DALLAS — Forty years since the HIV/AIDS epidemic hit the nation on June 5, 1981, HIV/AIDS survivors and people living with HIV report seeing similarities between the epidemic and the COVID-19 pandemic.
“The first thing was that the fear that living with HIV would put you at high risk for more severe COVID-19 infection. And many people I talked to talked about the fact that they've lived for 40 years with the past epidemic of HIV only to experience potentially dying over a weekend from COVID-19,” said Prism Health North Texas CEO Dr. John T. Carlo.
Prism Health North Texas has four health centers in Dallas and has been providing care for people living with HIV since 1986, around the height of the HIV/AIDS epidemic. Most of Dr. Carlo's career has been focused on public health emergencies like HIV/AIDS, Ebola, H1N1, West Nile Virus, and the community’s response to them. He says the unknowns of the HIV/AIDS epidemic are hauntingly similar to those associated with the COVID-19 pandemic.
“I think it really reminded us back when, in the early '80s, when we had this unknown virus, we didn't know where it came from and we had no treatment, and we barely had a way to test for it. So as you remember from coronavirus, it was very, very similar. You know, and now thankfully the vaccine came out, but that's another piece where we're just still waiting from the HIV and AIDS epidemic to have a vaccine like we've seen with the coronavirus,” Carlo said.
Dr. Carlo said the stigma surrounding infectious diseases like coronaviruses and HIV/AIDS is not new. However, he says with these diseases, the stigma became extremely apparent.
“It may be as a part of our evolution as human beings, but I do think it was extremely apparent, not only during HIV and AIDS but also during the coronavirus pandemic where we really were internalizing stigma by looking at who became infected and who did not. And oftentimes using, I think, what would be our innate fear of infectious diseases as a way to subdivide populations, which again is extremely dangerous, especially when you're looking at the tremendous health inequities that we have in this country,” Carlo said.
While developed countries had access to effective antiretrovirals in the late '90s, in places that were hard-hit like Sub-Saharan Africa and Haiti, the deaths continued to climb until at least a decade later.
“We may visualize from our history, you know, that those that were suffering from HIV and AIDS were white, male, gay men, and really this was not the case and is not the case,” Carlo said. "It's just it's interesting that that the fact that African Americans, Latinos, Hispanics, men and women were suffering from HIV and AIDS and yet even today we still see only this visible group of people that were affected. So, I think even back during our early '80s period, there was still this inequity of awareness that there were many populations that were more seriously affected.”
Dr. Carlo says the health inequities that existed during the AIDS crisis, once therapies became available, mirror how COVID-19 treatments and vaccine rollouts have been.
"Even early on with the coronavirus pandemic, we recognized that there were systemic inequities in terms of having available treatments. There were some early indications that certain medications might be effective for preventing severe coronavirus infections. These drugs were experimental but were being run at very specific hospitals. And what we found is even with that limited scope, there were still inequities within that system. And I think it just continued to perpetuate into what we saw with the vaccines initially as they came out,” Carlo said.
The biggest struggle with both HIV/AIDS and COVID is complacency. Despite the advances in technology, he wants to remind everyone there’s still a ways to go with both HIV/AIDS as well as COVID-19.
"We're certainly not done with HIV and AIDS after 40 years and we're certainly not done with coronavirus at this point with all the variants,” Carlo said. “With HIV/AIDS, many people who are becoming infected are not taking the precautions of prevention that really do work and could work. I think the same thing is happening with coronavirus today. I think many people are believing that it's not a problem anymore and that we're done, we’ve declared the victory. And we know we're not done yet. So I think there's a lot of parallels unfortunately, and it's back to our sense of complacency and wanting to perhaps move on from a terrible crisis that we've been under, but I think we've got to have that perspective that we're not done yet.”
Dr. Carlo believes we all need to celebrate the successes that we’ve had with COVID-19 treatments and vaccines, and the therapies created to control HIV. But he says there is still much to learn with these diseases.
"We are at our very best when we created vaccines that work incredibly well and are incredibly safe. And it's remarkable that we have these great vaccines so quickly and are able to move into this direction and we should celebrate that. But we are not at our best when we look at the health inequities and who suffered the most during this pandemic,” Carlo said. "And, as we know, that was a structured issue related to your socioeconomic background, your race and ethnicity, as well as your underlying medical conditions, which were not treated. So I think again, HIV and AIDS is very similar to this because these are the same successes and challenges that we continue to face.”
At Prism Health North Texas, people living with HIV are connected to care and services in the area. The organization strives to remove barriers that may prevent people from getting quality health care.
“We are very, very intentional, as we're looking at HIV as a virus that is treatable and preventable. And what we do from there is to really stage our resources so that we can reach as many people as effectively as possible. And to reach that end, we don't take the conditions of health insurance or how much money you have or how much money you make or what resources you have as a condition of whether or not we will see you. You know, we see everybody regardless of the ability to pay,” Carlo said. "The other part, though, is this is not a charitable clinic. This is a clinic that you can receive the very best HIV treatment in this area. So we're not here to just provide services for the for the low income, this is really a place for everybody. And that I think is the health equity model that I think is what makes this organization successful. We look at every individual as really somebody that really has a right to receive the best health care, and we strive to do the very best and make sure that we are supplying that health care and meeting those individual needs.”
Beyond just treatment, Prism Health North Texas addresses other unmet medical needs like behavioral health, depression, anxiety, substance abuse, even high blood pressure.
“We see it every day, and if we don't do that treatment, we can't be successful in HIV treatment and prevention. So we really have set the stage to supply the health care in a comprehensive manner, and really take it as a patient centered approach so that we can do the very best for our patients,” Carlo said.
Prism Health North Texas’ Case Management Team is seeking traditional school supplies in addition to personal protective equipment for its annual Back to School supply drive running through Monday, July 26 in an effort to aid North Texas families impacted by HIV as they prepare to transition back to the classroom from virtual learning. The organization is using an Amazon Wishlist to collect donations, though Dallas-area Bank of America offices and the Cathedral of Hope in Dallas are also accepting donations.