Sunday, April 25, 2010

1996: protease inhibitors were confusing

For my zine, I wrote this; although my life changed in other ways shortly afterwards, and somehow that also meant that I stopped publishing my zine. Those were in the days before blogs, children; in the days of photocopiers when self-published writers had to go to the Leather Tongue video store and drop off five copies of the zine for the magazine rack, in hopes that there might be only two when they returned a month later.

Not long after this I ended up going to work for an HIV vaccine research group, which restored my sense of urgency. It also stalled the question of doctor or account planner (see previous 1996 post); then I learned immunology, did some needle exchange, and with much more excitement and no inertia, I decided to become a doctor.

October 14, 1996

At my job [at an HIV prevention agency in San Francisco] another person has quit; everyone seems disspirited and low. To some extent, that’s because of the particular politics of the agency: personnel absences, departures, events, personality changes, etc. But I’ve been wondering, on my return, whether there’s something deeper. The advent of the new drug treatments, and the incredible promise of the protease inhibitors, may have subliminally actually depressed people.

The idea that we are an important lifesaving effort is slowly losing focus; if people are staying alive with HIV, then we are disease prevention specialists, not the first line of defense in a community under siege. In itself, that would be great news, but unfortunately, no one knows for sure what the truth is.

How many people will really benefit from the protease inhibitors? The most optimistic school of thought has it that the protease inhibitors, if used for somewhere around the range of three years, might be able to help some people’s immune systems to entirely eliminate HIV from the body--in other words, that in a couple of years, we might have a partial cure blossoming in front of our eyes! Others are more skeptical and uncertain about the longterm prospects of the new drugs; if this group of people is more correct, we will only see people with AIDS die a couple of years later than they would have before.

So we can’t yet cheer the end of an era. On the other hand, the urgent language of our previous era is fading and cracking under the dim light of future prospects. We are left with no sure knowledge of our role, no clear sense of how important our work will be, and no overtly stated acknowledgement that things have changed. I am beginning to suspect that inertia is the result.

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