AIDS at 30: Dallas Panel Examines Epidemic's Present and Future

Thirty years after AIDS began ravaging the gay community in San Francisco and New York, the epidemic is no longer a gay disease. Those who live with the virus can expect to live close to normal lifespans. And work is progressing towards a potential AIDS vaccine.

Several experts weighed in on the present and future of the event at the Cathedral of Hope in Dallas on Tuesday, June 28. Sponsored by the Dallas Voice, the panelists who took part in "AIDS at 30, A Community Forum" included Dr. Manisha H. Maskay, associate executive director of AIDS Arms, Inc.; Dr. Brady Allen of Uptown Physicians Group and Dr. Christopher Evans of AIDS Arms, Inc.'s Infectious Diseases Peabody Health Center.

In large part, the presenters had good news.

HIV/AIDS is no longer a death sentence. There are currently more than a million people in the United States living with the virus. The infection rate has been flat lining for many years and death rates are stable. In Texas, the number of people living with the virus is going up, but that's because people with HIV are living longer.

The outlook for a normal life span, however, may be breeding complacency. Panelists, as well as several audience members-many of who identified themselves as positive, expressed that particularly among young gay men, the guard has come down as fear of the disease has subsided.

Maskay offered cautionary statistics. In the United States today, someone contracts HIV every nine and a half minutes. Among men who have sex with men, infections are beginning to increase. Testing rates are flat. Misconceptions, complacency and a stigma about being positive continue. And moreover at any given point some 21 percent of those with HIV do not know they have it.

Maskay's suggested solutions include focusing outreach efforts on both people with HIV and those not infected. "We have not done that well until recently," he said. "We have focused on prevention with one group of people, and focused on treatment with those who are infected. Prevention and treatment need to be an integrated and sustained process."

Allen seemed to give credence to this approach. Research shows people who know they are positive practice risk-reducing behaviors. More, those with HIV with low viral loads have a significantly lower risk of transmitting HIV.

"There's clear-cut evidence that if the virus is undetectable, it's almost impossible to transmit," said Allen. "They've shown in San Francisco that with a lower community viral load, transmission rates decrease." That's not to say its' okay to have unprotected sex with low viral loads, as one audience member mistakenly took it to mean. He then asked for clarification.

Looking to the future, there is one case where AIDS has been cured. That process involved a Leukemia patient who received a transplant of HIV-resistant stem cells. Four years later, there's no trace of the virus.

Evans said efforts are under way to develop HIV vaccines and looking at how they could be used as therapy for someone who already lives with the virus. He added, however, a vaccine would be part of a multi-faceted approach. And as part of this multi-pronged effort, researchers are looking at ways to activate HIV that is lying dormant in the body of someone with it and block it with drugs.

Audience members also commented that younger adults now view HIV as a manageable disease, but don't realize the day-to-day difficulty and expense involved with managing it. Another commented that the message is concentrated in urban areas with high-risk populations, but falls flat in the suburbs with populations of closeted men who have sex with men who live heterosexual lives.

Allen said people with HIV/AIDS are dying from the same things of which old people die. He added a person who lives with HIV today may never even get sick.

"Everyone should be in remission," said Allen. "If you get into treatment and take medication, there's no reason to get sick."