Commemorating the 30th Anniversary of HIV

By Jill Foster, MD - Director of the DMC
It was 30 years ago this week that the first official account of a mysterious illness that would become known as HIV was made, in the June 5, 1981 issue of MMWR-- and the beginning of the summer when I would begin my medical career. My personal journey with HIV didn't become evident until two years later, in 1983 with my first job, as a physician assistant at Giuffree Medical Center on 8th and Girard in North Philadelphia-- a hot zone for HIV in Philadelphia. Hearing only whispers in the medical community of what was becoming known as a "gay plague", we started seeing previously healthy young people be admitted and abruptly die. There was fear from the patients as they sickened so quickly and fear from much of the staff that it was contagious. There was a lot more than whispers in the community as people saw friends taken from something ominous.
I have vivid memories of patients and friends from that time. Andre (not his real name) who was a twenty something whom I had cared for and laughed with during several dirty needle related illnesses who came in with PCP and died 2 days later. Phillip who was 2 whose mother had died and he had just been adopted and now had kidney failure from guess what, HIV. We had the "miracle cure" of AZT and ddI for him and he lasted a few years. Michael, my friend, who I begged to get an HIV test after he had a particularly nasty foot infection, but he said, "What would I do different?" The answer to a positive test for him since he was already symptomatic would have been to start preparing for the end and he still had so much life to live.
"What would I do different?" is such a different question for 2011 rather than 1985. Today, we have medications that are not a cure but in the majority of patients can get someone to having no detectable virus in their blood. Someone who knows his or her status can take risk reduction steps to protect him/herself and decrease the risk of transmission to others. Earlier this year, we heard about PrEP (Pre-Exposure Prophylaxis). PrEP from early clinical trials has the promise that we may be able to offer two medications (emtricitabine and tenofovir) and counseling to high risk HIV negative young men who have sex with men to potentially decrease their risk of HIV.
"What would I do different?" now, personally and professionally-- nothing. I remember the first time I ordered an HIV test on a patient and how glad I was to have it available. I also remember the first time I did an HIV test in a church rather than in a medical office and how magical it still seemed. I remember the first person I gave an HIV positive result to (a mother for her baby) and the most recent (a teen 2 weeks ago). I remember the first time I ordered AZT for a patient and where I was driving when I heard the news on NPR that a clinical trial giving AZT to pregnant women had been halted because of its success-- and that we would soon eliminate mother to child transmission. I am looking forward to remembering where I was when I heard there was a cure.
Here's some links to some other pieces on remembrances and other items about the 30 year anniversary. Op-Ed in the Inquirer by Dr. Marla Gold, Dean of the Drexel School of Public Health, features in the Inquirer, a New York Times Op-Ed, a piece by the Smithsonian on an exhibit commemorating the 30 year anniversary, and a message from Secretary of State, Hillary Clinton. View information and panels from the AIDS Quilt.