"AIDS is kind of like life, just speeded up. " JavonP.,
heroinaddictwithAIDS, Bronx, NewYork, 1988 "Now I'm not so much
scared of dying as scared of living. " Mike D., heroin addict with
AIDS, New Haven, Connecticut, 1998 Within little more than a
decade, AIDS has been tranformed from an untreatable, rapidly fatal
illness, into a manageable, chronic disease. Most of this
tranformation has occurred in the past five years, accelerated by
the advent of protease inhibitors and the proven benefits of
combination antiretroviral therapy and prophylaxis against
opportunistic infections. For people living with HIV/AIDS, these
developments have offered unprecedented hope, and also new
challenges. As reflected in the quotes above, some of the anxieties
and anticipation of premature dying have been replaced by the
uncertainties involved in living with a long-term, unpredictable
illness. The role of caregivers for people with HIV/AIDS has also
changed radically over this time. Earlier in the epidemic, we
learned to accompany patients through illness, to bear witness, to
advocate, to address issues of death, dying, and - reavement. The
arrival of more effective therapy has brought with it new capabi-
ties, but also new complexities, raising difficult problems
concerning access to care, adherence, and toxicity.
General
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