
2. If you test negative, but know that you have engaged in any of the risk behaviors mentioned above within the last 6 months, you need to be re-tested.
What does testing positive mean legally?
- This is a trickier question, especially for an international
society such as ours. Different states and countries have different
laws pertaining to HIV infection and AIDS. Before getting tested you
need to get the following information:
1. Is HIV testing anonymous (i.e. your name is never recorded together with your test result) or simply confidential (your name is recorded on hospital, health insurance &/or local or national records)?
2. What are the consequences of testing positive if you are a foreigner? How about if you are in the country illegally? Can you be deported?
3. Does your country or state have mandatory contact tracing, i.e. require information about who may have infected you and whom you may have infected?
4. Do the authorities in your country have the right to quarantine HIV positive individuals whom they feel pose a risk of infecting others?
5. Are there any other forms of discrimination against HIV infected individuals in your country, such as housing, employment, or health/life insurance restrictions?
You may also want to call ahead and ask about the general procedures involved in obtaining an HIV test, potential costs involved, whether pre- and post-test counselling is provided, and whether people can obtain written as well as oral test results.
This information can typically be provided by your local, state, or national health departments. In many countries these matters are handled by divisions within the health ministry that deal with infectious disease, venereal/ sexually transmitted diseases. Other countries have established special AIDS offices.
What does it mean psychologically to test positive?
As devotees we are fortunate enough to have realized that we are not our bodies but are spirit souls, thus our true selves cannot really become infected. This realization can be enormously helpful to our mental health as well, since we don't identify with our bodies. In spite of this knowledge, devotees whose bodies are infected by HIV are bound to experience a variety of emotions and have many questions. Some of these will be of a spiritual nature and can be best answered by our spiritual masters and senior devotees and friends. Other concerns are going to be more emotional or practical and for some people, it may be helpful to join a support group for HIV positive individuals, at least on a short-term basis. These groups usually help by reassuring their members that their feelings and concerns are perfectly normal. They also provide a forum to discuss specific practical issues and treatment options with others who have gone through the same process.
The endorsement of support groups with non-devotees is not meant to suggest that they can replace the support we can get within ISKCON. I hope that we have developed a strong enough support system within our society to help HIV infected devotees better handle these difficult news. I would also hope that we can respect each other's right to privacy about test results and to keep in confidence any news shared by others.
If a devotee in your temple or community has tested positive, it is only normal that other devotees there will be a little concerned about their own health risks. To reassure them, it may be helpful to review some of the information on transmission routes above. You can also use the example of health care workers who risk exposure to HIV and other contagious diseases on a daily basis, but who manage to stay uninfected. In medicine, there is a term called "universal precautions." That means that all patients are treated as if they were infected. Health care workers avoid exposure to their bodily fluids by using gloves, masks etc. Similarly, rather than worry about who is positive and who is negative, we should just avoid risk behaviors all together. This will also keep us safe from contracting many other, more common diseases, such as hepatitis B. The risk of HIV transmission is less of a problem in ISKCON than in other parts of society, given our regulative principles and way of life. Since you do not have to worry about casual transmission, the HIV status of other devotees really should not matter to you. There is no risk of transmission in any of the daily activities involved in living in an asrama with an infected individual. There is also no scientific reason to limit the types of service available to HIV positive devotees.
Living with HIV is stressful enough without having to worry about stigmatization and discrimination. The best gift we can give HIV positive devotees is to encourage them in their service, provide practical assistance as needed, and support their advancement in Krsna consciousness in any way that we can for as long as they remain in their bodies."
These two articles go to show that behind the scenes ISKCON is not all bad. Its a shame that thay are not more up-front with this kind of info. It took me hours to find it.
your servant and eternal well-wisher
formerly Bhakta Raven