June 5, 2006    

25 YEARS OF HIV/AIDS

By Jannette Williams, chair of the board of directors of Whitman-Walker Clinic (bio)

For gay men in America, the world would never be the same after June 5, 1981.

On that date 25 years ago, a newsletter published by the Centers for Disease Control published an article detailing what appeared to be an odd medical coincidence. The Mortality and Morbidity Weekly Report described the cases of five young gay men who all developed a rare pneumonia in conjunction with cytomegalovirus, a common but usually silent virus, and mucosal candidiasis, colloquially known as thrush. Two of the men, ages 33 and 29, were already dead when the two-page item appeared.

“The fact that these patients were all homosexuals suggests an association between some aspect of a homosexual lifestyle or disease acquired through sexual contact and Pneumocystis pneumonia in this population,” the piece noted drily. “All the above observations suggest the possibility of a cellular-immune dysfunction related to a common exposure that predisposes individuals to opportunistic infections such as pneumocystosis and candidiasis."

A month later, The New York Times ran a front-page story on this strange cluster of illnesses and soon, gay men everywhere seemed to be sick or dying. Only a dozen years after the Stonewall Rebellion had liberated so many from lives of quiet despair, a mysterious disease seemed to be targeting and terrorizing gay men. Ultimately, the illness that dared not speak its name finally acquired one that has endured: AIDS.

Twenty-five years later, we have come a long way, but at what price? More than half a million have died in the United States, more than all of the Americans killed in World War II. More than one million Americans are infected with HIV, one-third of whom don’t even know it; more than 22 million have died worldwide.

Despite those statistics, we have made some progress. Education and prevention efforts, including correct and consistent condom use and needle exchange, have helped to reduce the spread of the virus. New medications help keep people with HIV healthy for many years. Much of the panic and fear that accompanied the early days of the epidemic have faded as knowledge has increased.

However, that progress is not enough. Every year, 40,000 Americans are infected with HIV. Infection rates are skyrocketing among African-Americans, Latinos and women. New infections among gay and bisexual men are on the rise again. Government funding for services continues to remain flat despite an increasing number of HIV cases.

Stigma around the disease continues to hamper efforts to effectively combat it by making it a topic that is not discussed openly and honestly. And, sadly, death rates for AIDS have begun to rise again after nearly a decade of decline.

Life-prolonging HIV medications are expensive and have severe side effects. Patients who take these medications are on permanent chemotherapy.

Promising new medications are in development and clinical trials of vaccines are under way around the world. But, for now, there is no cure and there is no vaccine.

Whitman-Walker Clinic has been here from the very start of the HIV/AIDS epidemic. Over the last 25 years, we have built a model of competent, compassionate and effective care for our clients.

We offer free HIV counseling and testing at our Elizabeth Taylor Center in Northwest Washington site, our Max Robinson Center in Anacostia and our Northern Virginia facility in Arlington. Our mobile testing units go into the community and provide HIV testing and education to populations at high risk.

We wrap around our clients a range of medical and social support services to treat not just their HIV disease but other issues that could complicate effective treatment. These services include medical and dental care, counseling and addictions treatment, nutrition assistance, legal guidance, case management and day treatment.

Although we were once a free clinic, today we accept insurance, Medicaid, Medicare and other forms of payment. But no one is turned away because they can’t pay.

As we reflect on a quarter-century of HIV/AIDS, we remember our lost friends, too numerous to name. We recall their service to Whitman-Walker Clinic and continue to feel their absence.

And we hope that within the next 25 years – well within the next 25 years -- we can finally celebrate the end of this terrible human tragedy.