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Steps on the Critical Path: Arresting HIV/AIDS in Developing Countries


As an intern, I took care of the first patients with HIV/AIDS at San Francisco General Hospital, and so I grew up with AIDS in the early days of my medical career. We struggled through the confusion about what was making people so sick, and each new day brought a new discovery about the disease and its consequences. I went through that evolutionary process along with everybody else, and it shaped me in many profound ways. Before long, I recognized that this wasn't a disease of “those people over there.” This was a disease that could strike anyone, anytime. And as physicians, we had to adjust our thinking about our own vulnerability to occupational risk, and to emphasize prevention, because there wasn't going to be a cure for a long, long while. And not only physicians had to rethink things—AIDS has reshaped society's very notions of the most basic human behaviors.

I was in Uganda in 1985, early in the AIDS epidemic there. We knew then where that epidemic was going to go, absent an effective vaccine or cure, but few of us could have imagined that it would evolve so quickly without an end in sight. While the people of Africa have achieved a huge amount in tackling HIV/AIDS, particularly in Uganda, the epidemic is far from being under control on that continent and is spreading through other parts of the world with alarming speed.


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Information in this article was accurate in October 19, 2004. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.