Really good, useful HIV/AIDS treatment information is actually harder to write than it looks. You'll be the judge of how well we did in this issue, of course, but I already feel good about one thing: it was put together by people who are immersed in the fight against HIV/AIDS -- some of us live in it and some of us work in it and some of us do both -- and it's written for the very same kinds of people.
When I was asked to be the editor of this issue and was given a rough outline of the "systems check" idea, I immediately started thinking about how to approach each topic and with whom to do it. I wanted people who one, were committed to HIV education and passionate about helping people live well with HIV/AIDS and two, would speak their truths -- not what they've read in some guidelines or heard at a lecture, but what they know to be true from their lives and work. That much, I know I got right.
Greg Milward moved to Madison, Wisconsin, from Washington, D.C. I asked him to write about choosing a doctor because he had told me about his move here and how he feared that he'd have to commute to D.C. for his health care. How could he find physicians in this small city who he would feel as confident about as he did at Johns Hopkins and Georgetown? I thought he'd write about that but, instead, he wrote about his first experience with an HIV provider. I realized -- and his story is really about this -- that his search for good care in a small midwestern city was nothing he couldn't handle because his first experience forced him to learn everything he needed.
Once you find a good provider, how do you maintain a productive, healthy relationship with that person? By way of discussing this, Greg and I decided to share with you a conversation we had about our experiences as patients in the doctor-patient relationship. It crossed our minds that there should be something like marriage counselors for people and their physicians. You'll see what we mean.
There are some nuts-and-bolts parts of this issue, like which lab tests are key to good care and what goes into treatment decisions. I went to two other Midwesterners for these.
Melissa Ngo is a pharmacist I met when she started working in our Friday prisoner clinic. She was new to HIV, but I was struck by how eager she was to learn and how involved she became in the treatment of HIV disease. Melissa's piece on making antiretrovirals work for you is from the perspective of someone who's counseled people on HIV medications in clinic, in the outpatient pharmacy, and on the phone through the mail-order program. She sees it from every side and she was willing to share what she's learned with us.
Judith Feinberg is a clinician and researcher in Cincinnati, Ohio. She has years of HIV/AIDS experience that she agreed to lend to this issue by way of a piece on lab tests. This is a subject people often leave to their provider and don't know much about, but Judith lets us know exactly why these tests are important and how they help us figure out how things are working in the places we can't always see or feel.
I foiled my plot to have "all Midwesterners, all the time" for this issue when I realized there were some people I knew who could speak expertly and thoughtfully to some key issues ... and they didn't live in these parts. Although I'm eager to do what I can to help readers (and my activist colleagues!) from the coasts appreciate the smarts and skills that reside in the Midwest, I made a good decision.
Charlie Smigelski is a registered dietician from Boston who knows his way around nutrition, supplementation and other strategies to maximize the possibility for living well and long with HIV/ AIDS. His piece is about those nagging problems -- high lipids, gut distress, fatigue -- that resonate for a lot of people. Sure, we're living longer, but that means we're on a bunch of meds for a long time, we have to think about diseases of older age and -- you know this is true -- we're not in the shape we used to be. Fortunately, Charlie has some helpful information for us all.
I met Tonia Poteat, a physician's assistant from Atlanta, at a meeting about women and HIV/AIDS. It was clear to me that the HIV-positive women she treats at the Grady Infectious Disease Program and her years of HIV/AIDS advocacy before becoming a provider informed her perspective in a wonderful way. She graciously agreed to write about three critical influences on our mental health -- depression, anxiety, and addiction.
So, there you have it. I hope this "systems check" issue is helpful. It's important to take a look with fresh eyes at those things you're so used to that you don't even really see anymore. Remember the words (more or less) of the great philosopher, Ice Cube: Check yourself before you wreck yourself.