According to a recent edition of Pulse, Crain’s health newsletter, New York State has also stepped up its efforts to make the public aware of the new HIV strain. Besides the current $2.2 million budget, it plans to spend some $450,000 more on marketing and media campaigns, including television announcements that will focus on prevention and the importance of knowing one’s HIV status. State Health Commissioner Antonia Novella, MD, sent letters to physicians who care for patients with HIV/AIDS, asking their cooperation in getting the message across.

Jump the gun?

Some gay activists and HIV specialists, including Robert Gallo, MD, codiscoverer of the AIDS virus, claim that warning the public too soon would be a matter of “jumping the gun.”

Frickey disagrees. “Those at risk must be aware that this is a serious issue and accept the challenge,” she says. “People must take precautions, whether [that means] stopping risky sexual behavior, using condoms, being monogamous, limiting their number of sexual partners, going for HIV testing, or whatever else it takes to remain vigilant against infection.”

New York Mayor Michael Bloomberg agrees. In a recent statement, he noted that he’d rather be early than late in telling the public about a possibly stronger strain of HIV.

Hoping against hope

When the unidentified man was first diagnosed, officials hoped that he might have particular differences in his immune system or perhaps genetic reasons for his drug resistance and subsequent rapid progression from HIV infection to AIDS. Drug use had also been theorized as another possible cause for his fast-moving infection, since amphetamines may suppress the immune system, allowing a virus to replicate more quickly in the body.

While those issues are still being studied, they are unlikely to be the causative factors in his case. Results released later revealed that 3-DCR is especially deadly. Researchers claim that this HIV strain enters cells more easily and grows well in the lab, unlike most drug-resistant strains. It also causes infected cells to clump together, allowing them to destroy uninfected cells.

Lab tests show that the New York man is resistant to three of the four classes of anti-AIDS drugs, so he’s now taking other medications to fight the infection. His doctors have found no sign that his immune system is particularly vulnerable.

What lies ahead

Many call AIDS the plague of the 20th and 21st centuries. And advances in its treatment have created a false sense of security. Once feared as a lethal disease, AIDS is now considered by many to be a chronic condition, with costs and inconveniences, but not as deadly as it once seemed.

On entering the third decade of AIDS, we face a possible new strain of HIV, a powerful adversary that could reach epidemic proportions as a cure remains elusive. Wiping out this disease will take not only a fresh arsenal of medical weapons, but new attitudes, behaviors, habits, and for some a change of lifestyle.

Few people today are unaffected by the tragic toll taken by the first rampage of AIDS in the 1980s. Frickey’s concern is that too many people have forgotten what it takes to keep this potential epidemic in check. Unsafe sex is self-destructive, and AIDS still can kill.

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Mary Raju Cole, RN, MS, FNP, APRN, BC, is a Nursing Spectrum contributing writer.

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References

1. Santora M, Altman L.. Doctors discover new HIV strain. IHT online website. Available at: http://iht.com/bin/print_ipub.php?file=/articles/ 2005/02/11/news/HIV.html. Accessed March 3, 2005.