Wednesday, April 21, 2010

HIV/AIDS: From Death Sentence to Chronic Disease?

Yesterday, we talked about the childhood obesity epidemic in America, but as I stated at the beginning of this series, we have largely forgotten the problem of HIV and AIDS in America. Over time, it has become less popular to talk about HIV/AIDS, most likely because it is no longer considered a death sentence. During the beginning stages of the HIV epidemic in the late 70’s and early 80’s, there was little that clinicians could do to help HIV/AIDS patients, because no one knew what the mysterious illness was and people died within 16 months of exposure.

In 1983, we finally knew what the mysterious virus was that was causing so many people to get sick. Five years after identifying the actual virus we call HIV, the first anti-retroviral licensed as an effective treatment for HIV, AZT hit the market. This was a major breakthrough, significantly altering the course of HIV illness and helping destroy the notion that HIV/AIDS was an instant death sentence. Almost immediately, people were able to live longer with the virus. Basic science research helped to close the gap in time between identification of a virus and an effective treatment due to years of analyzing viruses and retroviruses, like HIV. Now there are over 20 different anti-retrovirals on the market.

While medical research has worked to find treatments and cures, the public health community has worked to prevent people from acquiring the virus. HIV testing has become widely available in health departments, clinics and doctor’s offices all over the country. Safe sex education has been paramount in limiting the spread of HIV. Public health has worked to make sure people use condoms during sexual activity and converse with their partners about knowing their HIV status.

The cutting edge research on HIV/AIDS bridges treatment and prevention by testing the effectiveness of pre-exposure prophyaxis, or PrEP. PrEP involves using anti-retrovirals as a prevention tool as opposed to treatment tool, to protect HIV-negative people from HIV infection. The theory behind this research is that if people take ARVs before they are exposed to HIV, they will lower their risk of infection if or when they do come in contact with the virus. If proven effective, PrEP would provide a safety net for anyone who is at risk of HIV infection.

Although PrEP is an exciting bridge between medical treatments and prevention, it is important to remember that we still must go forward in finding a cure or an effective vaccine against this illness. Worldwide, there are 33 million people living with HIV/AIDS. Medical research and public health must continue to work together, because there is much work yet to be done.

This is Part 4 of 5 in our Intersection of Medical Research and Public Health series.
Part 1 - The Intersection of Medical Research and Public Health
Part 2 - Research and Public Health Tackle the Flu Together
Part 3 - Today's Epidemic: Childhood Obesity
Part 4 - HIV/AIDS: From Death Sentence to Chronic Disease?
Part 5 - Advocating for the Intersection

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