AIDS Continues to Shape U.S., World Policies

RAY SUAREZ:

We have four views. Dr. Wafaa el-Sadr is the director of the International Center for AIDS Care and Treatment Programs at Columbia University's Mailman School of Public Health. She's also chief of infectious disease at Harlem Hospital.

Noerine Kaleeba is founder of the AIDS Support Organization of Uganda, Africa's largest community support group. Her husband died of AIDS in 1987; she does not have HIV.

Eric Sawyer is the co-founder of ACT-UP New York, an AIDS activist group, and co-founder of Housing Works, the largest provider of housing for people with AIDS in the U.S. Mr. Sawyer has been HIV-positive since 1981.

And Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Guests, welcome.

Dr. el-Sadr, we just heard a story from the early days of the public's awareness of AIDS. How have things changed since then, not only in who's getting the disease, but in how the world thinks about what AIDS is?

DR. WAFAA EL-SADR, International Center for AIDS Care and Treatment Programs: It's quite remarkable to think back on that moment when Rock Hudson disclosed that he had AIDS and to also realize the dilemmas and the struggles that he faced in trying to make that announcement.

I think today, unfortunately, while people are much more aware of the HIV epidemic, globally and in this country, there are still insurmountable barriers; there are still challenges that people with HIV face every day.

RAY SUAREZ:

Eric Sawyer, as I mentioned, you've been HIV-positive for a quarter-century, probably far longer than most people even imagined one could be HIV-positive. You've lived the trajectory of this disease. What changes have you seen in that time?

ERIC SAWYER, ACT-UP New York:

Well, I've seen remarkable changes, both for people like myself living with the virus in this country and with regard to the general population.

When HIV first emerged, and even in the time when Rock Hudson disclosed his status, there were almost no safety nets available to take care of people with AIDS. Groups were being formed by the communities most impacted by AIDS, such as the Gay Men's Health Crisis, to take care of people living with AIDS.

People were having potluck dinners where they were passing the hat to collect money to pay people's rents or their medical bills because there was no easy access to income maintenance or welfare payments. There were no fast access to Medicare or Medicaid, so that people who didn't have private health insurance or the ability to pay could not get any medical care themselves, unless their friends band together to pay for it.

It took a long time. There were many class-action lawsuits brought against city, state, local governments, as well as the federal government, to try to get expedited access to the Medicaid system, to social support systems such as welfare or housing allowances, to ensure that people who were poor that had AIDS didn't die in the streets, as was happening in places like New York City.

And, since that time, we've had incredible advances in medical treatment. As you mentioned, I've been symptomatic of HIV since 1981. That's long before the virus was discovered or before they even had a name for it.

But I've been able to survive because I've had quality medical care since the very beginning, because I was white, because I was born in the U.S., because I had private health insurance. And now, with the advent of combination therapy, I've rebounded.

I was quite sick. In 1991, I was forced onto a long-term disability retirement. But now I'm quite healthy because I've responded well to the treatments that people in the U.S. can get that help us live long, productive lives.