A Letter to the Editor


Photo Courtesy of Will Chai.

Senior Will Chai interns under Dr. Seble Kassaye, the Principal Investigator of the Women’s HIV Study at Georgetown University Medical Center.

By Will Chai, Guest Writer

About the Author: Will Chai is a CHS senior interning at Georgetown Medical Center’s Women’s Interagency HIV Study since 2016. He researches HIV transmission by constructing phylogenetic networks that identify HIV transmission clusters and could predict future outbreaks.

Preface: Since the early 1980s, the global HIV/AIDS pandemic has claimed millions of lives and impacted countless others. Although the disease has been relegated to a chronic illness in many developed nations, HIV remains a prominent issue even in our area. In fact, according to the Center for Disease Control (CDC), Washington D.C. has the highest rate of HIV infection in the nation.

The Pandemic Begins: It was 1982, a mysterious illness was gripping the nation. By the year’s end, the CDC reported 270 people in multiple states had been infected by the disease — and 121 of them had died. Strangely, patients across America began experiencing compromised immune systems and succumbed to normally benign diseases such as Kaposi’s Sarcoma. Scientists suspected an unknown factor was at play and by the end of 1982, a diagnosis was made: Acquired Immune Deficiency Syndrome (AIDS). Soon afterwards, the human immunodeficiency virus (HIV) was identified as the cause of AIDS.
But before the virus could be better understood, the global pandemic began. Countries across the world reported similar outbreaks, especially among homosexual populations and low-income, minority communities that were plagued with illegal drug use.

The Ensuing Turmoil: With the continuous uncertainty surrounding the transfer of HIV, fear and confusion spread faster than the virus. In national broadcasts, some televangelists such as Jerry Falwell even claimed AIDS was “not just God’s punishment for homosexuals” but also “punishment for the society that tolerates homosexuals.” Communities across America ostracized anyone who was suspected of being at risk for AIDS, and homophobia was rampant. But no anecdote captures the initial HIV panic as vividly as the story of Ryan White.

In Dec. 1984, a contaminated blood transfusion infected the 13-year-old boy with HIV/AIDS. He was given six months to live. Soon after his diagnosis, White faced intense discrimination from his community. According to an interview with the U.S. Health Resources Administration, his mother, Jeanne White Ginder said, “It was really bad. People were really cruel, people said that he had to be gay, that he had to have done something bad or wrong, or he wouldn’t have had it.” White was subsequently expelled from his middle school and forced to move out of his neighborhood. But after relocating to Cicero, IN, White was able to continue his education until his death — a month before high school graduation. Ryan White’s story brought the HIV conversation to the mainstream and inspired the passage of the Comprehensive AIDS Resources Emergency (CARE) Act, which provided federal grants to help people living with HIV. However, his tale remains a painful reminder of the stigma and discrimination that victims of HIV often still experience.

HIV in the Present Day: Today, through the development of antiretroviral medication, HIV is no longer a death sentence. However, there is no permanent cure for HIV, and it remains a dangerous threat in developing countries. According to The World Health Organization, 36.7 million people live with HIV/AIDS worldwide, and one million people died of the disease in 2016. No other region of the world is impacted by HIV/AIDS more so than Sub-Saharan Africa, where poverty, governmental corruption and a lack of infrastructure make the delivery of medication an enormous challenge.

In the U.S., HIV/AIDS disproportionately affects homosexual and minority populations. According to the CDC, in 2014 53 percent of total deaths attributed to HIV in America were African Americans. And 70 percent of all newly infected HIV patients were homosexual or bisexual. Furthermore, many HIV-positive people experience continued social stigma. In a 2011 study published in AIDS Patient Care and STDs, the most common reasons for not seeking HIV treatment were due to shame and embarrassment.

HIV Prevention: HIV awareness is a powerful tool for not just fighting against HIV stigma, but also to protect against infection. According to the CDC, Washington, D.C. has the highest rate of HIV infection in the nation, where one in 13 people in the District are at risk of acquiring the virus in their lifetime.
HIV can only be spread through the direct transmission of bodily fluids such as blood, semen or breast milk. According to the NIH, you cannot “get HIV from casual contact with a person infected with HIV, for example from a handshake, a hug, or a closed-mouth kiss. And you can’t get HIV from contact with objects such as toilet seats, door knobs, or dishes used by a person infected with HIV.” Safe sex and condom-use are also identified as essential practices for the prevention of HIV and STDs in general.
People who suspect they have been exposed to HIV should immediately contact their doctor and consider taking pre-exposure prophylaxis (PrEP) to reduce the risk of infection.