December 1 is my husband’s birthday. It marks 33 birthdays that we have celebrated together. December 1 is also World Aids Day. The first World Aids Day was Dec 1, 1988 which was 28 years ago.  I witnessed the first documented case of AIDS and Pneumocystis Carinii Pneumonia in our hospital in 1983 when I was a resident.  4 years later during my Family Medicine residency, we would diagnose many cases in men, women and children.  My residency and pediatrics rotation provided an opportunity to unfortunately hospitalize several children who had AIDS.  I provided care to many patients and watched too many of them die over a period of 12 years.

Caring for patients with HIV/AIDS influenced the direction of my entire medical career. I learned case management while working with the lone nurse and social worker from the local health department who had the arduous roles of following all the active patients from two counties.  We met monthly to discuss our patients.  The hospital Pharmacist helped us manage pain and treat complicated infections.  He calculated medication doses and consulted with other experts.

I had to study and improve my Women’s Health skills. Now I am the Women’s Health Coordinator for the Family Medicine Residency. Many patients wanted and demanded integrative medicine therapies.   I was forced to read about new herbs and vitamins to augment AZT and help ease its side effects. New drugs were being developed and it meant attending conferences to stay updated.

Now, I am training to be a health and wellness educator which includes being a yoga instructor. My goal is to teach physicians techniques to prevent burnout and maintain resilience in a demanding profession.

I always thought I had the ability to talk with patients but AIDS taught me how to deliver bad news and be loving and supportive. It led me into Hospice Care and for 6 years, I learned to be with a diverse group of patients at the end of their remarkable lives. I learned to ease the difficult transition for their families. It was for me lightening.

The number of new HIV diagnoses fell 19% from 2005 to 2014. It is hard to believe that with all the new information that there are a rising number of new HIV infections in young African American and Hispanic males.  This can also lead to an increase in infections in women.  The irony is that we relaxed push to get information out there to this group.  According to the Centers for Disease Control (CDC), African Americans represent approximately 13% of the U.S. population, but accounted for an estimated 45% of new HIV infections in 2015. Also, Hispanics/Latinos represented 18% of the population but accounted for 24 % of new HIV infections in 2015.

According to the United Nations November 2016 Factsheet:

• Worldwide, 2.1 million [1.8 million–2.4 million] people became newly infected with HIV in 2015.
• New HIV infections among children have declined by 50% since 2010.
  • Worldwide, 150 000 [110 000–190 000] children became newly infected with HIV in 2015, down from 290 000 [250 000–350 000] in 2010.
• Since 2010 there have been no declines in new HIV infections among adults.
  • Every year since 2010, around 1.9 million [1.9 million–2.2 million] adults have become newly infected with HIV.
• In 2015, 1.1 million [940 000–1.3 million] people died from AIDS-related causes worldwide, compared to 2 million [1.7 million–2.3 million] in 2005.

I am no longer working with patients who have AIDS but I do know that I will be diagnosing and referring new patients for treatment. This disease is still making an impact worldwide. I still remember all the sons, daughters, husbands, mothers, artists, and friends that have died.

Today, I celebrate my husband’s birthday. Meeting him 33 years ago changed my life.  I recognize the significant impact HIV/AIDS has had on the world and my medical career.  I recognize the tireless work being done to care for patients.  Also, we have a lot more work to do and recent updated UNAIDS information estimates that 26.2 billion US $ will be required for the AIDS response in 2020 and 23.9 billion required in 2030. We can impact these numbers through supporting education and prevention efforts both in the US and worldwide.