As the Prognosis for HIV Improves, the Ryan White Project Educates Students about the History of AIDS

A chronic disease rather than a death sentence, AIDS is still an important public health issue

When Natalie Aloyets Artel recently spoke to two undergraduate community health promotion classes at Rutgers about her work with the Ryan White Project, none of the students had heard of Ryan White, and few were familiar with the turbulent history of acquired immunodeficiency syndrome (AIDS).

Born around the time that Ryan White died, students were fascinated to learn about the Indiana teenager, a hemophiliac who contracted the virus through a blood transfusion and experienced discrimination because of his illness. 

Aloyets Artel, senior project coordinator for the Rutgers School of Social Work's Institute for Families, spoke about the hysteria that accompanied the emergence of HIV/AIDS, when those infected died quickly and painfully from a misunderstood disease. The community was not educated about transmission and as a result there was much fear. Ryan White was expelled from middle school because of his infection and when he tried to return, many parents and teachers rallied against his attendance.

“My generation has not experienced going to funerals constantly and friends passing away, so it is not as real to us. The talk gave us the back story to understand why the Ryan White Project was needed and what was sacrificed by Ryan and others who died from AIDS,” says Brian R. Robles, a senior majoring in public health who is also a peer educator and HIV counselor at Rutgers Health Services.

Robles said the talk inspired him to watch, How to Survive a Plague, a 2012 American documentary about the early years of the AIDS epidemic. More recently movies like Dallas Buyers Club hearken back to a time in the 1980s and early 1990s when whole communities were decimated. The first AIDS cases were reported in the United States in June 1981.

“Today HIV is a chronic condition managed through a medication regimen rather than the terminal illness it once was. Students are surprised to learn about the stigma that surrounded an AIDS diagnosis in the 1980s. The challenge today is to keep HIV/AIDS relevant for young people. It continues to be an important public health issue and should receive funding,” said Aloyets Artel, who assists the Middlesex County Department of Human Services in implementing the Ryan White CARE Act locally.  

Aloyets Artel provides administrative support to the Middlesex-Somerset-Hunterdon HIVHealth Services Planning Council. The national councils are federally funded by the Health Resources and Services Administration through the Ryan White HIV Treatment Extension Act of 2009 (originally the Ryan White CARE Act of 1990). They provide direct medical and psychosocial health services to people in areas with high levels of HIV and AIDS who are low-income and uninsured. Services include primary medical care, case management, dental care, food and housing assistance, mental health and substance abuse counseling.

With the increased success of medical management and HIV suppression through medications, the community viral load, which is the combination of individual viral loads of people infected with HIV in a community, is very low in the Middlesex/Somerset/Hunterdon area. Currently, 86 percent of people living with HIV in this geographic area have an undetectable viral load.  

“They are still HIV-positive, but their virus levels are considered undetectable. As a result, they are less likely to infect others. When individuals living with HIV adhere to their treatment, the number of transmissions in the community is greatly reduced. In this way, HIV becomes a chronic disease and not a death sentence,” says Aloyets Artel.

Despite the positive gains, many people with HIV/AIDS still experience a stigma related to their condition. Some individuals will not go to medical providers who specialize in HIV/AIDS for fear that someone will see them at the office and know that they are HIV positive, Aloyets Artel reports. 

For Robles, working with the HIV population in his future public health career is a priority.

“I have always been interested in this field, but learning more about the history of the disease has made it even more of a motivation for me to want to reduce the incidence of HIV,” he says.