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Behind the Story: David France Discusses New York Mag Aging Story; Casts Doubt on NYC HIV Statistic

November 16, 2009

David France
David France
photo credit: Karine Laval
"Being an AIDS journalist makes me one of the loneliest journalists around," David France lamented. "I know how difficult it is to get an AIDS article published in this day and age. Everyone thinks AIDS is over."

Despite the fact that the mainstream media isn't focused on AIDS issues, France keeps plugging along, doing work that he thinks activists are neglecting. His most recent article Another Kind of AIDS Crisis in New York Magazine about the health complications of aging with HIV hit a nerve with readers.

The article is the first mainstream feature article focusing on the health issues people aging with HIV face. Three weeks after its publication, it still tops's list of most e-mailed articles.

France, a veteran writer and AIDS activist (and former Housing Works board member), said the story came about when he noticed his friends with HIV and AIDS developing a myriad of health problems, including memory loss, osteoporosis, stuttering, kidney failure and cancer.

"A friend of mine was diagnosed with cancer. He just thought he was a man with bad luck. Like another bus that came out of nowhere. It's exactly the same bus. It's not an ill-fated course through life," France said. "I wanted to look at these specific health complaints in context with one another and in progression of AIDS itself."

That friend, writer Joe Westmoreland, ended up featured in the story, along with Housing Works client Cesar Figueroa and a dozen other people with HIV or AIDS over 50.

Just the Tip of the Iceberg

France noted that while people with AIDS are living longer thanks to antiretrovirals, AIDS is still a death sentence, albeit one with an incubation period. "A person who seroconverts at age 20 has a life expectancy of age 60. That's a reduction of a third," France said. "That means there's still a problem. That means there's still fatalities."

Some studies suggest that in order to avoid cognitive decline, people with HIV should go on treatment as soon as possible. And while many doctors recommend this (and France's longtime friend Housing Works President and CEO Charles King advocates early treatment for HIV in general), France, said he's not sure early treatment is the answer because of the lack of long-term research about people with AIDS on medication.

"It's a trade-off," France said. "Before you can argue that everybody with HIV should be on medication, you have to find out what the impact of these drugs are."

France, a veteran of ACT UP New York, said he thinks he needs AIDS treatment activism to focus more on these issues and less on negotiating with drug companies.

"We need activism to lead this. Treatment activism has taken a whole new form in the last few years. Where's the pressure of looking at the treatment itself?" France said.

More PWAs in NYC Than We Think?

The aging and HIV problem will only get worse. Although there are 109,000 known cases of HIV and AIDS in New York City, France took a closer look at the numbers, including looking at other stats, such as estimates that a quarter of people are undiagnosed, and concluded that at least 144,000, if not more, New Yorkers actually have HIV. The Department of Health stands by its numbers.

France said he doesn't think the under-counting is deliberate but notes that the only way to tell for sure would be with universal testing. "You'd have to get rid of some of those issues of HIV exceptionalism and know the identities of people," France said.

France said whatever the headcount though, problems with HIV and aging are going to become more profound as people with AIDS continue to age. And by 2015, the average age of people living with AIDS in New York, the center of the epidemic, will be over 50. "It's a huge balloon of illness and medical need. Even for that 20 year old who seroconverts today, there will be assisted living and general life issues. The last ten years aren't going to be pretty ten years."

To read more of France's work check out

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This article was provided by Housing Works. It is a part of the publication Housing Works AIDS Issues Update. Visit Housing Works' website to find out more about their activities, publications and services.
See Also
More on Aging & HIV

Reader Comments:

Comment by: Russell (UK) Sat., Dec. 19, 2009 at 1:32 pm EST
It's depressing that two of the three previous comments are from people who at best seem to be skeptical about current HIV treatments, if not downright hostile. There is NO evidence that so-called 'holistic' treatments have any specific benefit in HIV disease, except to the extent that measures to improve diet, increase exercise and reduce stress etc are likely to be beneficial to everyone. As for the statement that current treatments are more dangerous than the disease, this is simply AIDS-denial propaganda, with no basis in truth whatsoever. The scientific evidence overwhelmingly proves the benefits of early ART treatment in terms of increased life expectancy and improved quality of life, even with the undoubtedly real side-effects of treatment. We've come a hell of a long way in the last 20 years and there's every reason to think the picture will continue to improve, with better drugs and fewer side-effects. Hopefully this article will prove to be unduly pessimistic for the great majority.
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Comment by: goodman (dublin,ireland) Thu., Dec. 10, 2009 at 8:05 pm EST
medical scientists should put more effort in finding a cure for this disease. people are suffering and many are dying. even the current treatments for this disease is more dangerous than the disease
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Comment by: Neil (Los Angeles, CA) Tue., Dec. 1, 2009 at 12:22 am EST
This is a REALLY depressing outlook, not to mention totally pessimistic. The newer medications used for first-line therapy may not cause the same detrimental outcomes that people in their 50's are experiencing today as a result of "yesterday's" meds. I've heard plenty of HIV specialists say things like, "people infected today (2009) and starting HAART will have a much more favorable outcome than those infected in the early days of the disease." Today's medications are much less toxic than those used in the past, and most of the problems older HIVers are experiencing today are a direct result of those older medications. "The last 10 years aren't going to be pretty ten years?" You don't know that for sure? Maybe 20 years from now there will be a way to completely erradicate the virus from one's body (the cure), or at least take a medicine once per month, etc. Hepititus C can now be cured in some people, wherease not long ago that was not the case... nobody knows what the future will hold, but let's be more positive (no pun intended) than this doom and gloom David France article. I think this article was written to reawaken interest in the AIDS issue in light of public complacency about HIV amongst people today. Most people don't see it as the problem it once was, and this article brings a voice to those who are suffering in light of the complacency and I guess I don't blame them. This article was written to "scare people," and combat the complacency, and stir up conversation about AIDS again... I just think it over looks the fact that today's generation of newly infected folks will have a different outcome than those infected in the 80's and early 90's; and from what the experts predict, a much better outcome.
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Comment by: Keyla (San Francisco, CA ) Wed., Nov. 25, 2009 at 12:58 pm EST
... I have concluded that AIDS is still a death sentence just like France says. If the virus won't kill you, the drugs will. I would say after being diagnosed with hiv, people should avoid the drugs as much as they can for as long as they can, and practice holistic therapies and alternative medicine instead. 5 key things you must do: 1. Eat healthy 2. Exercise for at least 20-30 minutes a day 3. Sleep at least 8 hours a day 4. Stay away from alcohol, tobacco, or any other drug-including the HAART drugs-this is besides doing your alternative therapy(acupuncture, yoga, mind meditation...etc) 5. Keep your mind busy and try no to think about it too much.(less stress, higher CD4 counts)
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