Less than 20 years ago, when I started doing HIV/AIDS care, most of my patients died within a year or two of their diagnosis. Medications were only marginally effective and caused side effects (or even death), and the notion of long-term survival was only a hope. To discuss a normal life expectancy was wishful thinking, perhaps false hope.
As an AIDS specialist practicing during that era, I learned from patients in the intensive care unit or hospital bed. I memorized the alphabet soup of multidrug resistance mutations and complex treatment regimens, and I learned from textbooks the treatments for AIDS-related opportunistic infections. These things we knew.
We learned less (if barely at all) about managing things like heart disease, emphysema or osteoporosis, because we knew our patients wouldn't live long enough to witness these diseases of long life and aging.
But oh, how well things have changed. Highly active antiretroviral medications have transformed the landscape of HIV/AIDS for those who are aware of their diagnosis and successfully navigate the steep cascade of engagement in care and treatment adherence. For these people, normal
life expectancy is now, indeed, expected.
While the epidemic of new HIV infections continues, the face of care for people living with HIV has changed from those dark days. People with HIV live longer and better; many are now over the age of 50, as are their providers (um, like me). A significant number of newly diagnosed patients are also older.
The epidemic has reached all continents where people live. But the capacity to provide care has not reached these locations equally -- particularly in places where care providers might not speak English and able to learn from the wealth of resources that are available only in the English language.
Because of this demographical current, the lessons that need to be learned about HIV/AIDS care have also drifted. HIV care providers need to learn about non-communicable diseases like cardiovascular disease, endocrinology, mental health and cancer screening, as these complications are more common among the people that we care for. The tools we use to learn are different, too: While there's still something to be said for the textbook and lecture, new care providers learn from keyboard and mouse -- searching on the Web, watching YouTube videos and using social networks.
So, it's with excitement that we announce the launch of myHIVclinic.org, a multi-language Web portal to help frontline HIV care providers learn about these new HIV comorbidities and help ensure healthy aging among our patients with HIV. It's not a textbook; instead, the site consists of concise pages on a range of subjects -- from cardiovascular and renal disease to diabetes and osteoporosis management, to reproductive health, to managing frailty and aging.
myHIVclinic.org isn't written for the professors and experts; it's constructed for busy care providers, many of whom might not be full-time HIV providers and might not be physicians. It's for providers who might not have the privilege , in time or money, to travel to international HIV/AIDS conferences -- nor do they have the time to squeeze in a 60-minute lecture between patients, charting and rounding.
The content was selected by an international steering committee of expert clinical providers; it utilizes Web technology to quickly provide access to key documents, guidelines and clinical management tools. Soon, we'll have short video interview summaries with experts about important key lessons, conference findings and webinars. New content will be added monthly, including whole sections on important infections (such as hepatitis and tuberculosis), as well as mental and sexual health.
Today, the site's content is available in English and Spanish, but eventually it will be in five additional languages (including French, Portuguese and Russian). Our goal is to provide critical information to clinicians in the languages that they know, on their computer, laptop or smart phone.
On behalf of the International Association of Providers of AIDS Care, I hope that you'll find myHIVclinic.org of value in your work.
Benjamin Young, M.D., Ph.D., is the vice president and chief medical officer of the International Association of Providers of AIDS Care, as well as an adjunct professor at the Josef Korbel School of International Studies at the University of Denver. Click here to read a more detailed bio of Dr. Young, which includes financial disclosure information.