Conversations Around Diagnosing HIV, Shaping Treatment Expectations


A clinician offers insights on the initial conversations around learning to treat a chronic disease and the importance behind getting patients started down the right treatment path in the early days following a diagnosis.

The news can be devasting. Telling a patient for the first time they are diagnosed with HIV can be very difficult for patients to hear. Obviously, concerns about mortality may immediately surface, but other considerations may come to mind as well.

“It is oftentimes a shock for our patients. It is a difficult diagnosis just because there is a good amount of stigma out there, says clinician Jonathan Z. Li , MD. Li is the director of the Harvard/Brigham Virology Specialty Laboratory, the director of the Harvard University Center for AIDS Research Clinical Core. He is also an associate physician at Brigham and Women's Hospital in Boston, and associate professor of Medicine at Harvard Medical School.

However, Li says that once patients are reassured they can live long lives if they are adherent to their medications and make lifestyle choices that are condusive to their health, this can help them turn a corner.

“It is important for our patients to realize that managing HIV now is night and day compared to what it was like in the 80s and 90s,” Li stated. He notes the ability to take an injection on a monthly or bimonthly dosing schedule is one example that has made adherence easier.

HIV, when it first appeared in the early 1980s, was quite a mystery. Eventually medical science was able to understand the virus leading to the advent of antiretroviral therapies and taking it from an almost certain terminal diagnosis a generation ago to now one that has evolved into a chronic disease.

Interestingly, COVID-19 parallels the early days of HIV in that there is some mystery into why the virus acts the way it does. Certainly, one example is long COVID; another is why patients experience a viral rebound after treatment for acute SARS-CoV-2 infections.

In addition to his work in HIV, Li is a member of the NIH COVID-19 Treatment Guidelines Panel, and has been involved in research around SARS-CoV-2.

At this year’s CROI, Li will be presenting his topic, “Viral Rebound During AND After SARS-CoV-2 Treatment,” at a symposium titled COVID-19: Where Are We Now? on Tuesday from 4:00 PM - 5:30 PM PT.

Contagion spoke with Li on his CROI presentation, and will publish the interview after the embargo lifts later this week.

In this first interview segment, Li talks about conversations around an HIV diagnosis and shaping treatment expectations with patients.

Keep an eye out for our CROI coverage over the coming days as we will be onsite at the conference bringing you data and research on the latest topics and interviews with presenters, clinicians, and stakeholders.

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