Changing times: AIDS 20 years later

The epidemic has significantly changed all walks of medicine -- from the drug approval process to the nature of end-of-life care. But despite treatment advances, this anniversary marks only the beginning of the fight against AIDS.

By Victoria Stagg Elliott, AMNews staff. July 2, 2001.

AIDS hit the United States in 1981-- first in California and New York; first among gay men, then injection drug users, then hemophiliacs, and then those who had received blood transfusions. And it refused to stay put anywhere it landed -- rolling over the country like a slow-brewing storm and changing everything in its path.

"There's no disease like it," said Arthur Ammann, MD, a pediatric immunologist who saw the first HIV-infected babies in San Francisco in 1981. The 20 years since have been marked by far-reaching implications for both medicine and society.

The disease has turned patients into activists and quickened the drug approval process for terminal diseases. The extensive research connected with it has spilled over into a greater understanding of cancer and other life-threatening conditions. And palliative care has emerged as an important concern as doctors faced a mounting number of young people destined to die.

It has also led to a heightened level of awareness about certain health risks. The blood supply has become safer, not just from HIV, but from other infections that plagued it. Health care workers and others who come into contact with bodily fluids are now more likely to take precautions. And talking about sex and sexually transmitted disease has entered the medical mainstream.

In the beginning, doctors didn't know what they were looking at. They stood by as previously healthy patients' immune systems collapsed, and then they watched as those patients died. [...]