America's AIDS Miracle

By Michael Elliott

Originally published by Time on November 20, 2014

How the U.S. fought the disease by thinking big and staying smart

At my home in Washington, D.C., placed so that I see it every morning, is a photograph of Princess Adeyeo, a young Liberian woman I met in 2012. Princess had been a refugee during Liberia's civil war; when she returned there, she found that she was HIV-positive. But in Monrovia's John F. Kennedy Hospital she was put on a course of antiretroviral drugs (ARVs), which prevent mother-to-child transmission of the virus, and a few months before our visit she gave birth to a beautiful baby boy. He was HIV-negative, healthy.

Right now, of course, people associate Liberia with Ebola. It's right that we get mad about Ebola-mad that the world waited so long to tackle the outbreak; mad that poor, vulnerable societies don't have the resources needed to tackle infectious diseases. But we should remember too that in the past few years, Liberia-in fact, every country, rich or poor-has seen small miracles like the story of Princess and her son, and sees more of them each year.

In 2003, across all of sub-Saharan Africa, just 50,000 people were on ARVs, now more than 9 million are. There is no reason, in the next few years, that we cannot virtually end mother-to-child transmission of HIV in even the most challenging environments. Unheralded, we just passed a tipping point: in 2013, more people were added to the rolls of those on lifesaving treatment for HIV/AIDS than the number who were newly infected. That crossover of trend lines should mark the beginning of the end of AIDS.

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HIV Patients Desire More Dialogue with Doctors

HIV patients on antiretroviral therapy are very involved in engaging with their healthcare providers in the management of their HIV a new survey shows. The results were published in the Wall Street Journal and noted that 300 people living with HIV were surveyed online from across the country and 97% said that they are proactive about managing their HIV condition, including drug treatment.

Three out of four participants did say they would like to spend more time discussing their concerns with their doctor – specifically HIV drug treatment and the impact of HIV on their lives. The survey also showed that most respondents were active about managing their HIV, from scheduling doctor appointments to discussing treatment options with their doctor and researching HIV topics.

“The results of this survey are very encouraging, however they underscore the need for more in-depth discussions between people living with HIV and their doctors - not only regarding their treatment regimens, but also how the disease is affecting their lives overall," said Dr. Michael Gottlieb, Associate Clinical Professor of Medicine, David Geffen School of Medicine, UCLA. "Communication between healthcare providers and patients is the cornerstone of developing and maintaining a successful HIV treatment plan."

Some of the topics patients would like to discuss include: how their current HIV drug treatment regimen is working, other HIV treatment options, health conditions other than HIV and side effects of their current HIV medicine.

People living with HIV and taking antiretroviral medications are encouraged to speak with their doctor about HIV and their concerns. Preparing topics and questions ahead of an appointment and prioritizing those questions can be useful tools to improve communication with your doctor.