AIDS Is Not Manageable
by William R. Kersten

I was pleased to see all the media coverage commemorating 20 years of AIDS. However, much of the coverage has conveyed the message that AIDS has become a manageable disease. Based on our experience serving the needs of people in the end stages of AIDS, I urge extreme caution in use of the term "manageable" in association with this disease.

This assertion is based on two stark realities. First, AIDS is still a killer, and Houstonians are still dying from the ravages of this disease. Bering Omega’s current residential hospice is experiencing the highest occupancy rates recorded in its history.

Second, there is still no cure for AIDS. A long, healthy life is still an impossibility for those who have contracted this deadly disease. Combination anti-retroviral therapy is a major breakthrough that helps prolong life, but these drugs are costly and effective in less than half of the people who take them.

Even among those who are benefiting from drug therapy, the term "manageable" applies only if it is understood that those infected spend the majority of their time and energy managing their disease. These treatments involve highly complicated regimens of toxic medications, which, in turn, require great structure and discipline. Taking as many as 25 to 50 pills a day in complicated sequences and combinations can be overwhelming for many sufferers. For those who are already experiencing decreased mental capacity from the disease, the medications, or opportunistic infections, these regimens are especially difficult. Following the drug regimens, treating the side effects, and visiting the battalion of healthcare specialists, which are needed just to stay alive, consumes the lives of those who may be viewed as "managing" the disease.

Unfortunately, recent increases in new HIV infection rates indicate that these two realities have missed an entire generation. The fault lies at least partially with the frustrating images and messages contained in HIV-drug advertising. Images of healthy people who are usually engaged in rigorous physical activity, and messages designed to convey convenience complicate efforts to promote preventive behaviors. Few people taking combination therapies are engaging in rock climbing and mountain biking as portrayed in the advertisements. Fortunately, public pressure has forced the pharmaceutical industry to modify these ads.

However, we are paying the price for the complacency and false sense of security that has been created. Drug regimens cost approximately $15,000 per person, per year. The cost of doctor visits, lab fees, and other related expenses can easily increase this figure to $25,000. In Harris County alone, 1,700 men and women were diagnosed with HIV last year. With almost half of all people living with HIV/AIDS in this country depending on public-sector insurance programs for healthcare, these costs have fallen to all of us. Add to this the cost of lost productivity, lost talent, and lost contributions to the economy and society, and it is clear that we are paying far too high a price to entertain the notion that AIDS is "manageable."

Time is running out for many people and for the generation that has been lulled into a false sense of security and complacency. For the new generation at risk, I encourage them to volunteer at Bering Omega’s residential hospice or adult day care center. Such an experience would quickly counter this tragic myth. As Houstonians, we need a resurgence of energy and determination to educate those who are not infected, provide a compassionate support system for those living with AIDS, and to find a cure.

William R. Kersten is executive director of Bering Omega Community Services.