If I were given a choice, I would rather find out that I was HIV infected today, in 2007, than 20 years ago, in 1987. For people fortunate enough to live in places where it is available, combination antiretroviral therapy has changed the nature of HIV infection from a terminal condition to a treatable, chronic illness. Each time researchers recalculate the average life expectancy of HIV-infected persons taking antiretroviral therapy, they arrive at a higher figure. Even though there is no cure for HIV infection, daily treatment has emptied the HIV wards of hospitals and has allowed infected people to feel well and move on with their lives.

Nevertheless, would I rather have a chronic illness, or not?

I'd rather not.

I'd rather not take pills every day. I'd rather not worry that the medication will stop working. I'd rather not run the risk of experiencing side effects that some people get from the medications. I'd rather not worry about infecting my sex partners. I'd rather not increase my risk of getting other diseases such as lymphoma, coronary artery disease, and lung cancer that seem to be more common among HIV-infected individuals.

As with any life-changing experience, becoming infected with HIV has given some of my patients a valuable perspective on certain aspects of their existence. Nevertheless, almost all of them do whatever they can to avoid infecting others.

I am very, very glad that HIV is treatable, both for my HIV-infected patients and for anyone who becomes infected in the future. I'm also glad that we have condoms, which are very effective at preventing the sexual transmission of HIV when used correctly, so that all of us, whether HIV infected or uninfected, can help to reduce the number of people who need to take antiretrovirals in the first place.