November 17, 2006

HIV's death sentence commuted

Posted by: Chris

When I came out in 1992, a diagnosis of HIV was a death sentence.  In those very dark years, there was no drug "cocktail" and the gay papers will chock full of sometimes dozens of obituaries each week — men in the 30s and 40s, struck down in their prime.  At the time, with so many dying and turning positive, I remember imagining that I would probably live another 10 to 15 years before the virus would catch up with me and kill me, too.

Now an American can expect to live on average 24 years from the time he learns he's been infected with HIV, according to new research. That's a dramatic increase from 7-10 years from diagnosis to death in the '90s. The new drugs have a new pricetag, of course, as the average cost of care has skyrocketed to $25,200 per year, or more than $600,000 over a lifetime.  That explains why the longer life expectancy is good news limited to First World countries and those with health insurance, public or private.

But despite the upbeat tone from researchers, my reaction was negative shock. We have become so accustomed to thinking of HIV as a manageable, chronic condition that we forget it's still a killer.  In fact, the new drugs aren't a cure and can be lethal themselves.  Despite all the advances, someone diagnosed with HIV is still likely to die of complications associated with the virus or the meds they're taking to fight it. A 21-year-old who learns he has HIV can expect to die in his mid-40s. That's a message that's not getting out there.

Under George W. Bush, HIV prevention has morphed from a public campaign on safer sex to an emphasis on abstinence and making HIV testing routine and universal.  Both policy corrections were needed, although abstinence taught as anything more than a way to delay sex for teens can and does backfire.  But universal testing, as nervous as it's made HIV/AIDS groups, is critical to stopping the virus.  People who know they're infected are not only more likely to start treatment, but they're more likely to have safe sex, or limit their unsafe sex to other poz people, and that should slow the spread.

Even still, today's "good" news is a reminder that there's still a place for powerful public campaigns that remind people that HIV is out there, and it's still deadly.  The Europeans have always done a better job on that.

Thousands quit smoking every year because they're afraid of dying early from lung cancer.  Unsafe sex can have the same consequence, with a much shorter fuse and a world of complications along the way.  Twenty-four years is great, but it's not a cure.

Tags: gay men, HIV