HIV incurable and growing, but no longer a death sentence

August 15, 2006
Twenty-five years after the virus that causes AIDS was first identified, the disease still has no cure. But it is no longer a death sentence, either.

“It’s not considered a terminal illness anymore,” said Victoria Oxendine, Nurse Practitioner for the HIV Care Team based at New Hanover Regional Medical Center. “It’s now a chronic illness; a manageable disease.”

And with that positive trend comes some negatives as well. Patients with HIV, the precursor to AIDS, can lead long, productive lives – some in the NHRMC program have lived with HIV for 20 years – but the drugs that keep them healthy are expensive. Also, the success of medications has likely led to a relaxing of safeguards against HIV, notably unprotected sex, said Susan O’Brien, the team’s manager. In a recent survey of 2,500 people, only 17 percent identified HIV/AIDS as an urgent health problem.

The result is a steady steam of new HIV cases, both locally and nationally. And that’s where the HIV Care Team comes in.

Primarily funded through state and federal grants, the eight-member team provides comprehensive primary care to HIV-positive individuals, refers patients to specialists, arranges dental care, makes referrals for substance abuse and mental health issues and features a social worker who does crisis intervention and assesses psychosocial needs.

The team currently manages 730 patients, 61 of them new cases since Jan. 1. Since the team began in 1995, it has touched more than 2,000 patients – many of them with limited ability to access the resources offered at NHRMC.

“Availability of these resources has greatly enhanced the quality of life for our patients,” O’Brien said. “In the 2006 patient survey, one person said, ‘I appreciate everything that the wonderful staff has provided for me and my family. They gave me and my family hope.’ This is what makes all our efforts so rewarding.”

In the HIV Care Team’s 11 years at NHRMC, team members have seen HIV/AIDS evolve from a disease primarily impacting homosexuals or intravenous drug users to one that is affecting a more diverse population.

Today, heterosexuals make up at least 52 percent of NHRMC’s active patients. Intravenous drug users make up only 12 percent of active cases.

African-Americans make up 62 percent of the team’s overall patient population, and team members say the fastest-growing segment of the patient population is African-American females. Overall, men make up 65 percent of all active cases and 85 percent of this year’s cases.

Some 31 Care Team patients were transmitted HIV at birth through their infected mother. However, advances in testing of most pregnant women and proactive treatment of those who are infected have reduced the instances of HIV transmitted through birth to less than 100 a year nationwide, O’Brien said.

Team members support a Center for Disease Control recommendation that everyone – regardless of risk factors – be screened for HIV as part of a routine physical exam. With early detection, the chances of patients leading a long, productive life dramatically increase.

“Instead of learning how to manage their death, they’re learning how to manage their life,” O’Brien said.

For more information about the HIV Care Team, call 342.3128. For an appointment, call 343.7001 or 1.800.651.0407.