Sunday, Dec. 1, was World Aids Day, but HIV/AIDS is a year-round concern for a University of West Florida instructor. The road Dr. Wesley Farr took on his way to working with HIV/AIDS patients had a few turns. “I got interested in infectious disease as a way to do tropical medicine in the early 80s. That’s when I was active-duty Navy overseas. And when I visited programs that had an interest in tropical medicine they told me that there are no research funds anymore for tropical medicine. All of the research funds were going to HIV. That was in 1986, when I was looking for fellowships.”
That was also the year of the Surgeon General’s Report on AIDS. The report made it clear that HIV cannot be spread by casual contact and called for a nationwide education campaign, including early sex education in schools; increased use of condoms; and voluntary HIV testing.
“So I started seeing HIV patients. First in the Denver General clinic, and later on at the VA Hospital in Denver. I got very interested in it right in 1987 (which) was when the first HIV drug, AZT, was approved (by the Food and Drug Administration). And so we saw a remarkable response in patients who took (the drug)”. Eventually the virus built a resistance to AZT, and the treatments began to evolve. Now there is a three drug regimen that has changed the lives of people diagnosed with HIV. “And all of a sudden, the long-term outcome for HIV patients changed from a probably fatal infection to a chronic infection, (with) which they could live for 10, 20, 30, 40 (more) years. They could live relatively normal lives.”
Dr. Farr says that the face of the AIDS epidemic in the US has remained fairly constant. Injection drug users and men who have sex with men are still the two largest groups at risk for contracting HIV. Still, a little over 30% of new cases in Florida are heterosexual men and women. That number is slightly higher than the national average.
Overseas, the epidemic has been devastating. “The HIV epidemic in certain countries in Africa just decimated the young-adult population. It varies from country to country, but they are making progress in HIV prevention programs and getting HIV drugs to the patients who need them.”
Each month, Dr. Farr travels to Charleston, West Virginia and does hands-on work with patients.
“Charleston Area Medical Center is also a teaching site for the West Virginia University School of Medicine. So when I was a student, I did five months of rotations there, three (months) as a third-year student and two (months) as a fourth-year student. So I know the facility fairly well and I know some of the people there, too. So it’s kind of like coming home for me. But I go up one week a month. I do the in-patient infectious disease consults. The Ryan White Clinic that serves HIV patients is a separate clinic.”
Farr says the opioid epidemic has led to an increase in injection drug use which, in turn, has led to an increase in HIV infections in the region. And despite the advances in medications, he still sees one or two patients with full blown AIDS most months.
As for the future of treating patiens with HIV?
“I am not optimistic about a medical cure for HIV infection, and I am not optimistic about a vaccine. HIV has been defying the medical researchers for over 30 years now. I don’t see that changing anytime soon. The problem with the vaccine is there’s a lot of antigenic diversity with HIV. It rapidly changes. So it’s difficult to get a vaccine that’s going to be effective against all HIV viruses.”
However, medical research has fooled him before.
“I was very pessimistic about getting a medical cure for Hepatitis C, but by combining two or three drugs with two different mechanisms of action, which is what we did with HIV, they (now) have very effective cures for Hepatitis C. So, even though I’m pessimistic, I don’t see anything coming soon, the medical researchers have defied logic in the past so I’m sure they’ll do it sometime in the future.”
There are currently one point one million people living with HIV in the US. 15% of them don’t know it. If you think you or someone you know may be at risk, Oasis Florida offers free, confidential testing with no appointment needed at their Pensacola and Fort Walton Beach locations, as well as in their mobile test van. Learn more at Oasisflorida.org.