AIDS: no longer a death sentence
Robert Wood on the development and impact of effective treatment. (Oral history interview, June 2016.)
New medications: a sea changeIn 1994, researchers reported that the medication AZT was found to decrease the chance that babies of HIV-infected women would be born HIV-infected. Testing and treatment for pregnant women were quickly adopted. The new medications were also found to be effective in slowing or preventing AIDS-related illness in HIV-positive individuals. At first, treatment was provided to those who were close to becoming ill with AIDS. Then, from 2009, increasingly earlier treatment proved to be more effective in preventing illness, and, more recently, antiretroviral medications have been found to be effective in preventing new HIV infections. The availability of effective treatment changed people’s views on testing, partner notification, and HIV case reporting, as early knowledge of one’s HIV-status could prove life-saving. No longer a death sentence, HIV came to be regarded with less stigma and fear. A negative impact of this change was that some people began to abandon safer-sex practices, leading to an increased incidence of other STD’s, in response to which Public Health renewed its education and prevention efforts.
The epidemic peaks1996 was the first year the CDC reported a national decline in AIDS deaths, attributed both to new medications and a slowing of the epidemic and new cases of HIV. In the third quarter of 1996, Dr. Robert Wood, looking back at the first ten years of AIDS control, announced in the state’s HIV/AIDS Quarterly Epidemiology Report “the first (and very welcome) news that the local AIDS epidemic has reached a peak.”
1995577 new cases
2,852 deaths to date
1996493 new cases
3,164 deaths to date
1997319 new cases
3,302 deaths to date
“I think it has been beneficial for society to have had to struggle with a very serious disease for which there is yet no cure or preventative vaccine. [Instead of relying on medicines], HIV control has had to rely on…behavior change, targeting socially disparate and disadvantaged communities. “More frighteningly than many diseases, HIV has also highlighted for us the tight interconnections between diseases and social factors like poverty, homelessness, stigmatization, discrimination, and lack of fully effective sex and drug education.”
– Dr. Robert Wood, 1996.
HIV today in Seattle and King CountyBy 2015, HIV infection rates had dropped by one-third nationwide. Most of that decline occurred among heterosexuals and injection drug users. On the national level, the infection rate among men who had sex with men remained the same. But, in contrast to other areas of the country, Seattle-King County showed a decline in HIV among gay men.
In a July 2014 radio interview, Dr. Matthew Golden, director of the Public Health Department’s combined HIV/STD program, credited several historical factors contributing to the department’s comparative success in combatting AIDS:
Better funding for HIV/AIDS prevention and care in Washington State and King County than nationally
A demographic that did not disproportionately include injection drug users
Excellent collaboration with engaged community groups to bring AIDS prevention messages to groups at risk, particularly gay men
An efficient public health system