AIDS - so there's an effective "cure" now?

[Frank Hovis]

Most of us remember the 80s arrival of AIDS. Rock Hudson, Freddie Mercury, government adverts of fear, people catching it through blood transfusions, injecting heroin, dental treatment: "you don't have to be a gay man".

This was the late 20th century plague that would spread like wildfire and catching HIV was like AIDS clearing it's throat.

And now, I cannot think when AIDS was last even mentioned by the press.

Pete Burns' death reminded me that Holly Johnson (also a key member of that Liverpool late 70s early 80s musical scene before FGTH) was diagnosed with HIV about thirty years ago and AFAIK is still healthy.

So the transition from HIV to AIDS has been virtually stopped by the development of new drugs. That, to me, sounds like a huge achievement but because it's been achieved by small steps it's been pretty much ignored by the press who like big bang events.

Is this right or is it just that it has lost the media spotlight when the " plague " didn't materialise?

[SarahBell]

There's a bunch of people who would like to have everyone take the meds so you don't get it so they can continue to bing on drugs and unprotected sex. 

[Frank Hovis]

9 minutes ago, SarahBell said:

There's a bunch of people who would like to have everyone take the meds so you don't get it so they can continue to bing on drugs and unprotected sex. 

That sounds rather a high risk strategy!

It was flagged on here a while back about a subset of homosexual men who take all the drugs going and have every variety of sex they can think of.

Either this is a very small subset or I've just never worked with them as the gay men I've known have been as conventional as everyone else with the obvious exception. One very amusing chap's "drug of choice" was vintage sherry and he and his partner used to go on holiday to visit the makers.

[MrPin]

Like many diseases, it probably gets less virulent with time. I'm pretty sure I don't want bubonic plague or that 1918 flu again.

[RentingForever]

The big breakthrough was combination therapy where several drugs are used at once to target the virus at different points, not giving it time to mutate and develop resistance. That was introduced about 2000, and since then HIV infection has basically become a manageable chronic condition like diabetes. It has probably saved millions of lives (not just gay men, also heterosexuals in sub-Saharan Africa, probably way more of them)

You're right, it's a huge success story but not really reported. I guess the media prefer to scare people.

[spyguy]

1 hour ago, Frank Hovis said:

That sounds rather a high risk strategy!

It was flagged on here a while back about a subset of homosexual men who take all the drugs going and have every variety of sex they can think of.

Either this is a very small subset or I've just never worked with them as the gay men I've known have been as conventional as everyone else with the obvious exception. One very amusing chap's "drug of choice" was vintage sherry and he and his partner used to go on holiday to visit the makers.

Sadly, theres a hefty percentage of the Gay community still like that.

It drives a gay mate mental!

[Scunnered]

1 hour ago, Frank Hovis said:

So the transition from HIV to AIDS has been virtually stopped by the development of new drugs. That, to me, sounds like a huge achievement but because it's been achieved by small steps it's been pretty much ignored by the press who like big bang events.

Is this right or is it just that it has lost the media spotlight when the " plague " didn't materialise?

I think this really happened a long time ago, and it was a big thing at the time. If you look for graphs on Google, there are lots like this:

 

This is from  http://book-med.info/aids/42758, where it says

Quote

The introduction of combination antiretroviral treatment in the mid-1990s has resulted in a steep decline in the number of AIDS cases and deaths reported each year. In 1997, deaths among people living with HIV amounted to 748, compared to 1,481 the previous year. Since 1998 the annual number of people living with HIV who have died has remained more or less constant, usually between 400 and 600 each year.

 

The drugs started working about 20 years ago, and I think people have forgotten about AIDS to some extent.  Like you, I remember the 80s, and the stuff about AIDS in the media was just about enough to scare you off from any kind of sexual activity at all.  There were a lot of people dying, and that really got the message across.

HIV's pretty prevalent now: the yellow line in the graph above is just the number of diagnoses per year, not the total number of people with HIV.  The Terrence Higgins Trust has this to say:

Quote

Gay and bisexual men in the UK also have high rates of HIV infection.

Nationally, around one in 20 is estimated to be living with HIV. In London as many as one in eleven are living with the virus. Rates are even higher among men using the gay scenes of large cities.

In 2014 over 3,360 gay and bisexual men tested HIV positive, the highest figure ever reported.

See http://www.tht.org.uk/sexual-health/About-HIV/How-common-is-HIV_qm_

That's almost unbelievable when you think back to the 80s. 

[MrPin]

Yes, a gay mate of mine died of this. I was having a pint with him, and a month later I was at his funeral.

I haven't had sex with anything else but Catholic nuns since 1983.

[spyguy]

So, no visa for Africans without Aidd test then.

The stats are damming for gay men and Africans.

[RentingForever]

11 minutes ago, spyguy said:

So, no visa for Africans without Aidd test then.

The stats are damming for gay men and Africans.

"Damning"? Hmm. While treatment has advanced, clearly bigoted opinions haven't.

[DeepLurker]

1 hour ago, Scunnered said:

Any suggestions as to why the disease surged around the turn of the millennium? I read the linked page but could find no explanation for it.

[Scunnered]

7 minutes ago, DeepLurker said:

Any suggestions as to why the disease surged around the turn of the millennium? I read the linked page but could find no explanation for it.

Maybe people threw caution to the winds after a few years of effective treatment?  Maybe improved screening?

[RentingForever]

2 minutes ago, Scunnered said:

Maybe people threw caution to the winds after a few years of effective treatment?  Maybe improved screening?

New generation of young gay men who hadn't been traumatised into abstinence by seeing their friends die? 

[spyguy]

1 hour ago, RentingForever said:

"Damning"? Hmm. While treatment has advanced, clearly bigoted opinions haven't.

Not opinion, statistics.

When a couple of goups who make up a very small % of the  UK population, make the the top two, many times over, then there is a problem with those groups.

 

[winkie]

Protect yourself.

 

 

[The XYY Man]

10 minutes ago, winkie said:

Protect yourself.

 

 

 

I certainly did.

I've necked a glass of "Complan" every day since I first saw that .

As their TV ads of the time clearly stated - Complan aids digestion...

 

XYY

                                                                                                               

The dog's kennel is not the place to keep a sausage - Danish proverb

[JoeDavola]

 

[Clarky Cat]

2 hours ago, DeepLurker said:

Any suggestions as to why the disease surged around the turn of the millennium? I read the linked page but could find no explanation for it.

The vast majority of that increase was actually due to diagnoses in heterosexual men and women, rather than increased risky behaviour in men who have sex with men (MSM). Two thirds of HIV diagnoses in heterosexuals are in people of Black African origin, and HIV is now actually more prevalent in women of Black African origin (7.1%) than MSM (5.9%). I don't know whether the increased diagnoses were due to greater awareness of the prevalence in certain populations, or immigration from areas with high prevalence, or a combination of factors. 

Current trends are that the new diagnoses in MSM continue to increase, but are dropping off in heterosexuals.

Anyway, highly active anti-retroviral therapy has revolutionised treatment, and yes, HIV is becoming more of a chronic disease. A lot of the problems are now related to long term use of the therapies themselves, rather than the underlying disease.

If anyone's into statistics - reading the Public Health England report into HIV is interesting

Public Health England report

[JoeDavola]

Aaaaaaand here's the scariest one:

 

[The XYY Man]

Actually I totally screwed-up my AIDS anecdote.

The product was "Lucazade" and not "Complan".

And the tag-line was "Lucazade aids recovery".

Funny thing the human memory...

 

XYY

                                                                                                               

The dog's kennel is not the place to keep a sausage - Danish proverb

[Dorkins]

Combination therapy is not a cure, but it does offer a lifetime of control of the virus so that HIV infection does not progress to AIDS. The problem is that the virus lies dormant ('latent') in the infected person's genome. Drugs that target active stages of the virus life cycle like reverse transcription are not effective against latent viruses. Currently many groups are working on drugs which can reactivate the virus back out of latency so that cells carrying latent viruses can be targeted and killed with the right medication. If all cells carrying HIV viruses could be killed that really would be a "cure".

[The Knimbies who say No]

Seem to recall reading a section in one of geneticist Steve Jones' books which also mentioned that the typical disease profile has changed significantly, iirc there are two broad types. One type which kills people very quickly, and another type which progresses more slowly. In an environment where very little safe sex is practiced, the more aggresive type can spread rapidly without being limited by the short timespan in which an infected person becomes very unwell. Once people are more cautious the aggressive form can kill people more quickly than they can reinfect others, and I guess it becomes less significant overall.