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Reprint of an article by Anthony Bongiorno, President & Founder of The Friends of AIDS Foundation, on August 17, 2009.As a Professional who has worked with hundreds of individuals living with HIV, I know well that starting treatment for HIV is ultimately a personal decision. Every infected person, upon diagnosis, should have the opportunity to discuss the pros and cons of treatment and when to begin treatment with his or her medical provider. It should always be the patient’s choice when to initiate treatment and what treatment to initiate under the direction of a medical provider.
I also recognize that there is still not much known about the long term side effects of treatments and that legitimate fears remain. Despite this, I believe it is time for the medical community and the government to do more to promote the benefits of early treatment of HIV, both as a means of keeping people healthy and reducing the spread of the virus. In many cities, outdated definitions of HIV, and thus the standard of care used to treat it, mean that poor and chronically ill people are actually cut off from supportive services that are every bit as critical to their health as their medications.
There are many studies that indicate the start of treatment when a person’s cells fall to 350 or below. Even above that number, HIV seems to have an impact on the immune system and the chance for the onset of other diseases and complications exists. For that reason, many HIV positive people may choose and should have the right to choose treatment as soon as they learn of their infection. The Friends of AIDS Foundation strongly opposes any standard of care that denies treatment or sets a “one size fits all” protocol in regard to treatment.
Early treatment has a significant impact not just on health but also prevention efforts. First, it is apparent that treatment dramatically lowers the amount of virus in a person’s body, thereby making the virus significantly more difficult to transmit. The more positive people who have access to treatment, the less the virus will likely be transmitted. Thus, simply making treatment more widely available will have a major impact on the spread of HIV. It is apparent that these benefits should be recognized and incorporated into health and prevention efforts.
Many cities and programs to one degree or another tie HIV services to health status in relation to standards of care for treatment. The reality is that for low-income people living with HIV, and particularly for people with multiple co-morbidities such as homelessness, chronic chemical dependence and mental illness, basic supports are essential for their well-being whether or not they are on treatment.
If a person chooses treatment before reaching the current threshold of 350 T- cells or lower, that person may never achieve the threshold that would allow him or her to receive these supports. Thus, the current system provides a disincentive for people who would like to enter treatment before their T-cell count falls below 350.
There is strong evidence that housing and ancillary services are essential for the maintenance of the health of a person living with HIV, whether or not a person is ready for treatment. Treatment definitions and services need to be decoupled. But as long as they are coupled, it is imperative to recognize the changing recommendations regarding treatment.
Although HIV medications have saved many lives, the medications are not perfect and no one has a total understanding of their effects, especially because it can take years for problems to surface; that fact only underscores how important it is for people to be well informed about their treatment options. However, it is clear that we are not taking full advantage of one of our best weapons to treat and eradicate this epidemic.
The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals by protecting their well being and will continue to work to urge the government to address the flaws in AIDS service and effect meaningful change. Recognizing that none of us is as strong as all of us, I urge others in the community to do the same. Together We Remain Strong!
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The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
Together We Remain Strong!
