Q: What does it mean if you are diagnosed with HIV/AIDS today versus in the late 1980s and the 1990s?
A: In what we now refer to as the bad old days, which is really the late '80s through the the late '90s, when you had HIV it was pretty much uniformly fatal. Once a person had moved on to AIDS, the likelihood of them surviving more than a year or two was low. Now, if they get treatment, we can suppress their virus and we have every reason to believe that someone with HIV/AIDS can live a lifespan pretty close to what they would experience if they didn't have HIV. It's dramatic, there's no question about it. But there are some caveats to that. The earlier someone gets diagnosed, the better their long-term prognosis. If I find someone with HIV who's at an early stage and I put them on treatment, they will do a lot better than someone who's found when they have AIDS already. Those folks have more side effects from the medication, they're more likely to have complications related to the medication, they may already have opportunistic infections or malignancies. In that group, their prognosis is not quite as good. But even in that group, we still can significantly prolong people's lives. As long as they consistently take their medicines, get their virus suppressed and stay under a doctor's care, they're still going to live a long life.
Q: So the message here is ignorance is not bliss?
A: Absolutely. People must get tested. Back in the early days, people could say, "I'd rather not know because there's nothing you can do anyway." That certainly is not true now. There's a whole lot that you can do. And getting tested is not just important for the individual, it's important for society because once we suppress a person's virus, the likelihood of them transmitting the virus to another person goes down dramatically. We still obviously encourage people to have safe sex, always use condoms, but in the case that there are situations where the condom breaks, transmission is still very unlikely to occur from a person who has a suppressed virus.
Q: If you go to the doctor for a routine physical and they do routine blood work, will they test it for HIV/AIDs?
A: They will not. People have the misperception that when I say, "Doc, test me for everything," that means they are going to get an HIV test. That's not the case. Until recently, there was a lot of paperwork that went into having an HIV test. A lot of that has changed since the CDC [Centers for Disease Control and Prevention] changed their recommendations in 2006. Now you can do it with a verbal agreement, but the doctor needs to say to a patient "I'm going to test you for HIV unless you tell me not to." If you haven't had a conversation with your doctor about getting tested for HIV/AIDS specifically, you can assume you haven't been tested. If you're donating blood, part of the form you sign says that you're permitting them to test your blood for HIV and a variety of other things. If you test positive, they will definitely contact you and inform you that your blood tested positive and they recommend a doctor's care.