DR. HOOK- For the better: New HIV, AIDS treatments working

Sheryl Crow sang, "A Change Would Do You Good." Whether we like it or not, things change. Madonna changes her looks every five seconds. We hope you change your underwear everyday. Change in the pocket is like free money. When a straight couple gets married, he often thinks, "I hope she never changes," while she thinks, "I can't wait to change him." I change the channel like I'm flipping through a magazine. Boys going through puberty have a change in voice– well, except Michael Jackson. Even stocks ex-change.

Has our viewpoint changed about HIV and AIDS?   

In 1990, some medical students formed the first gay-lesbian-bisexual-transgender organization at a medical school. But unlike Journey's popular song "Open Arms," this group was not welcomed by the dean. He is reported to have said he didn't want the school associated with an "AIDS-spreading organization."

Little did he know that most gay men don't have HIV and that the majority of the 59 million people who have been infected with HIV are straight. Who says doctors are understanding, compassionate people?

December 1 marks World AIDS Day, and that day the Charlottesville AIDS Support Group celebrates its 20th anniversary. Things have certainly changed since AIDS was first described in 1981.

When I was a medical student and resident, AIDS was a death sentence. Professionally, I have seen many people succumb to AIDS, and personally I have lost friends. Before the age of highly active antiretroviral therapy (HAART), which was introduced in 1996, there were many HIV+ persons whose illness progressed to AIDS with many complications.  

Kaposi's Sarcoma (KS)'s purple lesions would mar beautiful faces and assault internal organs to cause myriad problems. Diarrhea from weird bugs like cryptosporidium and entamoeba histolytica caused people to waste away. Seizures from toxoplasmosis, blindness from CMV, painful swallowing from yeast infections, and many others were terrible complications of AIDS.

Pneumocystis carinii pneumonia (PCP) was an absolute plague for those with AIDS. A good friend of mine almost died of PCP.  His doctors didn't know enough about it, so they didn't put him on prophylactic antibiotics after it went away. They told him, "Well, if you get it again, we'll do something." I said to him on the phone, "You'll be dead!  Take Bactrim!"  

In fact, many people with AIDS cashed in their life insurance policies as they prepared to die.  

What was really bad was how family members lied about their "loved-ones" who had HIV or AIDS. "No, we won't tell anyone he has AIDS. We'll tell everyone he has liver cancer." (Why don't you just tell everyone he's gone to live with his grandparents for nine months?) I have seen so many people die alone because of rejection by family members.

However, within three years of HAART, death, hospitalizations, and AIDS-defining diagnoses decreased 60-80 percent. I cannot remember the last time I saw someone with KS or PCP.  Those with HIV are living healthier, longer lives. So things have changed for the better.  

What about the stigma of HIV? It seems to have improved to some degree, but not totally. Most people I know with HIV are afraid to tell family members and friends because they fear rejection and judgment. That is unfortunate because no one should be judged for any illness. What people need is support.  

Therefore, it is my honor to be an emcee at the AIDS Support Group auction November 10. This uplifting event is to bring awareness of HIV and support to those who are HIV+. Hey maybe I'll sing– like that is a change.

The gala and auction happen November 10 at the Monticello Event & Conference Center. 7-11pm, $65/each; $100/couple. Info: aidsservices.org or 434-979-7714.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.