In the early 1980s, I worked at a hospital situated near Chicago’s Boys Town, a neighborhood that had become popular with young gay men. The AIDS epidemic was just starting, and we knew nothing about the disease. What caused it, was it transmissible, how could we treat It? All we knew was that homosexuals admitted with red blotches all over their bodies and a weird pneumonia would almost certainly not leave the hospital upright.
A recent article in the “Annals of Internal Medicine” (September, 2021) illustrates a notable contrast between then and now.
HIV-related mortality has been decreasing since effective therapy was introduced in 1996. In the period between 1999 and 2004, when therapy was just beginning to get wide distribution, persons entering HIV care had a 14.5% chance of dying in five years. In the general population the figure was 3.4%. Between 2011 and 2017, these numbers were 5% and 2.3%.
In the 1990s, AIDS-related deaths accounted for 50,000 deaths annually in the United States (thru 2020, the world-wide death toll is over 36 million). Mortality has decreased by 37% from 2010 to 2018, and I wonder how many people we treated in the early 1980s would be alive today if we had had the medications we have today.
HIV-AIDS has basically become a chronic disease–manageable in much the way diabetes is. However, there is much work to be done: 14% of people with HIV in the US remain undiagnosed.