November 23, 2010
By David L. Lakey, M.D.
Commissioner, Texas Department of State Health Services
I was in high school in 1981 when
the first cases of a new and devastating disease were identified. The disease struck
hard and fast and dominated headlines nearly 30 years ago as doctors and
scientists tried to get their arms around what this mysterious affliction was –
and what it wasn’t.
The disease was Acquired Immune Deficiency Syndrome, or AIDS.
At the time, myths and rumors about how AIDS was spread multiplied
like the disease itself, but one thing was clear to everyone: AIDS was
destroying the immune systems of babies and adults, women and men, across the
planet, including Texas. AIDS was killing people.
I vividly remember the first patients with AIDS I was privileged to
care for during medical school in the late 1980s. At that time, we had little
to offer patients except compassion.
Over time, our country made tremendous progress. We discovered AIDS
was caused by the Human Immunodeficiency Virus, or HIV. Medicines were
developed to help manage the illness and its symptoms. People learned they
cannot tell if someone has AIDS by looking at them. We learned you can’t get HIV
from shaking hands, touching or hugging someone or from insect bites. It has nothing to do with race, age,
religion, nationality or sexual orientation. People get infected because of
what they do, not who they are.
The most important thing we learned is how to protect ourselves: Stay
with one partner. Don’t have unprotected sex unless you’re sure your partner is
not infected. Don’t share needles.
As an infectious disease doctor in Tyler, I cared for many people with
AIDS. I delivered the painful news to numerous patients who tested positive for
the disease. I looked into the eyes of young pregnant women, young gay men,
middle-aged women, elderly ICU patients and married men with children and tried
to help them understand their disease and the complicated regimens that would
follow this life-altering diagnosis. I wanted to tell them everything would be
OK. But I had to tell them the truth with respect and compassion. Since 1981,
the country had graduated to a new level of AIDS knowledge, and my patients
knew their lives would never be the same.
At the Texas Department of State Health Services, one of our missions
is to prevent the spread of AIDS. The loudest drum we beat is: Know your
status. Protect yourself.
Knowing your status is the single most important factor in preventing
the spread of infection. People who know they are infected change their
behavior. We have seen it over and over again.
Our challenge is that many HIV infected individuals do not know they
are infected, and furthermore they do not consider themselves at risk. Once
infected with HIV people typically have five to 10 years without symptoms
before they progress to AIDS. More than 99 percent of newly reported HIV
diagnoses in Texas are due to unprotected sex or sharing needles with people
who are HIV infected, many of whom do not know they are infected.
The earlier a person knows they are infected, the better their own
outcome. Most AIDS cases I encountered in my medical practice were diagnosed
late in the disease. Today, one out of three Texans newly diagnosed with HIV
already has AIDS. When people with HIV are diagnosed early, treatment works
better and there are more chances to prevent further spread.
The state works quickly to track the disease and look for trends. We
know the number of new infections has remained stable in recent years, with
about 4,500 new diagnoses annually. We know the infection rate among babies has
gone down dramatically. We know the disease affects black Texans the most. And
although 57 percent of new cases in 2008 occurred in gay men, 26 percent
occurred through heterosexual transmission. We know the number of Texans dying
from HIV/AIDS has stabilized at about 1,300 deaths each year. And we know the
number of people living with HIV/AIDS in Texas is growing by a little more than
3,000 each year. Right now there are more than 63,000 Texans – or one out of
every 387 – who are HIV infected.
HIV/AIDS patients are living longer than ever, thanks to major
advances in medical care. Patients diagnosed early who are committed to
following their medical regimens can now expect to live long lives.
We screen, test and counsel Texans every day for HIV/AIDS. Texas has
had long, solid support from the state Legislature to further our goals of
raising awareness and reducing the number of new infections. Huge strides have been
made in disease awareness and linking infected individuals to therapy.
AIDS is no longer the mysterious disease it was back in 1981. But it
is still spreading. It may not be a headline grabber, but we have momentum. We
know how to prevent the spread of HIV. Know your status. Protect each other.
Media: For more information contact Press Officer Carrie
Williams, 512-458-7119. A photograph of Dr. Lakey is attached and available online