How HIV/AIDS Treatment has Changed Over Time

Progress in HIV treatment is making it easier for people to stick to their medications. Recently, they've given the thumbs up to new monthly and bi-monthly injections instead of daily pills. This is a relief for those living with HIV. It seems like we're going back to the simpler times when patients only needed one dose, a significant shift from the days of juggling multiple pills every day.

HIV

In the early 1980s, while serving as a physician at the University of California Medical Center, I found myself at the heart of a burgeoning crisis that would define an entire era. San Francisco, known for its progressive spirit, became the battleground against a formidable foe – acquired immunodeficiency syndrome (AIDS).

As one of the pioneering physicians treating AIDS, I witnessed the emergence of an HIV/AIDS epidemic that would reshape healthcare and public health. This virus, attacking CD4 T cells, left people vulnerable to infections, marking the beginning of a global health crisis that has affected over 85 million people and claimed the lives of approximately 40 million since its onset.

Over the next 35 years, we witnessed a transformative journey from the grim days when HIV was a death sentence to today, where it is a manageable, lifelong illness. Collaborative efforts, increased awareness, medical research, and breakthroughs like highly active antiretroviral therapy (HAART) have significantly improved the lives of those living with HIV.

However, the fight against HIV persists. Despite advancements, challenges like poor adherence and first-line treatment failure persist. Treatment adherence is crucial, yet approximately 45,000 people in the U.S are clinically failing first-line ART, and 91,000 patients are non-adherent for complex reasons.

The battle against HIV faces hurdles such as stigma, comorbid mental disorders, and historically high pill burden, leading to treatment fatigue. To address these challenges, innovations like long-acting injectable antiretrovirals offer alternative options for those living with HIV.

As we strive for an HIV cure, recent developments in gene and cell therapy provide promising glimpses into the future. We stand at the brink of a new era, transitioning from daily pill regimens to potentially one-and-done single-dose treatments, unlocking the potential of cell and gene therapy.

Having dedicated my career to treating and seeking a cure for HIV, I find myself both hopeful and exasperated. Hopeful due to the remarkable medical progress, yet exasperated as adherence to HIV treatment remains a crucial yet elusive tool in controlling the epidemic.

While setbacks have been part of the journey, early clinical trials of gene and cell therapy bring renewed optimism. As we reflect on the progress made and the road ahead, I remain hopeful that we are closer than ever to finding a cure, bringing an end to the decades-long battle against HIV/AIDS.


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