It has been 30 years since the first cases of HIV/AIDS were officially reported in the United States.
A lot has changed since that initial group of patients was described in a report from researchers at the Centers for Disease Control and Prevention.
Innovations like rapid finger-prick blood testing and new antiviral medications that can make the virus virtually undetectable were major breakthroughs. But much remains the same: while HIV/AIDS is not the death sentence it once was, the stigma of infection is still so great that practitioners say it's tough to get people in for testing. Some people at high risk still don't take the disease seriously — or even realize they're at risk.
Lisa Cohen is a health educator who has been on the front lines of the epidemic since 1981, when she first started seeing extremely sick men turning up at the Pinellas County Health Department. Today she is operations manager and HIV/AIDS program coordinator for Pinellas.
"We had nothing to offer patients in the beginning," said Cohen, "But today, patients are living a long time, 30 years in some cases. It's amazing how far we've come."
Today is World AIDS Day, when the state of the disease is assessed and those who have died are remembered. Cohen talked to the Times about the changes she has seen and her hopes for the future.
What was it like to work in public health when the disease was first identified?
It was scary because we didn't know what we were dealing with. It was a new infection called a gay-related infection. People were getting so sick. They were coming in looking like they had been in a concentration camp, very, very thin, with flu-like symptoms, and they didn't have any place to go for treatment. There was nothing we could do. When we learned it was sexually transmitted, we started talking about prevention, how the disease was spread.
What about awareness today?
I don't think people have forgotten about AIDS, but they have become apathetic. There are so many other problems: homelessness, the economy, access to health care. I think people still don't take the disease seriously enough. They don't realize that one exposure through unsafe sex could put them at risk. Also, because it can now be treated, there seems to be a lack of concern.
Is it as easy to treat as some seem to think?
It's easier, yes, but not easy. It can be manageable if you get tested early, follow your doctor's orders and take your medication. But HIV infection and AIDS are still very, very serious. There is no cure for the disease and it is life-threatening if you don't get tested and start on medication. The drugs are very toxic, cause a lot of side effects, they are difficult to obtain and the cost is astronomical. It's much better not to become infected.
What surprises you most about AIDS today?
The increase in cases in people over age 40 — that's across the state. We're not sure why, maybe they think they don't need to practice safe sex at that age. We're working to educate this population. And, we're still whispering about it. There's still a huge stigma around HIV and AIDS. I'd love to create a campaign to get people talking about it.