May 7, 2006
Hi Drs. Young, Wohl and Pierone, I recently read the Newsweek article concerning AIDS 25 Years Later...this quote caught my interest: "Since then, the urgency that once surrounded the AIDS fight in the United States has ebbed, as HIV has come to be seen as a chronic, rather than fatal, condition. But the drugs aren't a panaceadespite the fact that many people too young to remember the funerals of the'80s think the new medications have made it safe to be unsafe. "Everywhere I go, I'm meeting young people who've just found out they've been infected, many with drug-resistant strains of the virus," says Cleve Jones, who two decades ago decided to start stitching a quilt to honor a friend who had died of AIDS. That quilt grew to become an iconic patchwork of more than 40,000 panels, each one the size of a grave, handmade by loved ones to honor their dead. Ever-expanding, it was displayed several times in Washington, transforming the National Mall into what Jones had always intended: a colorful cemetery that would force the country to acknowledge the toll of AIDS. If I'd have known 20 years ago that in 2006 I'd be watching a whole new generation facing this tragedy, I don't think I would have had the strength to continue," says Jones, whose own HIV infection has grown resistant to treatment."
I found this article very informative and helpful in that it helps promote discourse and, hopefully, further understanding of HIV. Still, this quote from the recent Newsweek article has left me a little disheartened. I know all of you, great experts and humanitarians, want to believe that HIV is controllabe. But when I hear about incidences like the one mentioned above, I lose hope again. I love that people like Cleve Jones exist, people who want to make sure that we remember all those who passed before us...but when I hear that someone as inspirational as Mr. Jones may be on his last lifeline, I think perhaps those living with HIV are eventually headed for a dismal existence. I don't know exactly what I'm asking..just want to know what your thoughts are about this article I suppose. Thanks so much...your words are always appreciated.
Response from Dr. Wohl
Thanks for sharing this article quote and your concerns.
Among those who have been living with HIV for 20 years, are individuals who were treated when we had much less understaning of the virus and what it does to the body than we do today. Before 1995, we had fewer therapies to apply to HIV infection and these came to market slowly. Many people back then were treated with AZT alone and then when 3TC came out, that drug was added and so on. We know today that using a single HIV drug alone almost always leads to resistance and that two-drug combos do likewise, albeit slower. So, some of these survivors were treated in ways we would not treat today and although treatment helped them to live in many cases to also led to the development of resistant virus. Fortunately, there are a bunch of new meds being designed to treat resistant strains of HIV and some of these will hit pharmacies soon.
The other point the the section of the article seems to be making is that this veteran of the HIV battle is exasperated by the rate of new HIV infections among younger people today. As has been discussed on this forum, it is sometimes astonishing how many people write in who are very recently infected. The incidence (new infections) in the US each year remains in the tens of thousands and in our clinic we are now regularly seeing young people, often men, with very high risk behaviors and new HIV and/or syphilis.
For those who fought so hard to raise awareness of the spreading epidemic, who lost their friends and, basically, their community, the spread of HIV among young men today can feel like a defeat. HIV is indeed controllable. But, it is certainly not controlled.
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