In 2021, more than 900 Ohioans were diagnosed with Human Immunodeficiency Virus, better known as HIV. That's according to the Centers for Disease Control and Prevention.
While a cure for HIV remains elusive, great advancements in prevention and treatment mean people with the virus are living longer, healthier lives.
Scott Wolf, a Columbus area resident, works as a financial advisor in the emergency room at Riverside Methodist Hospital in Columbus. It's rewarding work, he said, and feels like he's giving back.
“Working in an ER, too, helps you be aware of what can happen every day. I'm very grateful that I'm not hit by a car, you know, something like that," he said.
Wolf said he's also alarmed when he sees a patient arrive at the ER near death with late-stage AIDS. “Many times people wait too long and even if you're in the hospital, it's too late. They can't help you," Wolf said.
Wolf himself was diagnosed positive for HIV about 20 years ago. While it was scary at the time, Wolf said he was more fortunate than many other patients who contracted the virus years earlier.
“I lost a lot of friends, through no fault of their own. It was just the timing. You know, I was maybe luckier because I didn't get it until later and the medicines had advanced to where it was more of a manageable disease," he said.
Marko Phillips, also of Columbus, contracted HIV in 1994. He said the diagnosis sent him spiraling deep into depression.
“I cut myself off from everything and everyone because it was at a dark stage in my life and I was scared. I was nervous. And mostly I was depressed, because I didn't know a way out," Phillips said.
Phillips eventually climbed out of the abyss and took control of his illness, thanks in large part to an HIV-support group.
Instead of having to take as many as 14 pills, many of them with awful side effects, Phillips today keeps the virus in check with just three medications. "Which is miraculous," he said.
One of the physicians leading the research that has made these breakthroughs possible is Dr. Carlos Malvestutto, a professor of infectious diseases at Ohio State's Wexner Medical Center.
It is estimated that about one in seven HIV-positive individuals in the U.S. are completely unaware that they have HIV, which is why increased testing and early treatment are so important, Dr. Malvestutto said.
Today's treatments can render HIV effectively undetectable.
“If the virus is undetectable, then that equals untransmittable. So U equals U," Dr. Malvestutto said. "What it means is that treatment is, in fact, prevention."
Dr. Malvestutto points to mathematical modeling that shows if 90% of people living with HIV were on treatment, and 90% of those were virally suppressed, the HIV epidemic would effectively end.
But, he said, a set of Ohio laws written at the beginning of the AIDS scare actually discourage people from getting tested.
Ohioans living with HIV can be charged with a felony for failing to tell sexual partners about their status. They can even be charged for spitting on someone, despite the fact that such an act does not transmit the virus.
“We've known that for a very long time and yet people are still prosecuted," Dr. Malvestutto said.
On the medical science front, Dr. Malvestutto and his colleagues are working on strategies to target the latently-infected cells that harbor the virus.
"We call one of the strategies the 'kick and kill' strategy," Dr. Malvestutto said. “Can we wake those cells up, activate them and then we can clear them out, either harnessing the immune system to go after those cells or using some of the drugs that we currently use for treatment?"
But advanced HIV treatments don't come cheap. The federal Ryan White program continues to provide last-resort HIV drug assistance. The program is named for a teenager with hemophilia who faced AIDS-related discrimination at his Indiana school.
"He had to move, and the people of Kokomo at the time were were very awful to him," Wolf said. "But it was unknown. People were very afraid."
That fear and stigma persists to this day—but so does the risk, which is why public health officials are encouraging everyone to get tested.
"If you've never had an HIV test, you should have one. In fact, CDC recommends that everyone between the ages of 13 to 64 should have been tested at least once," Dr. Malvestutto said, adding that at-risk individuals should get tested regularly.
By knowing their HIV status, individuals can then take charge of their health and take the next steps toward prevention and treatment.
