HIV... AIDS... words that so commonly connote a mental image of gay man, IV drug abuser, or someone partaking in outrageously high risk behavior. While such behavior does contribute significantly to the epidemiology of this disease, I frequently find myself caught off guard with the true demographics of the patient population I see in my HIV clinic.
Take, for example, the patient I saw in clinic this morning. A very nice lady who has been married to her husband of 17 years. She denies any other sexual partners, has never had a blood transfusion, and has never used any injectable drugs. Over the last 3 weeks, she has noticed progressive right sided weakness and difficulty with her speech, symptoms which have exacerbated quickly leaving her wheelchair bound in a matter of days. In the last couple of weeks, she has seen multiple physicians and has had extensive work-ups. Somewhere in the process, an HIV test was performed and found to be positive.
It's unclear how long she's had HIV. After all, who would think to test a monogamous, ordinary woman who goes about her business as usual. Unfortunately for her, the presenting symptoms of her HIV manifested as a severe neurological complication seen in patients with advanced AIDS. I started her on medication today and am praying that she overcomes her slimming odds, the long shot possibility that she will come out on top. I can't begin to imagine what's going on in her head when just one month ago she was completely healthy. All I can do is try my hardest as a clinician to help this patient and make every effort to spread the word. To my colleagues- please test your patients- even those with no apparent risk factors. To my family and friends- please get tested yourself. Every 9 1/2 minutes, someone in the U.S. is infected with HIV.
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