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AIDS still occurring at very high levels?
Oct 18, 2006

Hey Dr. Wohl, Young, and Pierone,

I just looked at the recent news article on the site talking about how AIDS is the leading killer among gay men in San Francisco. It's pretty discouraging that gay men are still being so careless with their health but just as discouraging to me were the stats showing the percentages of deaths associated with HIV. From looking at that data, it looks like the percentage of deaths attributable to HIV has decreased a little over the past few years but not that much. If I read the article correctly, most infected people are dying in their 40s. Why are so many still dying of AIDS when they live in freakin San Francisco, the mecca of HIV research and treatment centers? It seems like, of all places, people infected in this city would have the best access to medications of anyone and, thus, have a better chance of not succumbing to AIDS. Am I wrong in thinking this way? The stats just really don't seem like they favor long term survival of this disease. Am I misinterpreting the data or is it really just that gloomy?

Response from Dr. Young

Thanks for pointing out this important article.

Yes, AIDS is still out there and still kills.

The fact that people still get HIV in numbers similar to the 1980s is emblematic of a collosal failure of prevention strategies. Too many people either don't think they're at risk or simply ignore their risk. Too many in government, church and community (as well as medical professionals) have forgotten the toll that HIV exacts on societies.

People die from AIDS when they don't get tested, wait too long to get tested, or wait too long to access healthcare. Despite all the best that medicine has to offer, if you don't avail yourself to medical care, these 'best access" situations don't have a chance to impact disease outcomes.

Fortunately, multiple studies show that IF one accesses care in the developed world, the prognosis is excellent. In such cohorts of patients (like our analysis of the CDC's HOPS cohort) the percentages of deaths caused by HIV-related complications is very, very low.

Thus, this is a tale of the haves and have nots- those who are fortunate enough to get tested and seek medical care (before catastrophic consequences) are likely to live a very long time.

Best, BY



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