This podcast, produced by Discovery Health, provides an overview of the HIV/AIDS epidemic from 1981 through 2008. Footage courtesy of Associated Press (AP). It's part of Discovery Health's continuing medical education (CME) program, Managing Comorbidities of HIV/AIDS, featuring infectious disease expert, Dr. John Bartlett, and former CDC Director, Dr. Julie Geberding. Created: 11/26/2007 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).
Date Released: 11/26/2008. Series Name: CDC Featured Podcasts.
[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC - safer, healthier people.
[Announcer] The lives of people with HIV and AIDS have changed dramatically since the beginning of the epidemic, almost 30 years ago. The combination of scientific advances, policy changes, and the activist movement led to major progress in a remarkably short period of time. Since the first cases appeared more than 25 years ago, HIV/AIDS has been transformed from a death sentence to a disease people can live with for decades. Here’s how it happened.
June, 1981: A report of five gay men with Pneumocystis pneumonia – a condition typically found in people with suppressed immune systems. That’s how it started. Five cases. No one could have known the enormity of the coming epidemic. Dr. Julie Gerberding is Director of the Centers for Disease Control and Prevention.
[Dr. Julie Gerberding] I was an intern when the first patients were observed and reported. And there was a period of time at San Francisco General Hospital when each day we’d have more patients than we had the day before.
[Announcer] Doctors were dumbfounded. They had no idea what was causing this strange disease in gay men. And soon, they were seeing it in other populations - I-V drug users and people who had had blood transfusions - and they had no idea how to treat it.
[Dr. John Bartlett] Until we had a virus in hand, we really had no therapy directed at the virus or against the cause of the disease. So we did the best we could, and we didn’t do well at all.
[Announcer] Then, in 1984, a big breakthrough: isolation of the virus. And in 1985, the next milestone: FDA approval of the first test for HIV antibodies. This was a major victory. It meant the blood supply could now be screened for HIV and the hope for truly effective treatment became reality.
[Dr. John Bartlett] The initial treatment was with AZT, a discarded cancer drug.
[Dr. Julie Gerberding] Initially there was this incredible hope because we saw a drug effect. And then there was this incredible crash when we saw that it didn’t last very long.
[Dr. John Bartlett] In the early years, every drug we threw at HIV learned to become resistant. And every one of them had kind of a short life of benefit.
[Announcer] In less than five years, AIDS had already claimed about 10,000 lives.
[Announcer] Fashion designer Kenneth Cole is chairman of amfAR, the Foundation for AIDS Research. He made the fight against AIDS his personal crusade very early on.
[Kenneth Cole] Here is something that so profoundly stands to affect so many, and we’re not dealing with it, and we’re not addressing it. Our leadership is not dealing with it in the place that they must if we’re ever going to get our hands around it.
[Announcer] As activists feared that silence and stigma were paralyzing progress, they called more and more visibly, for a government response.
[Dr. John Bartlett] They made their protest very loud and sometimes obnoxious. But I think most of us feel that all of medicine now is changed as a result of their presence and their protest.
[Announcer] By the early nineties, treatment took a substantial step forward when doctors learned to combine HIV medications to create so-called drug cocktails.
[Dr. John Bartlett] We did try to put the drugs together 'cause we knew one drug wasn’t gonna do it so we thought well, maybe if we mixed various combinations, which was the right way to go, but nothing worked 'cause it just didn’t have potency.
[Announcer] More had to be done. Heavy-hitting advocates, like Kenneth Cole and anfAR, brought the influence of star-power and cutting-edge campaigns to the effort. And a much different type of celebrity impact – some very high profile cases of HIV and AIDS.
[Magic Johnson] The HIV virus that I have, I will have to retire from the Lakers.
[Kenneth Cole] Magic Johnson kind of hit a nerve. He was African American; he was a big, strong, heterosexual, athletic male. And he changed that sense of at-risk, and it all got re-defined that afternoon for a lot of people. And it wasn’t comfortable for a lot of Americans.
[Announcer] Not comfortable because people began to see that anyone could get HIV.
After a decade of struggle, a new class of drugs revolutionized treatment. By attacking a key HIV enzyme called protease.
[Dr. John Bartlett] The protease inhibitors represented the swing point. Our clinic was a clinic where we prepared patients to die. Then we moved into an era where that clinic shifted, almost immediately in 1996, where we prepared patients to live. The transition was very dramatic. The death rate has gone way down.
We had the tools in 1996; now we’ve got really great tools, and a lot of them - 23 drugs. Now people are talking about “no patient left behind.”
[Announcer] Today, some can even treat their HIV with a single pill a day. Thanks to the incredible success of the combined efforts of medicine and activism against this fierce enemy in such a short time, people with HIV and AIDS can live much longer, healthier lives. But that’s posing a new challenge.
[Dr. Julie Gerberding] That can be interpreted to mean that this is no longer a serious problem – that it’s now somehow a chronic disease. Well, I would dispute that vehemently.
[Announcer] In part because, still, each year in the U.S., thousands of people die of AIDS. And many of those with HIV don’t even know they have it.
[Dr. Julie Gerberding] Today we’re in a position where HIV testing should be an absolutely routine part of good medical care for almost all adults.
[Announcer] And higher infection rates are being found in certain minority populations.
[Dr. Julie Gerberding] Right now, that includes men who have sex with men; it includes African-Americans and Hispanics in many areas.
[Announcer] So today, those same fighters who stood up and took action when the first cases appeared, are doing it again. Kenneth Cole – with a new campaign, called Awareness.
[Kenneth Cole] We’ve sought inspiring life stories of 86 individuals, who through their life’s example, will inspire anyone. And there’s a whole long chapter about HIV/AIDS.
[Announcer] And Dr. Gerberding and the CDC.
[Dr. Julie Gerberding] CDC is very much engaged in launching an enhanced campaign, a social mobilization campaign for HIV and involving community leaders from all sectors.
[Kenneth Cole] AIDS is preventable. It shouldn’t be something that should be so hard to do. We’re living in this delusional state. And we just don’t want to believe that we’re at risk. And that simple human behavior could render us so vulnerable and pay such a high price.
[Announcer]For the most accurate health information, visit www.cdc.gov or call 1-800-CDC-INFO, 24/7.