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    Vision: A Healthy Texas

    Mission: To improve health and well-being in Texas
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    Texas 211

Know Your Status, Protect Each Other

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Commissioner’s Commentary
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.

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(News Media: For more information contact Press Officer Carrie Williams, 512-458-7119. A photograph of Dr. Lakey is attached and available online at www.dshs.state.tx.us/commissioner/images/DrLakey_300dpi.jpg.)

Last updated September 22, 2011