by Dr. Colin Fields

Kaiser Foundation Health Plan

of Washington's HIV/PrEP

and Gender Health Programs

Forty years ago, on June 5, 1981, the CDC shared troubling reports of a rare, severe lung infection in five previously healthy Gay men. We know today that this was the start of the AIDS epidemic, a period of enormous suffering in the LGBTQIA+ community, with ongoing ripple effects across our country and the world.

Occasionally, my patients at Kaiser Permanente ask me, "Is HIV still a thing?" and I have to tell them it absolutely is. In this era of COVID-19, we unfortunately have two simultaneous viral pandemics right now.

When a COVID-19 outbreak trapped passengers onboard a returning cruise ship off San Francisco last year, some of my older patients remarked how emotional it was to observe the parallels between an isolated group of people so quickly and publicly stigmatized during the virus's initial outbreak and the Gay community's experience during the AIDS epidemic.

Although we still have a long way to go as a society to address the fear and discrimination that can accompany the emergence of any new virus, medical care for patients living with HIV has evolved significantly since 1981. Today, living with HIV/AIDS is comparable to monitoring and managing many chronic health conditions. In addition to the landmark development of pre-exposure prophylaxis (PrEP) almost a decade ago, this year we saw the appearance of the first long-acting injectable antiretrovirals.

King County has been an impactful global leader in the fight against HIV/AIDS, one of the few places in the world that has met the United Nation's 90-90-90 target, and one of the earliest and most successful adopters of syringe exchange and HIV PrEP programs. Kaiser Permanente is proud to be part of this region's collective effort to combat the virus, and we are committed to continuing to support our patients who are at risk for contracting HIV or already living with it.

One way we've supported our communities most at risk is to expand our PrEP program in the past year to better serve patients who live in areas of Washington state without reliable, high-quality access to care. Providing more virtual care options, including video visits with a provider, has helped us reach patients who can benefit from PrEP but may not otherwise have access to the preventive care they need.

The 40-year legacy of AIDS is still with us, but modern medicine is continuing to evolve to deliver quality, inclusive care that meets the needs of diverse populations, where it has historically fallen short. Every patient, whether they're facing a diagnosis of HIV or of COVID-19, deserves the same high-quality care and a relationship with their doctor that supports their total health and well-being.

When I travel around Capitol Hill, I pass the AIDS Memorial Pathway (AMP), a public art project under development around the Capitol Hill light rail station. The AMP is just one reminder of the importance of understanding and honoring our community's history as we continue to build a healthier future.

Dr. Colin Fields is the medical director of the Kaiser Foundation Health Plan of Washington's HIV/PrEP and Gender Health Programs. His practice includes care for adolescents, adults, and LGBTQ youth, as well as HIV and PrEP management.