The programmatic challenges we face today are profoundly different than the ones that plagued us 30 years ago—but the desire for helping ourselves, friends, lovers, family and patients live longer, healthier lives is the same.
I remember working in HIV in 1986, at a time when The Boston Globe published letters asking whether people with AIDS should be quarantined, and whether men with HIV should be tattooed to warn potential partners. Later, the first patient I had in my primary care clinic in San Francisco was a man with HIV who told eyebrow raising stories and brought small gifts to each of his visits. I suffered with him through pneumonia, cryptococcal meningitis and two episodes of a near fatal skin reaction from taking Bactrim every day to prevent Pneumocystis pneumonia and to help him live just a few more months. We discussed his loves and his losses. It was during my last month at San Francisco General Hospital when he died—effective antiretroviral therapy didn’t exist.
During the first 15 years, HIV was a constant companion—in our home, our office, our community, our partners, and our friends. We all learned how to care for people when there were only incremental clinical steps to offer, but a great deal of passion and empathy. Now, in 2011, we have the tools to reverse the HIV epidemic in the United States, as a recent study has shown that proper treatment for HIV can effectively prevent transmission to others.
Today’s Vital Signs report, released by the Centers for Disease Control and Prevention, however, shows the limits of our progress in bringing HIV testing and ongoing effective treatment to all people with HIV. Vital Signs also shines a light on the areas where focused efforts could provide real benefits to the 850,000 people with HIV in the country who do not have a suppressed viral load through regular, ongoing care and treatment.
Individuals with uncontrolled HIV virus deserve our attention and thoughtful, evidence-based efforts. Helping people with HIV know they have the virus and access effective treatment not only helps them live decades longer than they would otherwise, it also substantially lowers the chance that they will transmit the virus to their sexual partners. Alone, this won’t stop the epidemic, but combined with improved prevention education and support services for people with and without HIV, it will bring us much of the way there.
To learn what you can do to stop the HIV virus in the United States through testing, care and ongoing treatment, go to Vital Signs New Hope for Stopping HIV Web site or the November 29 edition of the Morbidity and Mortality Weekly Report (MMWR), entitled Vital Signs: HIV Prevention Through Care and Treatment — United States (PDF).