I am 28. White. A Female. And a former Peace Corps Volunteer. I am HIV Positive. This is my story of how a few months, a few people, and a few events in Zambia changed me and my life forever. This is the story of how I contracted HIV and brought my Peace Corps Journey to a crashing halt... and how I am working now to pick up and put back together the pieces of my life as a newly diagnosed person living with HIV. This was not the journey I had originally planned... my path has traumatically and dramatically changed... but it is the one I am on now. There is no going back. There is only forward. I welcome you to follow along with me as I attempt to explore this new life ahead of me, whether you are someone from the Peace Corps community, or someone living with HIV. I welcome your comments, questions, suggestions, and opinions. Let us go forward together. To start from the beginning, click here He Gave Me More Than A Bracelet.

Wednesday, January 4, 2012

Why Medical Separation?

Some people have wondered and asked why I was Medically Separated from the Peace Corps, especially since the current Peace Corps HIV Policy is not to automatically separate volunteers who contract HIV. Although I cannot speak to anyone else’s situation, this is a little bit more about how mine came about…

When I first tested Positive in South Africa, it seemed to be assumed by everyone, including me and the Peace Corps doctors that I would be sent home and Medically Separated. I am not exactly sure why I assumed this, because I had read about Peace Corp’s changing HIV policy before beginning service. But, maybe I was just still in a little bit of the initial shock from it all. And, it was not explicitly talked about or stated that I would be Medically Separated, it was more just like “Okay, you have HIV. We’re going to send you home now.” I didn’t even question it at first. I just went along with it and started making the plans. I talked to my APCD in Zambia, and I wrote Goodbye letters to my village and to my fellow PCVs (which I will share some of at a later time).

It wasn’t until I arrived in D.C. that I started to wake up a bit from it all, and I first said, “Hey. Wait a minute. Who says I have to be Medically Separated?” I did my research and re-read the stories about Jeremiah and Elizabeth from a couple of years ago. And then I started asking questions… to my IHC (International Health Coordinator) and my doctors. I really wanted to know if I could return to country and continue my service, and for the first week I kept up pretty high hopes that I could. I pushed my IHC to bring my questions to the PC Medical Board that meets each week to discuss each Medevac case. She came back from that meeting saying that the Board’s response was an overwhelming “Not Right Now”.

Those three words “Not Right Now” crushed me at first. I felt angry. And sad. And lost. But, as my time in D.C. went on, my feelings started to change. With the help of my counselor, and my doctors, and just the way I was physically feeling, I started to realize that the Board was right- I would not be able to return right now. I came to understand that my health was most important, and that I really needed to recover from this initial illness. I realized that my body did not have the strength, energy, or immunity to return to Africa right away. Thus, I finally came to accept that my Peace Corps journey was over, at least for now. I worked through the grieving process about this as much as I did about the HIV.

Before leaving D.C., I again pushed PC to talk to me more about what my “reinstatement” options would be, and how that process worked. (I don’t think they would have really discussed it with me much, unless I had pushed the way I did). I was told that I would have the option to apply for reinstatement within 1 year of my Medical Separation date. Furthermore, they told me that PC has some HIV lab requirements that I would need to meet (which to my knowledge, are not openly published to the public anywhere). They said that the typical requirements for HIV+ persons applying to become volunteers are that they are on a stable treatment regimen, with an undetectable viral load, and a CD4 of 500, for at least one year. I pushed (again) and asked how that would even be possible for me to meet those requirements within one year. They said that they would look at my case individually, and things would be a bit more flexible for me because I would be applying for “reinstatement” rather than as a “new applicant”. They said that they would still want me to be on a stable treatment regimen, with an undetectable viral load and a CD4 of 500, but may be flexible about what they considered to be a stable length of time.

So, this is how I came to accept my Medical Separation, and sit back and wait to see what the future brings. Although, with each set of lab results that come back not being at PC’s acceptable level, I feel my reinstatement option slipping further away…


  1. Oh Jess,

    Don't give up hope! I don't know how much one's positive attitude and well-being actually improve one's health but it's worth a shot! Focus on getting better and feeling better! Perhaps that will help get the viral loads to realize that they are not going to take you down! Stay positive as we are ALL behind you and are cheering you on to return to service! =)

  2. Jessica,

    I agree with Ms. Panikowski, focus on your health first and foremost. Strength & faith should help with positive thoughts.

    "When you get into a tight place and everything goes against you, till it seems though you could not hold on a minute longer, never give up then, for that is just the place and time that the tide will turn" Harriet Beecher Stowe

    Wishing you the best for good health and treatment.

    Warm regards,
    A concerned reader

  3. I realize you do not understand why you were medically separated and are not being reinstated, but there are a number of reasons, not the least of which are your own health and that of people with whom you would come in contact.

    On another note, hating to be the negative voice, I wonder why on Earth you even went into a sexual situation in a country where the rate of HIV infection is MORE THAN one in seven, WITHOUT protection of any kind, with a virtual stranger. I am sorry if you feel this is harsh, and certainly do not think anyone "deserves" to get HIV, but why? You were serving in an extremely high-risk country, in an extremely high-risk area. You are young enough to have grown up knowing about HIV and how to avoid it. Peace Corps gave you good training about it as well (I am also a PCV). Thus I wonder about your choices. Was it the naivety and arrogance of youth, thinking it would not happen to you? Was it ignorance - did you really not think it was possible?

    Sorry if my comment offends you or anyone else, but I am mystified at how you could have exposed yourself to this illness in the first place. ANY unprotected sexual contact in a country where one in seven people have it (and where it is more commonly found in middle and upper class people) baffles me.

  4. @anonymous-Through reading her blogs it seems that she caught the virus acutely. It also seems that the young man didn't know he had it, getting tested and confirming to her that he was hiv negative. In her blog she talks about how he had contracted it, then got tested during a time period where the virus was undetectable. If he was being honest-then you can't really blame her or him. HIV can lie dormant in the body going undetectable. Even if he got one test and found out he was negative, then go sick, it's highly unlikely that he would go get tested again. Which is why I believe he attributed his flu like symptoms to Malaria. On a more human level I got the impression that she was being as safe as medical doctors tell us as a society what safe is. wear a condom during sexual intercourse, which is not the same message proposed for oral sex. I'm too a pcv and I've witnessed-even in my short time at my site, people wanting some outlet-some sense of comfort. Here you are, thrown in a country and you don't know you're up from your down. All of a sudden someone speaks the same language as you or gives you affection or makes it okay to let your guard down-whatever..and those statistics fly out the window. I think your comment is legitimate, honest, and fair. I think it's important at this point to lift this young lady up by supporting her to be an example for the peace corps community. I remember the trainings on hiv as well-but I also remember so many people in that same training rolling their eyes, mumbling under their breath that lonliness will never happen to them. Share her story with your fellow pcvs. Share it because the holidays have come, people will get lonely and will let their guard down. They will kiss a sack of potatoes if they don't keep stories like this in the forefront of their minds. Peace and Love!

  5. Dear Anonymous,
    I just want to tell you that loneliness and despair can happen anywhere, and that people don't talk about protection with oral sex. I was in PC too and sat through multiple trainings. I even worked on an HIV vaccine in China. Oral sex still needs to be publicized as a very viable transmission option, whether or not there are sores or skin breakdown in the mouth. I lived and worked in Swaziland (higher rates of infection then Zambia!) and no one talked about or discussed oral sex as a transmission route. As you stated you're not trying to offend Jessica, but we do need to support her- it could have been any one of us! I know countless people who have had some moment of loneliness which could combine with poor judgement or doing something you wouldn't normally do, myself included. Bravo again Jessica for sharing your story.
    Gigi, RN, BSN, MPH

  6. Has anyone in the PC, or you even, considered you working through the PC as a trainer of sorts? You are being so open about this and your experience could help new volunteers. I'm not associated with the PC so have no idea how that works but you are perfectly suited for something like that. If you have the interest of course. Stay strong!

  7. Malaika and Gigi,
    Thanks for coming to my defense!

    I would love to have that opportunity, if Peace corps was ever to want me :-)

  8. Hang in there Jessica, I sincerely hope you are able to reach your goal and return to service.

    I was in training, slightly less than a month in country, when I severely broke my leg in a hiking accident. Although I did not become reinstated due to my continuing injury and personal developments, I think about the Peace Corps often and have been considering returning.

    I wish you all the best, never give up.