By: Inês Almeida
In 2016, some 36.7 million people were living with the HIV disease worldwide, with 1.8 million new infections, including 150,000 under-15 years of age children. Trailing Africa, the Asia Pacific region is the area with the greatest number of cases: on average, 5.1 million people have been infected, including 210,000 infected that year, while 170,000 died that year due to the disease.
According to data provided by the Health Bureau, 210 people with HIV or Acquired Immune Deficiency Syndrome (AIDS) are currently being treated by the Sao Januario public hospital (CHCSJ), comprising 190 residents and 20 non-residents, some of whom are currently serving prison sentences in Coloane Prison.
As an expert in public health working at the CDC, Leong says that in the last 10 years HIV positive results have increased due to the development of the faster examination network.
“In Macau, the main vehicle of transmission is sexual intercourse, with 40 per cent of cases from heterosexual partners and 31 per cent from homosexual or bisexual partners,” he says. “We know there is a growing trend of cases from homosexual and bisexual partners in recent years and we have been responding to that movement in terms of prevention campaigns”.
The doctor believes that plenty of information is available in the territory about the disease because “in Macau we have a programme to support non-governmental organisations with subsidies so that they can conduct activities” to promote disease prevention. In addition, “sex education is part of the curriculum, from primary school to high school. Students attend sexual education classes and learn how to prevent sexually transmitted diseases”.
Still, Leong Iek Hou admits that some residents are “ignorant as to how the disease is transmitted thus there are cases of infected individuals being fired from their jobs. The Law for the Prevention and Control of Infectious Diseases states that a worker cannot be fired from his/her job due to being diagnosed with an infectious disease. Obviously, if the disease is potentially transmissible through group work then the infected person must be segregated. HIV is not transmitted through regular everyday interaction. Infection is possible only through blood or sexual contact, so an HIV positive person cannot be fired because of it”.
As an example, the CDC doctor mentioned a case she is familiar with of a person who was diagnosed with hepatitis B and fired. “We contacted the company to inform them of their illegal act. We are not aware of any similar case with HIV carriers”.
Leong Iek Hou says that some non-resident individuals who work in saunas, karaoke bars and nightclubs are “legally obliged to present regular health check-ups . . . [and] . . . the employer may have access to the report and contact the Immigration Services, in which case they will lose their work permit”.
In an official reply to the magazine, the Public Security Police (PSP) say that no work permit authorisation revocation process has been initiated in the past five years due to infectious diseases.
400,000 patacas for yearly treatment
The treatment procedure is similar for residents and non-residents but there are huge differences in terms of cost. “If you’re a resident, the treatment is cost free, including consultations, exams and medicines. The SSM has a special channel for HIV carriers. People who are infected or suspect they may have been infected can call a hotline and schedule an appointment or they may directly go to our internal medicine unit at the CHCSJ, which takes about one to two weeks,” says Leong.
The internal medicine consultation includes a check-up, medication and treatment. “There is also a dedicated nurse to follow up on cases. A specific nurse follows and advises the patient in the psychological area on how to deal with the sexual partner and provides help regarding any discomfort that may arise from increasing the dosage of medication”.
For non-residents, the situation is quite different.
“Non-residents have access to the same services but they have to pay for them. Most non-residents go back to their home country to receive treatment”, says Leong, but 20 non-residents in Macau being treated at the public hospital pay “400,000 patacas per year, on average, for consultations, treatments and medicine”.
The CHCSJ has four doctors working in the infectious diseases unit dedicated to HIV cases. Leong Iek Hou says that following a positive diagnosis the first doctor’s appointment takes about one or two weeks, which is “much faster than normal waiting periods”.