Marie Bruckova: AIDS poses danger to all of us
There was little cause for optimism on World AIDS Day this year - according to the World Health Organisation and UNAIDS a record number of people were infected with HIV in 2003. The Czech Republic is described as a country with a low-level incidence of HIV - the official numbers are in the hundreds, rather than thousands. But the real number could be ten times higher. I've been speaking to Marie Bruckova, from the National Reference Laboratory for AIDS, part of Prague's National Institute of Public Health.
"I started in bacteriology, then switched to virology. Finally in 1985, when it was decided that the HIV/AIDS problem might eventually also come to Communist Czechoslovakia - something which was officially denied - the National Reference Laboratory for AIDS was founded. Of course there was a lack of people who wanted to do the work. At that time nobody knew how infectious or how dangerous it would be working in the AIDS lab, so not many people volunteered. Me and my boss at that time decided to do the job. We found several technicians who were also willing to do it."
Would be I correct in saying that the Communists believed AIDS was a Western, imperialist disease which good socialists didn't catch?
"That's right. Officially, it was said that the style of living of a socialist society was incompatible with Western diseases which were connected to very bad sexual habits."
You have a very heavy responsibility in deciding whether a questionable case of HIV infection is positive or negative. Is that responsibility sometimes quite difficult to bear?
"Difficult and sometimes very sad, when you have tell someone they are infected with HIV."
So it's also your job to tell the person concerned, face to face?
"Not all of them, but some of them. It depends where the person was tested and so on. But in many cases I myself personally deliver this bad message."
What was it like the first time you had to do that?
"Oh, it was a man who became infected abroad. He was a technician, and it happened when he had a blood transfusion in Egypt. His wife was a doctor, and she asked one of his Czech colleagues [who was also working in Egypt] to give his blood, because she was uncertain about the quality of the local blood. So the man came to the hospital to give blood. The woman later told me that the moment she saw the colleague's blood flowing into her husband's bloodstream, she became uncertain. She asked her herself whether the colleague's blood had been checked. It hadn't. It turned out that he was HIV positive. He lived with an Egyptian lady and had become infected through heterosexual contact. So the technician also became infected, and I had to deliver this message. To both of them. They were a very nice couple, they had two children. All they wanted to do was hide. They didn't want it known in public that he had become infected with HIV. It was very sad."
It sounds like it can be a very distressing and difficult job. Do you still enjoy it?
"I think so. I've learned a lot about science, about people, about friendship. A lot. For instance, I didn't know anything about the gay community. I didn't even know it existed. Nowadays I have a lot of friends who are gay. And that's really something very nice. Some people can't understand how I could be happy in the company of gay people, but my best friend now is a gay man."
How high is AIDS awareness in this country?
"Pretty high I'd say. There were some behavioural studies done among young people about the knowledge of how this infection can be transferred and how to protect yourself. And the knowledge was pretty high - young people seemed to know a lot. Another thing, of course, is if they are behaving according to this knowledge."
How many people here are infected with the HIV virus?
"According to the exact figures, at the end of October there were 652 registered cases of HIV infection in the Czech Republic. And of them, 175 have AIDS."
Those are registered figures, but the real number could be higher. How much higher?
"That's a pretty good question. Nobody knows in fact. Both the WHO and UNAIDS are trying right now to make better estimates than they did before, especially for countries like the Czech Republic which have a so-called low-level epidemic. It's very difficult to make estimates. Now we are being forced to make "guestimates" - we're guessing, so it's not too scientific. But the scientific models used by UNAIDS up to now - they failed. They admitted it openly. They're now trying to develop some new software - I saw it at the recent AIDS conference in Paris - but they're still checking whether it works in practice."
Despite those difficulties in estimating the real number of people with HIV in this country, it's still a low number. Is it really worth having an AIDS test if the risk is so low? Surely it's a lot of stress and anxiety for nothing?
"I think that's what we should stress. People are still not very concerned. They listen, and sometimes they get annoyed because they still think 'it doesn't concern me, I'm not in danger.' And that is in fact dangerous. We are all in danger. For instance, blood transfusion is not 100 percent safe, not at all. If you think that sex with somebody you know is safe, it might not be true. So really, everybody is in danger."
