I walked past this advertisement posted at a bus stop the other day and had to pause. It announces a new medication for the treatment of HIV-related belly fat, or lipodystrophy. It is remarkable for many reasons, but perhaps most strikingly it represents the latest sign that the battle against HIV/AIDS has further matured into chronic disease management and a tame discussion in the public realm. It hasn’t always been so of course.
Imagine this advertisement splashing across billboards in the 1980’s when there were no effective treatments for the disease, and the general public feared contracting the disease from any sort of contact with infected individuals. There has been, and continues to be, much suffering from HIV/AIDS. But when one considers the seismic cultural, scientific, and public health shifts that were needed to discover, educate, prevent, and manage this terrifying killer – a sign post proclaiming we can now help the cosmetic effects upon the belly is nothing short of a miracle.
Cynically we can look at this ad and lament the fact that even one penny is being diverted into “weight loss” medications instead of an all out continuing effort to defeat HIV/AIDS in total. One might also notice the irony of the discarded high fructose corn syrup soda bottle on the street beneath the sign. It might also lead to the false assumption that we have already won the battle, and that misery across the world and behind closed doors is only experienced when looking at the belly in the mirror.
But for some reason I felt like this sign was a glimpse of a promising future, and a reminder of a much darker past, in the saga against HIV/AIDS. Weight loss, wasting, and cachexia are now giving way to lipodystrophy and belly fat, according to the signs of the times at least.
These ads from the 1980’s seem rightfully dated:
In 1983 I sat in the Grady Hospital room of a 26 year old man whom I’d grown up with and watched him die of Aids. His parents and his sister weren’t there. They’d shunned him as a disgrace. After his demise his committed life partner had him cremated and invited me to the memorial service. His family didn’t attend. We scattered his ashes at Oakland Cemetery in Sheffield Alabama where he’d grown up. His mother, though much younger was a close friend of my grandmother. She never voiced regret over her decision to abandon her only son. As a cancer survivor I know that you don’t ask for this. You ask for love. You don’t deserve this. You hope for mercy. Years later when I started my current job I worked with a young man whose life mate was dying of aids. It was heart breaking, especially because other co-workers didn’t see the need to offer this man condolences. Where do we get off bearing the sword of judgement? Jesus lived on the street and hung out with the homeless and prostitutes. He attracted blue collar companions. His companions were all sinners. How do we dare judge these people? I am so pleased that there is effective treatment for AIDS now. I personally know that one of the men at the CDC in Atlanta who was on the original team investigating this disease was a devout Christian. He was my Sunday school teacher when I was a child. Still, while we can rejoice in the victories over the disease, there are still pockets of prejudice. I don’t care if it is a choice or inborn, God so loved the world. Who are we to judge?
Welcome back, Dr. Charles. I’ve missed your posts, and your absence has been felt.
I thought the same thing about this medication when I learned about it. I can tell you that the shame one feels about the body after learning you have the disease is abundant, so maybe this medicine helps some people feel in control of one small aspect of their weight. I don’t think it causes weight loss? Just redistribution?
Like so many others, I have missed you, Dr. Charles — not just in terms of frequency of posting but… *your* voice, telling what *your* eyes see, and what your brain/heart thought/felt.
It’s bound to be a challenge, but what a great one, to shift from a breathless pandemic mentality to a chronic-problem-solving mode. [Insert caveat that the pandemic continues.]
Keep writing… (for free, please). What? I’m not proud…