HIV/AIDS Still a Serious U.S. Problem

Published by Contra Costa Times

Posted on Sat, Aug. 21, 2004

By Anthony Jones, M.D.

Susan had felt tired for several months but thought it was because of her busy schedule. At first, losing weight pleased her. She could fit into some old clothes she'd outgrown, and her figure was becoming slimmer.

But eventually she sought medical help and was diagnosed with HIV/AIDS.

Before her symptoms, Susan had seemed fairly healthy, busy with her job, and raising teenage children and younger grandchildren. She had never "slept around," and she didn't use drugs.

Her ex-husband had used intravenous drugs when he was younger and had neglected his health for years. When they were married, he was gone a lot. He frequently criticized and yelled at her, and sometimes hit her. Once she had to go to the hospital emergency room for stitches because of her injuries. Eventually she couldn't take it anymore and left.

Years later, he became ill, and since he seemed less violent, she helped him by providing meals and occasionally let him sleep on their couch in the TV room. She was not completely surprised when he was diagnosed with advanced AIDS, which eventually contributed to his death.

Still, when she learned she had HIV/AIDS, she was shocked, confused and terrified. It had been so long since she'd been with her husband, and she had seemed healthy for so many years. She thought HIV/AIDS affected mostly gay men and men like her ex-husband, who had lived a rougher life than she had realized.

To protect Susan's identity, I've given her characteristics of many HIV/AIDS patients I see in my practice.

Before her diagnosis, she was like many Americans who have come to believe that HIV/AIDS is no longer a serious problem. A poll conducted last month by Associated Press found that 61 percent of Americans believe HIV/AIDS is a "very serious" problem. In the late 1980s, the percentage was nearly 90 percent.

Most of us are aware that there are now effective drugs to treat the disease. It is no longer an automatic "death sentence." Take Magic Johnson, for example, who looks as healthy and happy as anyone and has had the disease for years. But what most don't know is that Johnson had regular physicals and so was probably diagnosed early. Since then, he has diligently cared for his overall health and his disease with the help of his doctor. The virus is still just as deadly, but it is now sometimes containable with a rigorously healthful lifestyle and constant medical management.

Moreover, the populations most at risk for HIV/AIDS in the United States have changed drastically since the 1980s.

It used to be regarded as the "gay cancer," and now it is the communities of color and poverty that are at greatest risk.

Although the reasons for this are complex, one factor is the misperception that HIV/AIDS is no longer a serious health problem.

Because their disease has progressed for some time before diagnosis, patients such as Susan face an uphill battle. Medication usually helps, as do lifestyle changes: getting enough exercise and rest; eating healthful foods; not smoking; and drinking very moderately. But improvement is gradual and takes constant effort.

Getting tested for HIV/AIDS is the critical first step to prevent it from ruining your life.

Dr. Jones is a family practitioner at the Pittsburg Health Center and an HIV health care provider recognized by the American Academy of HIV Medicine.