From overcoming the stigma of HIV to expanding treatment with viral medications, there are ways to attain what Secretary of State Hillary Clinton recently called “an AIDS-free generation.”
Years ago, I recall a cardiologist saying, “The goal of a good physician should be to put himself out of business.” The suggestion was that if doctors are truly effective in preventing the diseases that we spend so much time and effort treating, we could focus our medical skills and knowledge elsewhere. I think this same advice holds true for those of us who treat patients with HIV/AIDS.
Since AIDS cases were first reported in the United States 31 years ago, we’ve achieved remarkable success in treating the disease and keeping people alive. However, in recent years we’ve failed to prevent new infections, of which there were 50,000 in the United States and 2.5 million worldwide in 2011. Lancaster General Health’s HIV clinical program saw about 60 new patients last year, and this trend continues. Most infections are preventable.
Secretary of State Hillary Clinton recently used the phrase “an AIDS-free generation.” She noted this could be ultimately possible if, ideally, no children were born with HIV infection; if they had a low risk of infection as they grew into adulthood due to the availability of prevention tools; and if people acquiring HIV had access to treatments to prevent them from developing AIDS and passing their virus to others.
Here are some specific things we all can do to help create an AIDS-free generation.
- Overcoming the stigma of the disease will enhance HIV testing, education, and thus prevention. Along with mental illness and the disease of addiction, HIV remains one of the most stigmatized medical conditions. I hear this from my patients every day when we discuss HIV disclosure. Persons with HIV infection still fear loss of employment, housing, and relationships.
- More focused prevention efforts are needed in the gay and bisexual community, which make up a significant number of new infections. Young gay men need to know that HIV is still a chronic disease and fatal without treatment.
- Mother-to-child transmission of HIV infection is now essentially 100% preventable by treating infected pregnant women with antiviral medications.
- We must expand HIV testing and remove the barriers to doing so. Doctors need to offer routine HIV testing in their practices and patients need to request it as well. Of the 1.2 million people in the United States with HIV, about 20% do not know they’re infected.
- Reaching people with drug addiction, assisting with clean needles for disease prevention, and directing them to addiction treatments will prevent new HIV infections.
- Expanding treatment with antiviral medications should be a priority. New research shows that essentially all people with HIV infections should receive antiviral medications to preserve their health and limit the spread of new infections. In addition, making medications more affordable should be a priority of insurance companies, the government and the pharmaceutical industry.
A cure for HIV unfortunately does not appear to be on the horizon, but research toward a cure is starting to show promise. So is research on an effective vaccine that would greatly reduce the number of global infections that have been slowly declining with effective therapies, education, and a variety of prevention interventions.
I have provided care to individuals with HIV/AIDS for 23 years. Offering care for an AIDS-free generation while having my patients living long-term with the virus to attain a normal life expectancy continues to be a personal goal and a goal of our program at Lancaster General Health.
Comprehensive Care Medicine at 554 N. Duke St., Lancaster, offers free, confidential HIV rapid testing with no appointment necessary each Tuesday from 1 to 5 p.m. and Thursday from 1 to 6 p.m. Tests are administered orally and individuals receive results within 20 minutes.
Jeffrey T. Kirchner, D.O., FAAFP, AAHIVS is board-certified in family medicine and HIV/AIDS medicine. A graduate of Villanova University, he received his medical degree from the Philadelphia College of Osteopathic Medicine. He completed a medical internship at the Osteopathic Medical Center of Philadelphia and completed his residency training at Abington Memorial Hospital, Abington, Pa.