Edwin J Bernard

In May, the largest analysis ever undertaken of cancer incidence trends among HIV-positive individuals in the United States  found that nine non-AIDS-defining cancers are more likely to be seen in HIV-positive individuals than in the general population. Notably, the study found that between 2000 and 2003 (the most recent time period analysed), anal cancer was almost 60 times more common in HIV-positive individuals than in the general population.

One of the tangible benefits of successfully treated HIV infection is the expectation of a longer – and healthier – life. A recent article in the New York Times, entitled ‘AIDS patients face downside of living longer’ suggested otherwise. The article paints a bleak picture of prematurely aging long-term survivors, and suggests that this may be the future for all HIV-positive individuals. But how real are the risks of premature aging for someone on effective treatment today? Is it correct to call an increased risk of heart disease, cancer, bone disease and other illnesses traditionally associated with aging ‘premature aging’? And is it true that these health conditions are an inevitable result of living with HIV, and that we are powerless to do anything about it?  And what about the benefits of aging? If you are aging with HIV, doesn’t that mean that you are still alive? And doesn’t the wisdom that comes with aging with HIV mean anything?

I don't recall the exact moment when I realised that my face looked different. It was some time in 1999; 16 years after I became infected with HIV, 11 years after my HIV diagnosis, six years since I first began antiretrovirals, and three years into dual therapy with 3TC and d4T.