December 1, 2020

World AIDS Day

Covid-19 is not my first pandemic as a doctor. HIV/AIDS was the first. Beginning in 1981, a mysterious killer of young gay men in the US was recognized and the AIDS epidemic grew, with little to no options for treating this new viral disease. By 2018, 1.2 million in the US had been infected, with more than 700,000 deaths from AIDS. Due to growth in knowledge about viruses and treatment advances, deaths have now slowed to a trickle, compared to the gushes that happened in the ‘80’s and ‘90’s.

Caring for people with HIV has been a passion of mine. I was interested in HIV from the beginning of medical school, which I started in 1986. One of my New Games Foundation influencers, Burton Naiditch died of AIDS and I knew others: my dear cousin’s husband, co-workers at a restaurant prior to medical school, friends and teachers. For those reasons, I found a way to work as a provider caring for people with AIDS and then, as active medications came along, caring for people living with HIV. Even though I no longer work at a clinic specializing in HIV care, I still care for many patients with HIV as their primary care provider.

The virus is easily treatable now compared to the mid ‘90’s when people needed to take handfuls of meds to suppress the virus. Now they often only need one combo pill daily that is very tolerable and very effective. Life expectancy is normalized, as long as those living with HIV take their meds. Now we use some of those same meds to help prevent infection if someone is at risk due to their sexual activity or other reasons. It is called PREP or Pre-Exposure Prophylaxis.

I have been on this journey for years with patients and have seen many come back from near death after starting the meds, I have seen people flourish with the care they receive, and I have seen tragedy when people can’t get the meds or care they need, or they worry so much about the stigma of HIV that they don’t take their meds to protect their health.

But still no vaccine. That has been harder to come by because of the virus and its mutability, at least to the immune system. One of the good outcomes is that the AIDS epidemic really developed and improved worldwide collaboration and sharing. I had the privilege of attending the World AIDS Conference in Mexico City in 2008, which was an amazing collaboration and cross cultural event with people worldwide coming to show what they were doing to save lives and improve health. I still remember that feeling of hope and wonder from seeing so many different cultures and peoples working toward the same goal of ending that pandemic.

And that is some good that has occurred with this new pandemic- the global sharing of knowledge and collaboration. The networks established during the HIV/AIDS pandemic have helped with the COVID-19 collaborative effort.

So today I celebrate World AIDS Day in memory of those we lost and in honor of my patients and fellow health care providers who have given so much.

Wash your hands, cover your nose, keep safe six, and be sensible.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.