For many readers, HIV/AIDS is old news. Their fascination with infectious threats has moved on to other exotic viruses like Zika and Ebola. Many HIV patients in the U.S. and Europe can have a normal lifespan as a result of better treatments.
Ironically, this better prognosis makes the epidemic less newsworthy. To get any media coverage of this devastating global epidemic, we are obliged to take advantage of anniversary events and World AIDS Day (Dec. 1).
June 5, 2016, is one such opportunity, the 35th anniversary of the start date of the epidemic — the Centers for Disease Control and Prevention identifies that as June 5, 1981, the date my
report was published describing five patients with the immune deficiency we now call AIDS.
In retrospect, rare cases occurred years, and in some instances decades before. In 1984, HIV (the human immunodeficiency virus) was identified as the cause, and a blood test revealed the true extent of the epidemic. By 2015, 36.9 million people worldwide were living with HIV, yet only one-third were receiving lifesaving treatment.
The ongoing toll of HIV in the developing world is out of sight and out of mind for most Americans. It is a sad fact that in 2016, whether a person survives HIV or not depends on whether they live north or south of the equator.
A vaccine is the goal for prevention, but this prize has been elusive. In the meantime, lowering patients’ blood levels of HIV to near zero with medications, termed “undetectable,” can be achieved routinely; achieving this dramatically reduces the chances that a person will transmit HIV.
In the U.S. and Europe, many HIV-negative people at high risk for infection take an antiviral pill called Truvada to prevent infection, known as pre-exposure prophylaxis (PrEP). Applied more widely, treatment and PrEP would be expected to reduce the number of new infections worldwide, 2 million in 2014 alone. The formidable barriers of economics and apathy stand in the way.
In the U.S., 1.3 million are living with HIV and 50,000 new infections occur each year with a shocking high incidence among young gay and bisexual African-Americans. The more widespread use of PrEP in this and other groups at high risk for HIV has the potential to prevent patients from becoming statistics.
Millennials, too young to have witnessed the horror of AIDS in the 1980s, are dead wrong if they dismiss becoming HIV positive as a trivial matter. While survival for patients on treatment is improved, there are still complications of being HIV positive; medications must be taken daily and may have side effects.
The social stigma of having HIV is very much alive and there is ongoing risk of discrimination. As a result, many patients keep their HIV status secret, unable to share a worrisome health issue with parents, family, coworkers and employers.
Thirty-five years into the epidemic, numerous challenges remain, not the least of which is society’s ability to accept HIV as a medical illness rather than three scarlet letters.