AIDS In The USA

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Questions of the Week
1) Why is the CDC so concerned about pandemic diseases like AIDS and influenza?
2) Why has it been so hard for scientists to develop a vaccine for AIDS?

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In 1986, I was privileged to be caught up in some of the early research on HIV. It was a rather idealistic situation in which 100% of members of all the armed services were tested for HIV. The ones who were positive were referred to a generous teaching and research hospital to set up extensive individual data bases. If underlying illness such as syphilis or other STD’s, or AIDS-defining illness such as pneumocystis pneumonia were learned, treatment was initiated. The huge difference between then and now, but, is that we had nothing with which to directly treat the Human Immunodeficiency Virus itself. By the time an AIDS-defining illness presented, it was usually months until that person died, or even sooner. It was a very helpless and frustrating situation for a caring physician.

Equipment have changed now. Instead of HIV being the mark of death, it has been redefined into a chronic illness which can be managed for decades. The advents of antiretroviral therapy (ART) medications have made it possible to keep the HIV disease in try out and to prevent the real occurrence of AIDS.

At present the CDC is trying to greatly enlarge the scope of HIV testing. It is recommended that the rapid HIV test be performed on everyone 15 to 64 years ancient, either on annual physical exams or with any illness that maybe resembles acute HIV. It is also recommended at the earliest confirmed time of pregnancy with a repeat near the end of the pregnancy. The reason for this is that there are 1.1 million people in the U.S. who have HIV, and one in five doesn’t know they are infected. When they don’t know, they usually present in the later stages of the disease. With augmented testing it is hoped that the spread and severity of the disease can be reduced.

The rapid tests for HIV are exceptionally sensitive, though previous to the test is confirmed a sample has to be examined with the Western Blot or IFA tests. The rapid tests are done with blood samples, and some require only an oral swab. Testing used to involve obtaining written knowledgeable consent from the patient, but now physicians can say, “You will be tested for HIV unless you specifically opt out of testing, and sign a statement that you decline testing.”

HIV affects certain lymphocyte white blood cells called CD4 cells, and causes them to die. This is why resistance to the disease is so dramatically decreased. When the CD4 count cascade below a certain measurable amount, it is deemed time to start antiretroviral therapy (ART). The resolution number of real viral particles can now be measured, and this number can also be used to start ART.

There are a considerable number of antiretroviral drugs available at this time.  Skilled usage of them includes determining if the virus is resistant and if adverse effects of the drugs might be anticipated. Usually three of the drugs are given as a “cocktail” to avoid viral resistance. The patient is checked every three months for CD4 count and viral load to see if the cocktail is effective or if new drugs need to be used.

Once again, early diagnosis and treatment is the key to survival. If you are a patient, and the doctor says, “We are going to try out you for HIV unless you opt out,” don’t be offended or get your feelings hurt. It’s sort of like being scanned at the airport: nobody said you had a bomb; it’s just what is done to care for everyone’s protection, including yours. The doctor is simply doing his job. If you turn up positive, the doctor has probably just saved your life. There will be a lot of repercussions like “Everywhere did I get this?” and the psychological shock and denial of having a chronic illness, but these can all be dealt with on an individual basis.

Don’t be a mortality statistic. Get tested on a regular basis (e.g., annual physical, Pap smear, pregnancy, etc.).  If you have HIV, follow-up with your doctor every three months. Take your ART every day, exactly on time and without missing a dose. With more universal testing and treatment, we hope to minimize the incidence of this disease, and to manage it over several decades, rather than the too common small survival of AIDS once the HIV has progressed.

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This digital document is an article from Morbidity and Mortality Weekly Report, published by Thomson Gale on February 3, 2006. The length of the article is 485 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after buy. You can view it with any web browser.

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National Black HIV/AIDS Awareness Day, February 7, 2006.: … from: Morbidity and Mortality Weekly Report

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In a people everywhere 200 die of AIDS every day, a new way of life is emerging. Malawi, a small people in South East Africa, has reached a turning point–it will either sink into unknown depths of despair and poverty or it must grow and change with AIDS as a catalyst. Lifecycles: a tale of AIDS in Malawi is a 57 small documentary that explores the themes of sex, witchcraft, poverty, death and religion in relation to AIDS. With a soulful soundtrack from Bobby McFerrin, … More >>

Lifecycles: a tale of AIDS in Malawi

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Statistics only tell a part of the tale–putting faces to the numbers. The AIDS epidemic is not going away. An entire generation has been decimated and the prospect looks bleak. ___, ___, ___ people are affected by AIDS every day. Yet hope remains. ___, ___, ___ people are not giving up hope, will we? Delight follow these links to gather more about the reality of HIV/AIDS: www.amsa.org www.unaids.org www.cdc.gov Just a few ways to get caught up: www.amsa.org www.amsa.org my.care.org www.joinred.com http

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A few years ago, I took a class at ETSU: Biology and Beyond which was a course that dealt with education on HIV and the history of AIDS. I wanted to gather more about the disease so I signed up for the class. It was one that would forever change my life. While taking the class, I was not only able to hear the tales of extraordinary people but I also learned of their horrific, yet heroic lives after learning they were living with HIV. Today, our global convergence ignores the fact that HIV and AIDS is on the rise again and as the memory of persons lost to AIDS seemingly fades in the eyes of our leaders; their voices should forever be heard throughout the world.

HIV and AIDS are as different as Night and Day, HIV is Life and AIDS is (still) a death sentence.

You can live with HIV but you will die of AIDS. You can fight the battle as hard as your body will allocate but AIDS will win the war. While our leaders refuse to spend more money and time on prevention, people continue to die and AIDS is gaining ground on us as a global convergence.

We haven’t found AIDS to be contained at any point since its first advent in 1981, when the CDC learned of the epidemic that would later be referred to as AIDS (Bought Immune Deficiency Syndrome). By the year 2000, an estimated 36.1 million people were living with HIV/AIDS and an estimated 800,000-900,000 people were living with the virus in the United States. According to statistics posted at http://www.one.org , 38 million people are now infected by HIV/AIDS. While some say there is progression toward finding a cure, many are blinded by facts that simply don’t exist. While some will convince themselves it will not change them or their lives, an estimated 2.8 million people died in 2005 and in that same year, an estimated 4.1 million people were infected with the virus (2006 Report on the Global AIDS epidemic, UNAIDS, May 2006). With rising numbers once again, eventually this disease will change you or someone you know.

The timeline of the disease is staggering and persons lives that have been affected by HIV and AIDS include far more than the names we will all remember. I have the permanent tales of Kimberly Bergalis, Elizabeth Glaser, Debbie Runions, and a precious small boy named Ryan White forever in my mind. All of these individuals seemed to live with splendid daring yet they have died in vain if this people doesn’t start to take a stand now.

I really judge that tomorrow will come with a hellish vengeance if today we ignore what we should’ve done yesterday about this disease.

There’s no question about it. When I first signed up for the Biology and Beyond Class, I thought there would eventually be a cure for AIDS. But, by the end of the semester, after I spent time effective at a local hospital everywhere there were patients diagnosed with the disease, I saw their vision. There wasn’t one. It’s ironic really, many of persons people living with HIV, and later even in the face of death, felt as if they were just the early victims. They knew others would follow and persons who died, knew the tomorrow they wouldn’t see held the same for many more victims as they started to battle for their own last days. The reason is apparent now but back then, it wasn’t that clear to me. HIV and AIDS patients knew there was too much of a stigma attached for full awareness to ever be thriving. This is thanks to misdirected political agendas and it still exists today.

In 1992, Elizabeth Glaser addressed the Democratic National Convention and stated, “Exactly 4 years ago, my daughter died of AIDS. She did not carry on the Reagan administration. I am here because my son and I may not carry on 4 more years of leaders who say they care but do nothing.” She later went on to say, “America Wake up. We are all in a struggle between life and death.”

Elizabeth Glaser pleaded with our leaders in 1992 and all who were in attendance heard her but chose to do nothing. Today, we sit at a standstill as our elected and appointed officials choose how to spend more money and more time just to avoid accepting responsibility. I absolutely judge that tomorrow will come with a hellish vengeance if today we ignore what we should’ve done yesterday about this disease. There is no doubt in my mind.

While state and federal leaders spent hours opposing online wagering, sardonically, they were gambling with the lives of persons who could’ve used their support and would have appreciated the appropriated funds to work toward the fight against AIDS. Instead, our government chose to play craps with human lives and people continued to die.

The fact is, Americans have been led to judge through silence that the AIDS epidemic was on a road that would soon end when in actuality; the spread of HIV has apparently taken a U-Turn when you look at the shocking numbers above.

Let Us Stop This Disease Previous to It Stops All of Us Who Are Left

While I was a student at ETSU, I had the opportunity to meet Debbie Runions who became an advocate for the education and prevention of AIDS. Debbie, after just one sexual encounter became very ill three weeks later and three months later tested positive for HIV. That was in 1992. She too, addressed the Democratic National Convention in 1996 and she too was heard. Our politicians then simply pushed forward in a further direction. Debbie died in October of 2005.

When I heard her speak at ETSU and later had the opportunity to sit down and talk with her, I learned what her life had been like after she was diagnosed with HIV. She talked openly and honestly about her disease. She surprised me when she talked about the fact that she was thankful she had been given the opportunity to have the disease because of what it had allowed her to do. I learned later that was Debbie. She radiated optimism. Debbie knew her fate was sealed yet she chose to make the most of the life she had to live while she could live it even if it would be within the parameters and limitations of living with the virus.

Debbie’s tale will always be imbedded in my mind. I can honestly say after hearing her speak, I was deeply humbled and truly feel she made a profound difference in so many lives. She had a gift to give through her message and her moral fiber will live on forever but her hope for political intervention may not.

While our politicians have been slinging mud at one a further, their efforts could’ve been redirected in a more positive light. Instead of ministers on television running around with an entourage of followers running up astronomical bills on lavish lifestyles, they too could help. Instead of picking up prostitutes on their congregation’s dollars, they could make a choice to spend their money to save a family ridden by poverty and AIDS.

Our people and the entire global convergence must know, this disease doesn’t just pick out favorites. It attacks people of all races, young and ancient, straight and gay. The disease is not interested in what you look like, who you’ve slept with, or what drug you’ve place in a needle. This disease takes hostages and then slowly but surely, starts terrorizing them with the stigma of the disease itself and the dread of dying.

We do have an epidemic on our hands. While our leaders have gone from one issue to a further, people have gotten sick. While meetings were conducted to choose something as frivolous as whether or not Americans could have the freedom to gamble online, more people died. While a television evangelist took his body guards out for a further four thousand dollar outing, countless people clung to their one dollar a week and still others were left in the epitome of poverty because of the high cost of health care and medications for a person living with HIV.

What have we chose holds value in this people? Does a human life no longer hold any substantial meaning to persons in political office with the means to do something to help mankind? Apparently not, but as Americans, we have an obligation to do something to help. This is our world and our problem.

We no longer have the Debbie Runions and Elizabeth Glasers to speak out at the Democratic Conventions. Now it is up to everyone else to lead by their model. Visit ONE and start doing your best to make a difference. Global AIDS and extreme poverty is more vital than who’s sleeping with whom. It’s far more detrimental to our society than any online gambling campaign just to prove a political point and it is surely more vital than listening to the ramblings of a television evangelist asking for your money so he can go buy his methamphetamines.

Isn’t it time after all the pleading from persons who had their lives cut small that we finally take a stand? Isn’t it time we demand for our government to take the initiative to fight extreme poverty and Global AIDS? Isn’t it time for a day of reckoning? The debt we’ve paid to this global crisis has already been way too high. It’s time this people took a stand on the vital issues at hand. It is time for retribution.

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The XVII International AIDS Conference in Mexico City from August 3 through 8 has, as its stated goal, to conduct a forum that â??promotes scientific excellence and investigation, encourages individual and collective action and dialogues, and fosters accountability.â? The conferenceâ??s impressive agenda is testimony to how far we have come in production with the worldwide problem as well as how much has been forgotten regarding the early causes, and rapid spread, of the illness in America. Specifically, why were the rather obvious dual goals of prevention and education ignored for so long?

By the summer of 1981, an unnamed phenomenon was being usually discussed in medical circles. Three here-to-fore rare illnesses: a pneumonia (Pneumocystis Carinii), a cancer (Kaposiâ??s Sarcoma) and a fungus (Candida) were atypically being observed in increasing numbers in generous American metropolitan centers. A Center for Disease Control (CDC) task force made a new term grouping them as â??Opportunistic Infectionsâ? meaning conditions that would not normally appear in healthy individuals and which, therefore, needed some â??opportunityâ? to show themselves. Sadly, since the problem was so fundamentally based in the homosexual convergence, it did not place a match to concern in government or even among the general public. A conservative wave had come to power in Washington, DC, and it was clear that as long as â??normal Americansâ? were not at risk, there was no reason to prioritize research programs or even education. 

In January of 1982, the CDC had documented one hundred eight cases of the â??syndromeâ? and formed an â??Opportunistic Infection and Kaposiâ??s Sarcoma task force.â? It requested $830,000 from the NIH (National Institute of Health) multi-billion dollar budget â?? a request that was denied. Of primary concern was whether the illness was bacterial or viral. If the former was right, surely an antibiotic could easily be identified to kill the bacteria. In the case of the latter, the virus would have to be â??isolatedâ? so that a vaccine could be made from the antibodies the infected personâ??s immune system makes to fight the virus. The term â??isolatedâ? was coined with the discovery of the electron microscope in the mid-twentieth century that allowed researchers to really â??seeâ? tiny viruses. Once the virus is isolated, it was thought, a vaccine could easily be made â?? like Jonas Salk had done with Polio. As we all know, the Polio virus still exists. The vaccine does not ruin the virus but rather it changes the host who has been immunized so that the virus becomes ineffective and thus irrelevant. 

While scientists on both sides of the Atlantic were racing to identify the virus, the condition was being called â??the gay plague.â? Fortunately, the gay convergence thought during the winter of 1982, there were increasing hints that the new illness was not confined to homosexuals. On February 25, 1982, The Wall Street Journal featured an article titled â??New, Often Fatal, Illness in Homosexuals Turns up in Women, Heterosexual Males.â? A month later, The Los Angeles Timesprinted a similar piece to coincide with the CDCâ??s announcement that the number of cases had nearly tripled in three months to two hundred eighty-five. The CDC had changed its name for the disease from GRID (Gay Related Infectious Disease) to AIDS (Bought Immune Deficiency Syndrome), signaling the discovery that the general populationâ??s immune system was somehow being targeted.

Clusters of new sub-groups started to emerge which led to the calloused term â??four Hâ??sâ? for homosexuals, heroin addicts, Haitians and hemophiliacs, presumably in decreasing peacefulness of undesirability. 

By 1983, the illness had been observed in sixteen countries and most scientists had come to judge that AIDS was indeed caused by a virus. Jean-Claude Chermann, at The Pasteur Institute in Paris, was the first to suggest that AIDS was not only a virus but a â??retro-virusâ? and, importantly, was not the same virus that causes leukemia as was theorized by Robert Gallo at The National Cancer Institute (NCI). A retro-virus not only attacks and kills its target but it invades the cells thus releasing many clone viruses after it destroys the attacked cells. This soon to be recognized fact, along with the added problem that, with the passage of time, the virus was â??mutatingâ? (making variations of itself) seriously magnified the difficulty of producing a vaccine. 

In November, 1983 representatives from thirty nations attended the first AIDS conference in Geneva, Switzerland, as the number of reported AIDS cases in America rose to over 3,000. Regular annual meetings named â??International AIDS Conferencesâ? started in 1985 in Atlanta, Georgia. 

1984 saw the beginnings of a sad phenomenon that slowed the research trying to isolate the still unseen virus that causes AIDS. The Pasteur Institute in France and the National Cancer Institute in Washington started competing rather than cooperating â?? both in suspense to win the Nobel Prize in Medicine. The two teams could not even choose on what to call the mystery they were looking for. The French referred to the virus as â??LAVâ? while Doctor Gallo, holding firm to the concept of a link with HTLV-I (the virus that causes leukemia), called it HTLV-III. As any hopes of a trans-Atlantic cooperation disappeared, the number of reported cases was skyrocketing. In April of 1984 there were 4,100 reported cases in America with 1,807 deaths. Two months later the facts had risen to 5,000 cases and 2,300 fatalities while only a few superficial, palliative treatments were available. 

In the spring of 1984 America lost a splendid opportunity to de-stigmatize AIDS which would have accelerated research and education. Actor Rock Hudson was diagnosed with AIDS. For months he tried in vain to hide the news while being treated in France â?? sardonically at The American Hospital of Paris. He did manage to fool one vital friend, but. At a White House celebration in August, 1984, and in response to First Lady, Nancy Reaganâ??s question regarding the actorâ??s gaunt advent, Hudson claimed he had been food poisoned in Israel while shooting a film. Worse, perhaps, Reverend Jerry Falwell said we all â??needed to return to moral sanityâ? and not to â??favor homosexualsâ? in medical research. The un-protested comment was made during a speech at the Democratic National Convention in San Francisco. 

Finally, and for the first time since one of the most overt act of discrimination in modern history had begun, public protests erupted in California and New York amid confusion of how the virus was contracted. Many believed it was transmitted through casual contact such as kissing or sad and, therefore it was suggested, the â??contaminatedâ? individuals should be quarantined. Others took an opposite point of view. Doctor Gallo said that only one out of one hundred people who were exposed to the virus would progress to developing â??full blown AIDSâ?. That theory was discounted when the number of reported cases crossed the 6,000 mark and Ronald Reaganâ??s first term was drawing to a close without the Head having ever addressed the problem during a policy speech. In fact he had never uttered the word â??AIDSâ?. 

Shortly after Ronald Reagan was sworn in for his second term, and as the number of American AIDS cases reached 8,000, the Office of Management and Budget (OMB) really cut spending for AIDS research from $96 million to $85 million. Equally disappointing was the fact that the CDC did not fund a proposed unit which was suggested to be called â??Operations AIDS Controlâ? even though there was increasing documentation of heterosexual transmission of the virus as well as a reported incidence of the disease in the US Army and new awareness of the risks associated with allotment IV needles.

By mid 1986, the â??two virusesâ? (HTLV-III and LAV) were recognized as one and internationally renamed HIV (Human Immunodeficiency Virus). At the same time, it was becoming usually accepted that that there were several strains of the virus and that the simplest way to determine the virusâ??s look and hurt to the immune system was to measure a type of white blood cell called the CD-4 lymphocyte, also known as the â??T Helper Cellâ? and commonly referred to as the â??T-Cellâ?. By this time, the number of AIDS cases in America had passed 10,000.

The early evolution of AIDS in America chronicles a sad chapter in our history. Questions proliferate regarding what the progression of AIDS might have been if Head Reagan had emphasized education and prevention. Would an early government â??Manhattan-type Projectâ? to learn a vaccine previous to HIV mutated have been possible? If Rock Hudson had confided in Nancy Reagan, might she have convinced the Head to consult experts and call attention to safe sex education? Obviously, there are no verifiable answers to these theoretical questions. 

Luckily, but, the world now benefits from Herculean efforts to combat the AIDS crisis such as the Clinton Global Initiative (CGI) and the Bill and Melinda Gates Foundation in cooperation with Warren Buffet. These laudable programs are trying to address the challenges posed by the thirty-three million cases of HIV worldwide. But, while these topics will be discussed and analyzed at the XVII International AIDS Conference, let us remember the innocent, early victims who died frightening, painful and dehumanizing deaths. 

©2008 Richard René Silvin

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This video podcast from the CDC, AmfAR, and Discovery Health, focuses on the history of HIV/AIDS from 1981 through 2008.

On Tuesday, February 19th, 2008, at 12pm, local youth HIV/AIDS activists will hold a press conference in front of Graham, Putnam and Mahoney Funeral Home at 838 Main Street, Worcester, demanding that the US Centers for Disease Control release statistics showing that 50% more people per year are infected with HIV than previously believed. The CDC has had these statistics since at least November 2007, but has yet to publically release them or make them available on the CDC website….