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NY Magazine: Who Still Dies of AIDS, and Why

Posted Jun 13 2008 12:00am

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New York magazine features its annual Best Doctors issue and, in one story, contributing writer Gary Taubes looks at why, in the age of HAART, the HIV virus can still outwit modern medicine…"Who Still Dies of AIDS, and Why"

One of the ironies of the success of HAART is that it has fostered the myth that the AIDS epidemic has come to an end, and that living with HIV is only marginally more problematic than living with herpes or genital warts. This is one obvious explanation for why HIV infection is once again on the rise among young men—specifically, MSMs, as they’re now known in the public-health jargon, for men who have sex with men—increasing by a third between 2001 and 2006. Among those 30 and over, the infection rate is still decreasing, notes Thomas Frieden, commissioner of the city’s Department of Health and Mental Hygiene, suggesting that the increased rate of infection among men under 30 is due in part to decreased awareness of the disease or the toll it can take.
“If you do the mathematics,” Frieden says, “HAART became available in 1996. If you were of age before then, sexually active, and you saw a lot of people dying or sick or disfigured from AIDS, maybe you’re more careful than if you came of age after 1996 and didn’t see that. When we’ve done focus groups, what young men have told us is that the only thing they hear about HIV these days is that if you get it, you can climb mountains, like Magic Johnson. Certainly it’s true that the treatment for HIV is very effective and it’s possible to live a long and productive life with an HIV infection. It’s also true that it remains an incurable infection. That the treatment is very arduous and sometimes unsuccessful. It remains a disease often fatal, and frequently disabling.”

At the moment, some 100,000 New Yorkers are infected with the HIV virus, and AIDS remains the third leading cause of death in men under 65, exceeded only by heart disease and cancer. The question of who will die from AIDS in the HAART era—or who dies with an HIV infection but not technically from AIDS—and what kills them is worth asking now that such deaths have become relatively infrequent.

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