Thread by @drmt

1/ My first patient with AIDS was a young Black man - young enough to be the oldest on a pediatric ward - with wasting, diarrhea, fevers. Dx=DMAC. He died without a official diagnosis of AIDS. I was on my first clinical rotation in medical school. It was 1982.

2/ My last pt w HIV/AIDS during training was a young Black woman who presented to the ER with “asthma” that did not clear in the “asthma room” and who had PCP on bronchoscopy. She had had only one relationship.

3/ Many of my patients @GradyHealth with HIV/AIDS were Black in those early days. Some were Latinx. The myth of “gay white” AIDS has never been true, and that has cost many lives and worsened stigma.

4/Today, 40 years after the 1st @CDCMMWR describing AIDS, we have amazing treatments that are improving all the time, thanks to investments in science & research. Some ppl live a normal lifespan. Others die in the prime of life with AIDS, esp in the South. In 2021.

5/ In 2021, we can prevent HIV transmission, even without a vaccine, through U=U & #PrEP. But GA has highest rate of new HIV dx, mostly Black (also brown) & young. Only half of PWH have suppressed virus. W/o #MedicaidExpansion most lack access to PrEP (& healthcare.)

6/ The story of #HIV here is abt housing, income inequality, food instability, poor transportation derived fr generational poverty & structural racism. And stigma. And injustice. Equity begins with justice.

7/ Our workforce is strained & inadequate. The old systems are not working for us. While NYC & SF may end their epidemics in 2030 or even 2025, we won’t end AIDS here any time soon without a sea change.

8/ We were not surprised by the disparities of COVID. We have lived them for 40 years. And yet, we are a resilient lot - PWH, LGBTQI+ folk, racial & ethnic minorities, & healthcare/public health workers. Our pandemic will be smoldering on when COVID has been largely contained.

9/ The COVID pandemic taught us we can do the impossible. We must translate that urgency into ending the HIV pandemic. Rise up. Change laws. Educate. Fund health. Rethink healthcare. End criminalization. Reform criminal justice. No excuses. Do it now. Don’t wait for 50.