78 |^5280 |^ AUGUST^2019
*Last name has been withheld for privacy reasons.
been nothing short of extraordinary. Back then,
patients frequently lost 50 years to the disease,
even while taking drugs that often had debili-
tating side effects. Today, the life expectancy of a
patient with HIV is nearly the same as that of
a healthy adult. The modern drugs are so good
they’ve essentially turned what was once a death
sentence into a manageable chronic condition.
But that overwhelming success has had other,
less-desirable effects, too: Because the mortal-
ity rate of HIV in the U.S. population decreased
from a high of 16.2 deaths per 100,000 people
in 1995—at that point, it was the eighth lead-
ing cause of death for all Americans—to a rate of
1.9 deaths per 100,000 in 2016, the most recent
data available, the disease that once captured the
world’s attention has receded from the spotlight.
Front-page, HIV-related headlines are a rarity
today, and while the lack of publicity arguably
underscores progress, University of Colorado
Hospital infectious disease physician Dr. Steven
Johnson says it can also lead to complacency.
In Colorado, we might be seeing the impact
of that out of sight, out of mind nonchalance.
After several years of declining rates of new HIV
transmissions statewide, the numbers began to
increase in 2014. The rates have since plateaued
and are holding steady at around 430 new cases
diagnosed annually, up from 2013’s low of 326.
Although the jump may seem slight, Dr. Sarah
Rowan, an infectious disease specialist at Den-
ver Health, follows the numbers with trepidation.
“It’s not really on people’s minds as much,” Rowan
says of the disease. “We could not only plateau
but also see a reversal of progress. It’s important
we continue the efforts and continue funding for
research and implementation—that’s what it will
take to not lose ground.”IN THE EARLY DAYS OF the HIV/AIDS epidemic in
the United States, Denver solidified its place in
the fight against the disease and the stigma that,
even today, surrounds it. In 1983, two years after
the first official report of the virus in this country,
a collection of activists traveled from the coastsHis regularly scheduled appointment had been
on the books for earlier in the week, but he’d had
to reschedule. Jack had attempted the four-hour
drive from his home just over the Kansas state
line even though a powerful winter storm—a
rare event known as a bomb cyclone—had been
sweeping across the Front Range and the Eastern
Plains. State patrol had closed the highways, so
Jack navigated onto back roads. About an hour
outside the city, the wind blew his vehicle into a
ditch, and he had to spend the night in his car.
The National Guard helped dig him out the next
morning. In hindsight, Jack acknowledged it was
reckless to have made the trip in that weather.
But, he says, “it was important for me to be at that
appointment.” After all, doctor visits at the Rocky
Mountain CARES HIV clinic had saved his life.
Roughly two years earlier, in late summer
2017, Jack had gotten sick. He’d caught a lung
infection and began losing so much weight that
his five-foot-nine-inch frame withered to a skel-
etal 94 pounds. He couldn’t figure out what was
wrong, and the physicians at a nearby medical
center couldn’t either. It shouldn’t have taken a
two-week stay in the ICU at a hospital in Hays,
Kansas, for Jack to learn he had HIV, but it did.
And it was almost too late. Doctors measure HIV,
or human immunodeficiency virus, by count-
ing the number of CD4 white blood cells in the
body. Healthy individuals’ counts typically range
between 500 and 1,500 cells. Anything lower
indicates a severely compromised immune sys-
tem—the hallmark of HIV. A count below 200
triggers an official diagnosis of AIDS (acquired
immunodeficiency syndrome), an advanced-stage
condition of the infection. When Dr. Ken Green-
berg, an infectious disease specialist in Denver to
whom Jack was referred, started seeing Jack, his
CD4 cells numbered well below 100.
Fortunately for Jack, contracting HIV is not
the one-way road it used to be. Since the emer-
gence of the disease in the United States in the
1980s, advancements in treatment options have
Get Tested
The Centers for Disease
Control and Prevention and
the U.S. Preventive Services
Task Force recommend every
American ages 13 to 64 be
tested at least once for HIV.
Anyone who is at higher risk
for HIV acquisition should
test more frequently—for
instance, people who have
sex without condoms with
people of unknown HIV
status. The good news is
testing is inexpensive, and
there is a variety of options
for how to get screened in
the Denver area. “The easi-
est way is for people to talk
to their primary care doc and
have the test conducted with
routine labs,” says Denver
Health’s Dr. Sarah Rowan.
“But anyone who doesn’t
feel comfortable testing in
that environment can test for
free or at a low cost at the
Denver Health STI clinic or
one of our outreach sites.”
Find testing locations at
denverpublichealth.org or
call 303-602-3540.Two things to know
about an HIV test:› A rapid HIV test using a
finger stick shows results in
approximately 20 minutes
and is extremely accurate.
Occasionally, a second test is
done to confirm a positive result.› A brand-new transmission
might not produce a positive
result in a rapid HIV test. If some-
one suspects he or she could
have acquired HIV recently, that
person should get tested again
after a few months.ON A FRIDAY MORNING THIS PAST MARCH, JACK
*
WALKEDINTO THE FIRST FLOOR OF AN OFFICE BUILDING AT
DENVER’S ROSE MEDICAL CENTER FEELING A BIT FOOLISH.
TOP
DOC TORS
2019Previous^ spread^source^photography:^GettyImages(^2)