HIV-AIDS – Yesterday & Today

When the pandemic first stuck in 1981, there was no treatment. It was not even called AIDS (acquired immunodeficiency disease syndrome). It was called 'gay cancer', 'gay compromise syndrome', 'community-acquitted immune dysfunction' and GRID (gay-related immune deficiency) KS (Karposi's Sarcoma), a specific type of cancer, and PCP (Pneumocystis carinii pneumonia) were soon the two main medical conditions being discovered by doctors in a certain population of people who met a certain criteria.

Known primarily to affect only those with compromised immune systems, these conditions were very rare but over time more and more cases were reported in hospital emergency rooms. Patients, who were primarily gay men at the time, were dying in a matter of months. As researchers worked on containing a virus, which attacked the body's immune system, it soon became apparent that a vaccine was going to be impossible to develop.

This virus, historically named HIV (human immunodeficiency virus) was classified as a 'retrovirus', meaning it was able to duplicate itself into many different forms when spreading through the body so one 'single' vaccine was not going to be able to conquer it . This dismal picture of AIDS was prevalent throughout the 1980's. Although there was not a cure, the medical community concentrated on treating the symptoms of the many 'opportunistic infections' (a group of maladies affecting only those with compromised immune systems) seen in those with AIDS.

The goal was to improve the quality of ones life and promote longevity but, unfortunately, these treatments were not very successful and many continued to die. From the gay community, AIDS found its way into the IV drug using community and eventually into the straight community. Mothers contracting the virus were giving birth to babies already infected. The AIDS virus was found in blood, semen, vaginal fluid and breast milk. Transmission occurred when the bodily fluids of one infected person were transferred into the blood system of a non-infected person.

The nation went into panic mode and AIDS social service agencies could not be developed fast enough. And with AIDS came fear, hatred, bigotry and rejection. People were fired from their jobs and displaced from their homes. Teen-agers were being turned away from their own families as feeling guilty and shame were damaging all self worth in many of those infected. As drastic as this was, AIDS activist groups were also, being created to fight for funding for research, medicine and education.

Dame Elizabeth Taylor became the first and foremost leader of this battle creating amFAR (The American Foundation for AIDS Research) and her own Elizabeth Taylor AIDS Foundation. She slowly raised millions of dollars with her philanthropic efforts. Radial groups such as ACT-UP demonstrated and held protests demanding equal rights and better societal treatment. It took years until one single drug, AZT, showed promise in slowing down the production of the virus in the blood stream. It was a major advancement and in some cases, it prolonged life but not significantly.

As other drugs came down the pipeline, ACT-UP demanded that the FDA (Federal Drug & Food Administration) streamline experimental drug and to release them quickly for human consumption. People simply did not have the opportunity to wait extended periods of time for drugs to be approved. Some drugs, commonly known as Nucleoside / Nucleotide Reverse Transcriptase Inhibitors (NRTIs) and Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) were developed and clinical trials for effectiveness started as soon as possible.

Now, some with AIDS were able to add some years, instead of months, to their lives. But it was still a life with an inevitable end in sight. Even though there were advances in the treatment of AIDS, health issues were still an uphill battle. Systems of a severely compromised immune system, as well as side effects from the new medication, caused problems to themselves. There were those who were too ill on a daily basis to enjoy the extension of their lives and misery prevailed once again. Those infected with HIV brave up their employment and went on disability. Some were lending in their life insurance policies for money to exist on. And exist they did. Isolation, depression, hopelessness, and substance abuse addictions plagued this population of people who were left to ponder the meaning of their life having acquired this affliction.

Finally, in 1996, there was a significant discovery. The creation of a group of drugs called 'Protease Inhibitors' (PIs) attacked the virus in a method never seen before and, at last, there seemed to be some hope. Although these drugs did not cure AIDS, they initiated an entire new phase in the history of AIDS treatment. PI's came with their own particular troublesome list of side effects and a battle ensued in regards to taking the medication, which made most people ill or not to take them. In the years that followed, more and more drugs were created with less and less side effects.

HIV could potentially be undetected in the body with the proper use of these medications. Without HIV destroying the body's immune system, the immune system had a chance to repair itself. As AIDS was slowly slipping away from having a reputation of being an instant death sentence, people were building back the foundation of their lives. They were feeling better, living longer and were able to enjoy life, once again. Unfortunately, this was not the case for everyone and there were still those who succumbed to the disease.

Today, we have several classifications of effective drugs: Fusion Inhibitors and Intergrase Inhibitors all attack the virus in different ways. These drugs are now used in conjunction with others in combinations commonly called 'a cocktail'. Taking these medications is now a daily routine and vital in the lives of those suffering from HIV / AIDS. Now, it is hopeful that living ten, twenty or thirty years may be a reality. The medical profession is now calling HIV / AIDS a manageable disease. There is a downside, though. The long term use of these potent medicines is not fully understood and, as years go by, these medications may be more harmful to the body that actually having AIDS itself. Only time will tell. A second drawback is drug resistance. Each of these medications may only be effective for a certain amount of time and then they are no longer able to keep the virus at bay. So, the discovery for a cure can never be pushed onto the back burner.

For only when AIDS is eradicated from the face of the Earth, is when we shall find peace. Researchers are skeptical that this will occur in the near future but advances in AIDS treatment remain tremendously in comparison to a quarter of a century ago. Although there is still a stigma attached to those with AIDS, it is not the face of quivering sickness as it once was in our society. It is the face of health and prosperity. And we remain forever hopeful.

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Rich Bassett

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