Sometimes all it takes to change someone’s life is for one brave person to step outside their comfort zone and put another person first. This post comes from our Health Outcomes Manager Alison… and whilst it serves to make a point, this is a true story…
“A couple of months before my Grandma Lois’s 80th birthday, she decided to visit her (in my mind) favourite granddaughter in South America and together we planned to go to the Amazon Rainforest. As our trip would involve adventure travel in areas of high malaria, yellow fever and dengue prevalence, Grandma Lois decided to go to her local travel clinic in conservative Salt Lake City, Utah to get a full travel health check.
Little did Grandma know, as she showed up for her travel health appointment (her toy poodle Dwina sleeping comfortably in her handbag), just how thorough her travel health appointment would be.
The travel health nurse asked Grandma Lois the usual questions: “where are you going?” “how long will you be gone?” and “do you have any pre-existing health conditions?”. Then, after explaining how malaria medication works and giving my grandmother the usual travel jabs, she sat down at her desk and said, “I need to have a very serious conversation with you about sexual health and the risks to an older woman of having unprotected sex while travelling.”
The travel health nurse then proceeded to give my 80-year old Grandma a full health teaching session in which she covered the risks associated with unprotected sex and the importance of condom use. At the end of her health-teaching session, the travel nurse offered my grandmother an HIV test.
I would be lying to say that Grandma Lois was anything less than taken aback by the travel nurse’s frank questioning. In fact, initially she was downright offended. But the more Grandma Lois thought about it and the more she was forced to talk about it with her giggling grandchild (me), the more she realized that the nurse had not only done her job, she had done her job in such a thorough, professional, selfless way that it could have saved her life, had my Grandmother had any inclination towards broadening the “adventure” in her adventure travel.
People over the age of 50 represent one of the fastest growing populations in terms of sexual health risk, and this travel nurse (clearly aware of the risks for this population) had taken the time to actually provide meaningful information so that my grandmother wouldn’t become part of the statistics. Yes, Grandma Lois was a little uncomfortable with the conversation, but some of the most important conversations in life are uncomfortable.
Since starting work at Body & Soul in September 2010, I’ve thought a lot about my grandmother’s experience. In the UK, GPs are the people who deliver primary health services. In this role, they should be able to confidently provide their patients with a thorough health screen, including a sexual health screen, and should conduct this screen regardless of their personal views or preconceptions on their patients’ behaviours.
Thorough screening and early intervention correlates with positive health outcomes in pretty much all health conditions. For example, early detection of common conditions such as high blood pressure, type 2 diabetes, and cancer can allow for quicker treatment, better prognosis, and (in the case of many chronic diseases) behaviour modifications that can mitigate the impact of the condition or even address it entirely. While there is no cure for HIV, early diagnosis has multiple benefits to a person’s wellbeing.
According to the UK’s Health Protection Agency, over half of people diagnosed HIV positive in the UK are diagnosed at a late stage of infection and over a quarter are diagnosed when already severely immunocompromised. When a person is diagnosed late, it means that it will be more difficult and more costly for them to return to normal immune function.
With early diagnosis, a person is more likely to have appropriate treatment, less damage to their immune system, and less chance of progressing to the point where he or she is vulnerable to opportunistic infections. A person who is living with HIV but has not yet been diagnosed HIV positive is quadruple as likely to transmit HIV to a sexual partner, therefore having clear public health implications. A third of all deaths related to HIV occur because of late diagnosis.
I shared my wonderful Grandma’s story with you today because there are some clear messages. I truly believe that if all clinicians were as informed as my grandmother’s travel health nurse and as willing to step outside of their personal comfort zones for the sake of their patients, then fewer people would be diagnosed HIV positive late, thus reducing the number of HIV transmissions and deaths due to complications of HIV.
My advice to them: be the person who is willing to ask the important questions.”