20 Years after an HIV Scare in Africa

– Brian Guse, RPCV, and PC Trainer, Mali

I was perusing the National Peace Corps Association site on Facebook today and saw a post urging readers to check out an RPCV’s blog titled “No Going Back – There Is Only Forward.

The author is a young woman who was recently med-separated from Peace Corps after contracting HIV while in country (Zambia). Her story is one of courage and strength and she is an inspiration to all – Peace Corps or not, HIV positive or not.

After reading her blog I couldn’t help but think back to where I was 20 years ago and the intersection HIV made with my own Peace Corps experience. By no means do I compare my “scare” with what she is going through, but I think some of you might be able to relate to the story I am about to tell.

20 years ago, almost to the day, I was sitting on an airplane crossing the Atlantic on my way back to Mali. I had been away from my village, my friends and my Malian family for more than 45 days – on medical evacuation for a serious life threatening illness. After having spent a week in Georgetown University hospital, another 2 weeks recuperating in the Virginian Hotel in Rosslyn, VA (Washington, DC) and a couple of weeks fattening up back home in the Midwest, I was anxious to get back to my mission and finish my remaining months as a Peace Corps Volunteer.

To many of the other PCVs I met on medevac, the time spent in DC was like a vacation – time to recuperate from whatever ailed them, job hunt or visit the sites of the Nation’s Capital. For me, those weeks in DC were some of the most frightening days of my life; a time when I thought I was going to die.

As a sexually active gay man in the late 1980’s and early 1990’s I was extremely aware of and paranoid about the prospects of acquiring HIV. Nonetheless, safe sex was a concept but not always a reality for me. Getting tested for HIV was a nerve wracking affair yet throughout college I had been pretty good about getting tested on a regular yet anonymous basis. Then, as now, Peace Corps required a full physical including an HIV test in order to be placed in a country. Before submitting to the full physical, I went to a city health clinic and was tested anonymously one last time. I tested negative. I was ready for the real deal, the official, named and documented HIV test. I tested negative.

I was living in Chicago the day the acceptance letter arrived. Mali, West Africa. Never heard of it. Still, what a happy day. I sat at my favorite Chicago hotdog stand and cried tears of joy and relief as I opened the acceptance letter. The moment the invitation package arrived, the HIV testing stopped. I wanted nothing to get in the way of being a PCV. I knew testing positive would put an end to my dreams of joining Peace Corps so I put it out of my mind and assured myself that I was and would remain negative. If later I discovered I was positive I would be compelled to disclose the information to Peace Corps and end my PCV experience before it ever began. Better not to know. In four non-celibate months I would be on the plane to Mali. Nothing to worry about.

I wasn’t sure of my HIV status the day I flew to New Orleans for pre-service orientation. Stupidly or rather naively, it never occurred to me that Peace Corps would require one final HIV test before allowing me to get on that flight to Mali. The test took place on the first day. I lost sleep in New Orleans. While my fellow trainees were out enjoying their last few nights in the US, I sat in my hotel room shaking with fear. I wasn’t afraid for my health or even my long-term future. Testing positive meant only one thing to me: the end of ever being a Peace Corps volunteer. I tested negative.

After getting settled into my rural village the fears of HIV passed and I focused on other things. In 1990, AIDS hadn’t penetrated land-locked West Africa yet. Peace Corps hadn’t even begun to build an HIV/AIDS sector yet. In my mind the next 2+ years would be a time free from worry. HIV would not get near me.

Several months into my service I received a cassette tape (yes it was the 90’s) from my best friend back home. We went to high school together and came out to each other at a time when coming out was not in vogue. Hearing his voice was wonderful; hearing news about our friends and families brought a smile to my face; hearing him cry as he told me had tested positive for HIV devastated me. HIV had returned to my life; it suddenly became of part of my reality albeit it through someone else; someone for whom I cared deeply but could not comfort in person. I immediately got on my motorcycle and drove to the capital. I placed a phone call to my mom asking her to arrange for my friend to call me from her home the next day. He and I talked for an hour. We laughed and cried and discussed how he became infected. We talked about the future – my future. I felt selfish and petty talking about the community garden I was working on when all he could focus on was whether he’d live long enough to see his 22nd birthday and avoid a slow and painful demise. The early 90’s were an especially frightening time for people with HIV. My generation witnessed the sudden loss of the gay generation before us to AIDS. We had no mentors; we had no role models. To us, AIDS meant death. He was positive. I was negative. He could only focus on the present. I was able to look forward; look to the future. Guilt.

Fast forward one year to three restless nights of fevers and sweats in my mud hut. I had already come down with malaria a few times while in country but this was something different. My Malian host mother had seen enough and insisted that I make my way to the capital to seek medical attention. She sent word by mouth from village to village until a nearby PCV learned I was ill and gave me a lift on his motorcycle to the capital. A few days later I was unable to eat; was losing weight too quickly; had abdominal pains and high fevers. PC sent me to several specialists – no one had an answer. During that time a close friend came to country for a visit. When he saw me at the airport his jaw dropped. I looked bad. In a way that only close friends can speak to one another he said, “You look like you have AIDS.”

Months before, as part of our mid-service physical, Peace Corps required an HIV test. I tested negative. Shortly after the physical I went on vacation to Europe and made up for sexual lost time. For the most part, I was safe. I had nothing to worry about. Until, “You look like you have AIDS.”

The Peace Corps medical unit was unable to diagnose what ailed me. The only choice was medevac. My heart sank. I knew deep down it was HIV. I knew that once it was confirmed Peace Corps would separate me and I would never again see my Malian family. I would never have the chance to say good-bye.

The Peace Corps doctor escorted me on the flight to DC where I was immediately admitted into Georgetown University hospital. I weighed 109 lbs. I had lost 50 lbs in less than a month. The fevers continued. I couldn’t eat. I was delusional at times. I called my mom and told her she needed to come to DC. The doctor spoke with her and said make it quick.

For days, doctors examined me. Phlebotomists drew blood. Nurses held my hand. Students studied me. Most had never seen my symptoms. One intern, I never got her name, boldly suggested a bone marrow exam. She had an idea. She was correct. Typhoid. Curable. Not HIV. No, that test came back negative. Twice. Called mom and said not to worry. “I’ll come visit you once I recover.” Bacon – the first solid food I ate in weeks. I love bacon.

A week in the hospital. Christmas and New Years in the Virginian hotel. Finally, home to mom. More bacon. I spent a good amount of time with my friend. I was embarrassed. I had been worried about myself. I was negative. He was positive. But in those months since sending me the cassette tape much about him had changed. He had come to terms with HIV and was under the care of a number of HIV/AIDS specialists. In the time since we had spoken on the phone he had become positive about life again. He was looking forward; looking to the future. He was not defeated.

20 years later he still is looking to the future. He has lived with HIV for over 20 years. He has suffered losses and buried a lover. He graduated from college. He witnessed his brother’s wedding and watched his nephews grow into fine young men. He bought a house and started a career. He and his partner adopted one too many pugs. Through his strength and perseverance he has inspired all who know him.

I remain engaged in international development. Over the past 20 years I’ve seen African nations fall victim one by one to HIV/AIDS. I’ve seen hope disappear and reappear on the faces of the farmers, students and professionals that I have come into contact with. This month marks the 20th anniversary of my return to Mali. Not a day goes by where I don’t think how lucky I was to have a second chance on life – a second chance to complete my Peace Corps service – although really, come to think of it, do we ever really finish Peace Corps?

You can contact Brian Guse at bvguse@aol.com and visit the story on the blog that inspired this article “There is no going back, there is only forward.”

Questions About Sex and HIV in Guatemala

- A Liberman, PCV

I was getting blank stares from a sea of uniformed fifteen-year-olds as I fumbled through explaining how AIDS doesn’t actually kill an infected person. Opportunistic infections are what inevitably bring about the demise of the patient. It was a struggle. I felt like I was explaining the process well but I didn’t get a single reassuring nod from the crowd. I hesitated and then turned to my counterpart for the HIV/AIDS training I was conducting for help. In previous sessions he was quick to jump in and eloquently state what my Spanish language deficiency prohibited me from spitting out. Not that day. I glanced over to the side of the room where he was standing silently and noticed he didn’t jump in to save me because he was otherwise occupied; occupied texting on his Blackberry. If he had taken a second to look up from his mobile device he would have seen the look of, “Are you kidding me?” on my face. It seems not even the developing world can escape the digital world.

He never did look up from his phone so I continued to explain myself in circles until I asked the students, “Understand? Clear as water?” And the responded with a resounding, “Sí.” We ended up wrapping up the training with much success, despite my counterpart’s diminishing interest. In three days we gave three HIV/AIDS education and prevention training sessions to the entire high school, a total of 79 students.

Throughout the process I was surprised at how easy it was for me to talk about sex in front of a classroom full of pubescents. Every time I had to say, “secreciones vaginales,” I thought to myself, “those words would not roll so easily off my tongue if I was speaking in English.” Maybe they would, I just never have had the opportunity to test it out.

My favorite part of the sessions was a question and answer period. Right after an activity we did acting out how HIV attacks white blood cells, I’d give each student a piece of blank paper and ask that they write a question on it. Any question pertaining to HIV/AIDS or sexual activity in general. I received a lot of broken/ripped condom questions, a few asking for the symptoms of HIV/AIDS and even one that asked if a girl could get HIV from having sex with a 40 year old man. I’m still a little worried about the girl that asked that question.

The purpose of conducting HIV/AIDS training is to educate the adolescent population on the disease, how it is transmitted, how it can be prevented and to discredit stereotypes about the disease. A secondary benefit of these sessions is to allow the teenagers to speak openly about sexual reproduction, sexuality and the inherent risks of being sexually active. The sessions in themselves were truly gratifying however, there was one moment, outside of the classroom that I am most proud of.

During the question and answer session of our first training, my counterpart took charge of reading the papers and I did the answering. Nearing the end of the pile he picked up the following question and read it aloud, “Can HIV be sexually transmitted from male to male?” I could tell the question made him uneasy. Homosexuality is a touchy subject in Guatemala. Machismo is deep-rooted in Latin culture and often hinders many Guatemalans from being accepting of non-heterosexual sexual orientations. At that moment I was experiencing the negative impacts of that ideology. It pained me to watch him read the question with discomfort and then it broke my heart to hear him squeak an awkward giggle after the question. He did this in front of the entire classroom. Not the best behavior for promoting tolerance. I resolved to have a discussion with him before the next session.

The next day before our second training I pulled my counterpart aside and told him that I thought we did a wonderful job the day before, the kids seemed really receptive, blah, blah blah. There was only one thing we needed to watch out for today.

“We have to remain completely professional, especially during the question period, I noticed yesterday you laughed when reading the question about HIV being transmitted between two men.”

“I did?” He responded with seemingly genuine astonishment.

“We can’t laugh at any question especially ones pertaining to homosexuality because if there is a homosexual in the class we don’t want to make her or him feel uncomfortable. We need to be completely accepting and professional. If you don’t feel comfortable reading those questions, let me know because I can read them instead.”

“No,” he replied, “I can do it.”

Sure enough, during the second session we received a question identical to the one he had laughed at the day before. As he breezed through the papers at the onset of the answer session I saw him move the question from the middle of the stack to the end. When it finally came up, the slip of paper gently rattled in his quivering hand. However, he read the question aloud in a completely unwavering voice. “Can HIV be sexually transmitted from one man to another?” No giggle.

We both gave a sigh of relief.

 

HIV Positive and Serving as a Peace Corps Volunteer

-Elizabeth Tunkle, RPCV, Zambia and Lesotho

When you join the Peace Corps, many people ask you why. I never had a very good answer. But the truth is something way down deep inside of me told me that is what I needed to do and I listened. I really had no idea what I was getting into. I thought 2 years would go by in a flash and I would come home better for having gone so far from home and for having done such a noble thing. Two years did not go by in a flash and I came home changed but not how I thought I would.

I started out my service in Zambia and after getting posted to my village, as I was settling in, I met my future boyfriend. When we started dating, I asked him if he had been tested for HIV. He told me yes. He told me his test was negative just 1 year before and he had not had unprotected sex since his last test. We mutually decided it would be safe for us to use birth control and not condoms. We were wrong. Despite the fact that I knew all about HIV prevention I had unprotected sex with him anyway.

A few weeks later, I decided we should get tested. I had a bad feeling. I tried telling myself that it couldn’t be me. I was going to be fine. Too many times in my life I had played with all kinds of fire and survived. Not me. I was too nice and honest and fun and giving and I practiced yoga and meditation. We get bonus points in life for being good, right? No, I guess we don’t. HIV doesn’t just choose mean people or people who tell lies. It turned out it chose me. We found out my boyfriend was positive and that I was also infected. As if that news isn’t devastating enough, the Peace Corps told me I had to go home and that I would not be able to serve as a Peace Corps Volunteer anymore, anywhere. I was too shocked to fully understand what was happening, but I did feel like the Peace Corps was acting contrary to what they teach us. “Fight the virus not people with it.” “Treat people with HIV just like you would treat anyone else.” But yet, here I was going home. I felt like a weed that had been violently ripped out and was being thrown away.

I was shocked and traumatized and had to pack up my things and say goodbye to my life in Zambia. I felt like a failure. I had come to teach prevention and here I was infected. I was asking myself that why question all over again. Why did I come to Zambia, did I come to ruin my life? Who did I think I was coming over to Africa to tell people how to live? I didn’t even know the meaning of my own words.

PC Washington told me that I would be evaluated and then separated. I asked my nurse who worked for PC if it was possible for me to continue to serve and she said no. If I was positive I would have to be separated. However, after I had been home for a month PC changed its mind. Why? My friend was digging around on the Internet and found a story about another volunteer who had been sent home earlier that year because of an HIV infection. He felt like his rights had been violated and had asked the ACLU to help him out. ACLU went to the PC and told them that their policy discriminated against people with HIV and they needed to be more accommodating (see our August 2008 article for information about the Jeremiah Johnson case and changing Peace Corps policy related to PCVs with HIV.) They just told me they were considering clearing me. Everyone seemed to agree that I was physically and mentally well enough to go back.

It was suggested that my asthma was reason enough to keep me from going back to Zambia but I could go to Lesotho if I wanted. I was faced with a big decision. At first, I was not given a choice and now I was. What did I want to do? It seemed like a difficult decision at the time but I think I knew all along that I wanted to finish. That I was not going to let some illness or my shame stop me from returning to do the work I had set out to do. I even had a hint of an idea that I could do it better the second time around. So I said yes!

I was in a plane flying to a new country in Africa. Lesotho was going to be my new home. I arrived and met a whole new group of staff and volunteers. I made the most of my new home and my new family. I started making friends but I kept my status to myself. I felt alienated for having to keep such a heavy secret. I wasn’t sure I wanted to share my status at all. I felt too vulnerable and I wasn’t sure how I would be received. After only 2 months in Lesotho, I went to a volunteer training session. Volunteers were struggling with the emotional toll of living in a country where so many people were infected. We had a session to talk about it. I sat in knowing that no one in the room knew about me. One guy shared, “I found out my counterpart was positive and I am trying to give him support and but it is emotional for me to know.” They were all being so honest and I wanted to run out of the room screaming. After so many people had shared, our director said, “One good thing about all this is that you have each other. We are all in the same boat.” I then did run out of the room screaming. Well, ok, not screaming. I walked actually. But I left the session early and went to the medical office and talked to the only people who did know. “I am not in their boat,” I said. I felt even lonelier and more left out than I had before and I hadn’t thought that was possible.

After I calmed down a bit, I went to see the Country Director. I told him I had been thinking and I wanted to share my status with all of the Peace Corps Volunteers, all 87 of them. We were going to have an All-Volunteer conference in January and I wanted to have a session all to myself to share my story. I knew I couldn’t keep it a secret and this way I could control how the information got to them. I would not be gossip. I would just tell them. So, January of this year (2009) marked my big coming out ceremony. The day of my talk, I was terrified. I knew that I was going to be taking my most personal and private reality and laying it bare for everyone to see. I started my talk with a news article about the ACLU case against the Peace Corps. Then, I told them my story. I told them I knew better than to have sex without a condom. I told them I knew all the things they know that make them feel immune and I still got infected. In the end I asked them to make good use of me. I was the first infected person in service and I wanted to tell people what happened to me so that maybe they could learn from my mistake and not repeat it. That was, after all, why I returned to Africa

They started using me immediately. I went to a Diversity Camp in Butha-Buthe district. 20 something teenagers came together to learn to be more accepting of the differences around them. I was one of the key speakers. I asked them to brainstorm words that came into their mind when they heard “HIV.” “Don’t censor yourselves. Just say what ever comes to mind. Good or bad!” They did. I heard words like prostitute and sex, anger and fear, stigma and blood. We made a long list. And then I told them my story. I told them everything. They were teenagers and statistics said they were all probably having sex already. They really listened. Afterwards, they asked me questions. One woman asked me, “How do you have so much courage to stand up in front of us and tell us these things?” I just looked back at the list we made and said, ”If I feel too afraid to speak about this to all of you then I let this list define me. I refuse to let this illness keep me locked up in my own world of shame. And if by sharing my story with you, maybe one of you rethinks having unprotected sex then I have accomplished something out of this.” For the first time, I felt like I hadn’t become infected for nothing. Maybe this happened to me so that I could share it with people. Maybe it had a purpose in my life.

I did that many more times in my time in Lesotho. I went to 4 Diversity Camps. I spoke at schools and youth centers. I had one audience as big as 140 students. I spoke to peer educators, youth groups, and students. I spoke to primary schools and secondary schools. I even traveled 2 days up into the mountains to speak to a HIV+ support group about a healthy way to deal with hard and dark emotions. People really heard me. I felt connections with the people of Lesotho like I had never felt in Zambia. People came and shared their stories back with me. They asked me questions and invited me to their homes. I felt the force of belonging to a community.

I spent my second year of the Peace Corps speaking my truth over and over again. The fact is none of that would have been possible if it weren’t for the courage of other Volunteers who stood up to the Peace Corps. The Peace Corps did something they had never done before and let me, an HIV+ volunteer serve out my time in Africa. I received more from sharing my story than I could have ever given to the people of Lesotho. I think the Peace Corps is like that. We go to far away lands to give of ourselves, to help, to make something better but it is the people who house us and love us and work beside us that truly give to us. They gave me a sense of purpose. They made me believe that something good could come out of getting a very scary, chronic illness diagnosis. And I believe that it did. I would never had asked to become infected with HIV but without it the community of people living with the virus around the world would be just out of reach and I want to connect. I want to cross over the line that separates and make a connection. So here I find myself. My service is complete. I am back in America. I served my country. I told my story. Somehow I think I answered my “why.” The work I did as a volunteer in Zambia was forever on the outside looking in. Later, infected in Lesotho I felt as though I had stepped through an invisible barrier and was welcomed with open arms.

Elizabeth can be contacted at elizabethtunkle@yahoo.com.

Believing AIDS is Real

-Timothy Mah, RPCV, The Gambia, 2001-03

The Peace Corps experience is filled with hurdles and obstacles, which if overcome, can turn into very positive defining moments. As a recent college graduate, I looked upon my Peace Corps service as an opportunity to find that specific path that I knew awaited me somewhere – possibly in one of those Peace Corps moments that I had previously heard about.

I applied to the Peace Corps with the notion that I wanted to do HIV/AIDS work – whatever that meant in the context of my assigned country and community. I had some previous experience as a pediatric AIDS researcher during college and as an intern at an AIDS service organization, but I was unsure what those experiences would mean to me as a community health educator in Africa. At some point during the application process, I was asked why I wanted to work in the HIV/AIDS field. At the time, I didn’t have a very clear answer. But I think I can answer that now.

AIDS is an intriguing epidemic that has affected communities in countless ways – some foreseeable, others with surprise. AIDS is unique in its ability to transcend its label as solely a health problem; it has social and cultural, religious, political, and economic components, all of which have had a role in defining the epidemic. For many years, HIV was seen as a gay disease. Some purported it be punishment for homosexual deviance, and some people continue to believe this. It was at another time a Haitian disease, brought to the US by unwanted immigrants. Some have theorized that it was engineered as a social and scientific tool to dissuade overly sexual and promiscuous people from their immoral behaviors. It has been and still is used as a political vehicle – linking funding for prevention efforts with primarily one form of prevention, abstinence, rather than a more effective and comprehensive approach. From an economic perspective, an entire generation of working age men and women in parts of southern Africa has nearly been wiped out.

It is different from any other disease that has so affected people. Unlike many of the common ailments found in developing countries, HIV doesn’t necessarily show outward symptoms all the time. While sicknesses such as malaria, tuberculosis, or a host of stomach ailments can be easily seen and understood, HIV is invisible and more often than not, not understood. HIV also strikes through a basic yet taboo subject – sex, which is rarely if ever breached in many communities. All of these factors make this epidemic multi-faceted and utterly dynamic – changing with time and place.

I spent much of my Peace Corps service organizing HIV/AIDS education programs and events for youths throughout The Gambia, a small country in West Africa. These programs provided the youths with basic information about HIV/AIDS – prevention strategies and modes of transmission, as well as more general “life skills,” such as relationship, decision-making, thinking, and negotiating skills. Some of the boys were trained to be peer health advocates in their schools and communities, while others were trained simply to help prevent themselves and their friends from becoming infected and to dispel the rumors and misinformation that floated around the villages.

During many of my workshops on HIV/AIDS with Gambian youths, the questions would inevitably come up: “Where is AIDS from? How was it found?” How could such simple questions be so difficult to answer? I could easily have said, “AIDS was discovered in America and France in 1981, by doctors who noticed an unusual number of gay men were becoming sick with strange and rare sicknesses.” Finished. Next topic. That answer however was not as simple as it sounds and introduced myriad cultural, political, and colonialist issues into the discussion: If it was discovered in America, why do people say it started in Africa? If it started among gay men, how did it get to Africa, since there are no gay people here? If it was discovered in America, why are there so many more people in Africa who have it now?

At first, the answers to these questions just seemed secondary. Shouldn’t these boys ultimately be concerned with whether or not they have the information and ability to prevent themselves and their friends from getting HIV? To the participants however, the answers they knew to these questions were the basis for their denial of the existence of HIV. The answers fed into the numerous conspiracy theories that surround the AIDS epidemic in The Gambia. I soon learned that it didn’t matter if the boys knew everything about prevention or the modes of transmission. It mattered that they first believe that HIV was real and could have an impact on their health and well being. It therefore often became my role to persuade the youths that HIV was indeed real and that it could affect anyone in their community, from their friends and siblings to their parents and the village leaders. Whenever possible, I would include HIV positive individuals in the workshops. 99% of the youths I worked with had never known, heard of, seen, or interacted with a Gambian living with the virus. My hope was that seeing truly would mean believing.

So many of the simple scientific aspects of the AIDS epidemic are completely intertwined with seemingly distant political and cultural issues. From questions about the discovery of the disease to prevention (aren’t condoms just a western way of keeping Africa’s population in check?) and treatment issues (why are there drug treatments widely available in the US, but not in The Gambia?), there are no simple answers. But these are the challenges that make the AIDS epidemic unique, interesting and frustrating.

In addition to those motives for being interested in working in the HIV/AIDS field, there were the more personal reasons. There was the issue of being gay. Did I subconsciously feel that I needed to give back in some way to the gay community, which has been so grossly affected by AIDS? Would I be able to do that by going to The Gambia? Would my efforts in The Gambia even have an impact on the gay community in the US?

In a general sense, no, my efforts in The Gambia didn’t have an effect on the gay community in the US. However, despite the obvious differences, the epidemics in the US and throughout Africa are inextricably linked. Progress on one front means progress on another. My work in The Gambia gave me the opportunity to see the epidemic from a different perspective. It put me in a place where the reality of the epidemic was still not understood. I was lucky to have the foresight when I worked in the Gambian villages that if people weren’t educated early on about the dangers and consequences of this disease, then communities there and around the world would continue to be unnecessarily hurt.

In the past two decades, there has been much progress in the fight against AIDS. While the epidemic has hopefully peaked in many communities, there are countless others in every corner of the world where it is just beginning. There is still so much work left to be done.


Tim Mah has spent the last 7 months working in the Public Policy Department of the San Francisco AIDS Foundation. He starts graduate work at the Harvard School of Public Health in September. He can be contacted attlmah22@hotmail.com.

HIV Status and Application to the Peace Corps

-Mike Learned, RPCV Malawi

At annual Pride/Parade celebrations, many Peace Corps regional offices will have information and recruiting staffs present at such events. A question that always comes up on such occasions is “can people who are HIV positive, but otherwise healthy, apply for the Peace Corps?” For the last few years, the answer to this question has been, “yes.” HIV disease is treated as a medical condition. All applicants who are invited to take part in a Peace Corps program are medically evaluated.

Several things have to be determined. Will an applicant’s health allow her or him to serve in a particular Peace Corps assignment without jeopardizing his or her health? Are there medical resources available to support the medical needs of an applicant with a particular medical condition at a particular site, in a particular program, in a particular country? Can the applicant with a medical condition be expected to complete a full tour without undue interruption to his or her program or Peace Corps service?

Peace Corps considers HIV a chronic disease, as it does diabetes, high blood pressure and other medical conditions. Peace Corps does consider applicants with HIV disease, and Peace Corps’ Office of Medical Services advises and has evaluated applicants who are HIV positive.

Our position as an organization is that Peace Corps treat HIV disease in a way similar to other chronic diseases and medical conditions. We understand that most Peace Corps assignments require rigorous good health. Would we recommend that a volunteer with HIV disease be allowed to serve anywhere? I think not. Many of us (young, energetic and healthy) experienced serious health problems during our service in remote and disease-ridden areas. Can you imagine what might have happened with compromised immune systems?

I have chosen not to ask the Office of Medical Services if applicants with HIV disease have served as volunteers. The reason – I don’t think it’s any of our business. If I were an applicant with HIV disease who was accepted, I would not want the Peace Corps or anyone else broadcasting my presence, even if I remained unidentified. On the other hand, if there’s an HIV positive applicant out there who feels he or she has been unfairly evaluated, and she or he wants to pursue that decision as discriminatory, that’s another issue, and we’d like to hear about it.

Mike Learned was a volunteer in Malawi. He can be reached at lgbrpcv-news@lgbrpcv.org.

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