HIV: A Physician’s Perspective

Mark Bloch, MD, has been working in the field of HIV medicine since 1983, and he is now the director of clinical research at Holdsworth House in Sydney, Australia. Dr. Bloch is actively involved in research surrounding HIV and sexually transmitted diseases. He completed his medical degree at the University of Western Australia and Master of Medicine in HIV and Sexual Health at the University of Sydney.

BSTQ: Is there still a stigma attached to an HIV diagnosis?

Dr. Bloch: Getting an HIV-positive diagnosis typically comes as a shock, and patients find it hard to fully absorb the news. It can take time to adjust to their new reality and, yes, with the perceived stigma, people experience a range of emotions, including anger toward whomever may have transmitted the virus to them, feelings of shame about the diagnosis itself and, of course, fear about the future. 

BSTQ: What is the biggest misconception about HIV today?

Dr. Bloch: Many people simply don’t know that HIV has become a manageable condition and not a death sentence. Thanks to medical advances, we can now control symptoms extremely effectively, so much so that the virus can actually be suppressed. That means a person diagnosed with HIV today can not only expect to enjoy a normal life span, they also can avoid passing HIV on to others.

BSTQ: What can you share about HIV treatment?

Dr. Bloch: Early treatment is always advised. Research has shown that starting antiretroviral treatment early in the course of a diagnosed HIV infection when the immune system is stronger results in better long-term health outcomes compared with delaying it. When HIV diagnosis and treatment are delayed, HIV continues to replicate, and this can not only negatively impact the infected individual’s health, it also increases the risk of transmitting the virus to others. 

BSTQ: What types of medications are used to treat HIV?

Dr. Bloch: Medications used to treat HIV are called antivirals or antiretrovirals. They work by stopping the HIV virus from multiplying in the body and preventing the damage that the infection can cause. Typically, the treatments include a menu of medications that, when combined, help prevent the virus from becoming treatment-resistant. In most cases, treatment can be combined into a single pill, taken once daily. From a long-term perspective, HIV treatment must be taken indefinitely to control the HIV infection. In the future, there will be longer-acting treatments in pills or injections that need to be taken only every few months. Research is also looking at finding a cure for HIV; this, too, may be an option one day.

BSTQ: What kind of side effects do patients undergoing HIV treatment experience?

Dr. Bloch: Obviously, people react differently to specific medications, but on the whole, the currently available treatments for HIV are simple, highly effective and very well-tolerated. If side effects do occur, they tend to be on the mild side. The other positive news for newly diagnosed HIV patients is that there are multiple treatment options, so if one is not tolerated, we can try something different. For those who are hesitant about moving forward with treatment, I remind them that the effects of living with an untreated HIV infection are much, much greater than any side effects from the treatments themselves.

BSTQ: What lifestyle changes do you suggest to HIV patients?

Dr. Bloch: HIV treatment alone can make a huge difference in the quality of life for HIV patients, but adopting a healthy lifestyle is also a key component for long-term health. For example, it’s important to mitigate the risk of developing other conditions such as diabetes or heart disease, which can worsen HIV symptoms and compromise treatment plans. In my experience, an HIV diagnosis can often serve as a wake-up call and motivate someone to pursue more health-conscious lifestyle choices.

BSTQ: What support do HIV-positive patients usually require after finding out their diagnosis?

Dr. Bloch: HIV-positive patients require medical support that includes ample factual information about their condition. There is still a lot of misinformation out there, so getting the facts can actually be a relief and, in some cases, even empowering. They will also need additional testing to confirm the diagnosis and find out their viral load (how much virus is circulating in the body) and CD4 count (the condition of the immune system that fights infection). Equally important is mental health support from either a counselor or peer support group. Patients often benefit from the opportunity to discuss their diagnosis with others who have HIV and understand the unique issues associated with it.