Earlier this year VICE profiled the progress made in battling HIV with a drug called Truvada. When taken daily, Truvada is 99 percent effective in preventing HIV negative people from contracting the virus. It isn't a cure, but it is miles from where we were in the early 1980s.
It is difficult to comprehend the fear that HIV/AIDS spurred when the virus first appeared in 1981. Nor is it easy to appreciate how much hospitals have done to improve their responses to new diseases, simply because of lessons taken from that early period. To get a sense of this progress, we spoke with Professor Suzanne Crowe, an infectious diseases physician who co-established Australia's first HIV clinic at the Fairfield Hospital in Melbourne.
VICE: Hi, Suzanne. Do you remember when you first heard the terms HIV or AIDS?
Professor Suzanne Crowe: The first time I heard about it, I was sitting in a journal club at the Alfred Hospital in 1983 or 1982. We were hearing about a new disease that was affecting gay men in San Francisco, Los Angeles, and New York. And we were all sort of listening to it, wondering, "Oh my goodness, I wonder if that will ever come to Australia."
Do you have a vivid memory of the first case you encountered in Australia
Yeah, I do. There was one fellow, an American. He was a young man with an Australian partner, and he'd come here to say goodbye to his friend. So he arrived in Melbourne and they went out to dinner in a fancy restaurant in Armadale and while he was there he developed seizures so he was brought by ambulance to Fairfield Hospital and he was one of our very first patients.
He had an infection in the brain and stayed in the hospital for weeks getting sicker and sicker, and all that time he wanted to go home to the US to say goodbye to his mother. But in order to fly, he needed a medical escort because he was receiving intravenous treatment and oxygen. In those days the airlines were very, very nervous, so I was his medical escort and the airline insisted that I dressed in a yellow plastic suit and wore a mask. When we got to the US, the airline in Texas had cancelled our tickets so that delayed us another 12 hours. By the time we got there, he'd died without seeing his mother. That was a very poignant case that I remember.
In those early days, how much did we know about the virus?
At the very beginning, we didn't even know how the virus was transmitted. We knew it was sexually, but we didn't know if there was any other way, so I remember examining patients and having to look in their eyes and holding my breath while I was doing it because I didn't know if there was aerosol transmission of HIV.
It was tough. People were dying left, right, and center. We didn't have any treatment; we just best managed their infections and malignancies.
What was life in the clinic like at that stage?
Fairfield at that stage was known for its culture of care. The patients who came in were almost all gay men, mostly young, and virtually all of them were really grateful.
They really retained their sense of humor as well; we'd be on a ward-round taking young medical students around who probably had never seen an outwardly gay man before in their lives, it was a totally new experience for them and I can remember one young medical student who was asked to take a history of one of our new patients. The young medical student asked my patient, "Do you have a history of engaging in homosexual sex?" And the patient said, "Of course, darling." So my student asked, "How many sexual partners do you have?" And the patient said, "Oh, maybe 20." And the student asked, "Is that in a year?" And my patient replied, "No, darling, we're talking every night."
Our patients were gorgeous, many of them would stay with us for months because they were too sick to go home and we became very good friends.
There were other hospitals in Melbourne that left food for patients outside the door because no one wanted to go near them.
What was the first bit of medical progress in combating the virus?
I think it was August of 1984, Ian Gust, the head of the laboratory at Fairfield Hospital heard there was this new diagnosis and he brought the test back from the States. That was when we first learned that it was caused by a virus and we could actually test for it. If I look back on it, at that stage, 25 percent or more of the gay men who came to our clinic turned out to be HIV positive.
There was a sense of impatience because we knew we had a test but we didn't know if people stayed positive for life. We also didn't know if it meant the person had just recently been infected, or if everybody with a positive test would go on to get AIDS. It was really hard.
Did you feel supported by the Australian Government at that time?
Yes. There was a very rapid and strong response and there were people in government who came on board very quickly to support our efforts.
Certainly there were other hospitals in Melbourne that left food for patients outside the door because no one wanted to go near them. There was certainly that kind of discrimination in hospitals in the late 1980s. But it boiled down to fear and not understanding how the virus was transmitted.
In terms of the learning curve for Australian medicine, how do you think our treatment of the HIV epidemic shaped how we deal with new diseases?
The learning curve in Australia was incredibly steep and incredibly rapid. There were probably a dozen people in Australia who very quickly moved into leadership positions and those same people have since helped the government and hospital administrations with responses to other epidemics since. We now have mechanisms in place and experience from HIV that has been translated to SARS, Asian Flu, and Ebola.
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