This post was adapted from an article written by ASA for Austin MD Magazine. Read the full issue online.
Of all the viruses and diseases we have had to face over the centuries, perhaps none have baffled us, challenged us, and strengthened us as much as HIV and AIDS. When AIDS first appeared as a mysterious illness in a handful of gay men in the early 80s, it was feared, people with HIV were shunned, and organizations that tried to help were picketed and harassed. Now, HIV has all but vanished from the public eye as new medications help people live normal, healthy lives.
Over the past three decades, we have learned a tremendous amount about HIV, making many mistakes along the way. But after all these years, are we any closer to a cure? Have we been able to reduce the spread of HIV? And have our old misconceptions and biases simply been replaced with new ones?
The Power of HIV
To many people who study HIV, it seems the epidemic was a perfect storm of different issues colliding. The virus itself has unique properties, making it hard to combat. It hides in our immune systems, lying dormant for years. HIV also replicates quickly and mutates easily, making effective treatments harder to find. These properties also make developing a vaccine nearly impossible to this day.
In addition, because HIV is spread primarily through sexual contact, it has been an uphill battle to educate people. In many cultures around the world, including the United States, talking about sex can be uncomfortable or taboo. Since HIV disproportionately affects gay men and other already stigmatized populations—such as intravenous drug users or people in the prison system—negative opinions about HIV-positive people abound.
While our current treatments offer hope to millions of people, they can be a double-edged sword. As the visibility of HIV decreases in the public eye, fewer people—especially in the younger generations—remember the danger it still poses. Over the past few years, nearly 40% of new infections occurred in young people under the age of 29. And an estimated 60% of young people infected with HIV do not know their status.
The New Struggle
While older stigmas about how you contract HIV and who can contract HIV may have been cleared up, doctors and HIV prevention specialists now face a new set of misconceptions, primarily that HIV can be cured with just a pill.
“The biggest issue that we wrestle with now is that people have to be treated for a lifetime,” Dr. Wright from Blackstock Family Health Center explains. Dr. Wright has been treating people with HIV for three decades now. “It’s understanding that you are going to be on medications for an indefinite period of time, and if you stop the medications, at some point the virus is going to come back.”
Now that people are living longer, there are other unanswered questions that current research hopes to address:
- Does being positive reduce life expectancy, even if medications have lowered the viral load?
- Is there a way to flush all of the virus out and stop medications?
- Can we give people an infusion of medication that is long-acting rather than a daily pill?
- How do we make care more accessible, more open, and less threatening?
- How do we make medications more affordable?
Just like in the 80s, it will require a concerted effort on the part of healthcare specialists, government agencies, drug manufacturers, and community supporters. Dr. Wright is optimistic about the future. “We will probably find a way to cure this illness.”