May 5, 2014

Cayuga Medical Doctor Speaks on Importance of HIV Testing

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Douglas MacQueen ’00, an infectious disease doctor at Cayuga Medical Center, spoke Monday evening about sexually transmitted infections, especially the human immunodeficiency virus.

MacQueen began by explaining that HIV works by attacking CD4 T-cells — “part of the immune system that help other parts of the immune system fight infections” — and hijacking their machinery to procreate, eventually killing the cell.

Once the CD4 count hits a certain low, victims become susceptible to acquired immunodeficiency syndrome and other opportunistic infections, some of which are potentially fatal, according to MacQueen.

According to MacQueen, the first cases of AIDS were recognized in the 1980s, but HIV was not identified as the cause until 1984. Initially, the virus seemed to be concentrated among gay men and hemophiliacs, but now “being human is the most important risk factor,” MacQueen said, though the Centers for Disease Control and Prevention continue to identify certain population segments as being at especially high risk for contracting the virus.

MacQueen listed blood, vaginal fluid and semen as “high risk fluids” for transmitting the disease through behaviors such as sex and intravenous drug use.

At-home tests are now available over the counter, according to MacQueen. Despite the relative ease of diagnosis, he said, only 60 to 80 percent of Americans with HIV know they have it.“I feel that through education, we can combat this phobia towards HIV-positive people.” — Lex Brown ’15

This unawareness, coupled with the fact that the virus can remain asymptomatic for several years, can be problematic in delaying treatment and furthering its spread, MacQueen said. Due to the time gap between contracting the disease and detection of the antibodies, he cautioned that even a negative test result should be repeated to ensure HIV status.

“It takes about three or four months for the body to make antibodies for the infection, so in those first few weeks, if you do the test, it is going to come back negative, and it may be a false negative,” he said.

Although the virus is not yet curable, MacQueen said it is treatable. Around 1987, the first antiretroviral drug — which inhibits the lifecycle of the virus by keeping it suppressed to allow the CD4 cells to reproduce — became available. The modern treatment has reduced side effects and is an easier to maintain regimen, according to MacQueen.

“We can give you medicine to keep the lid on it and allow you to have an otherwise normal life,” he said.

MacQueen also spoke about a treatment that can be used immediately after exposure to HIV transmission risk which leads to about a zero percent transmission rate of HIV infection.

MacQueen said that this protocol is available at Gannett in addition to the ER and convenient care, and should be used by students if they have or think they have been exposed to HIV.

The discussion also briefly addressed the stigma associated with homosexual behavior, with one audience member questioning the law which prohibits men who have sex with other men from donating blood.

“It’s obviously ludicrous,” MacQueen said of the law.

MacQueen concluded with a brief overview of the symptoms and treatments for other sexually transmitted infections, including gonorrhea, chlamydia, herpes and syphilis, emphasizing that the infections can remain asymptomatic and encouraging testing and pursuing treatment.

Lex Brown ’15, one of the cofounders of the HIV support group on campus, said he organized the event to promote a more thorough understanding of the virus, how it is transmitted and what it means to be HIV-positive.

“I know that pos-phobia on campus is mainly due to just people being uneducated,” he said. “I feel that through education, we can combat this phobia towards HIV-positive people.”

The presentation was sponsored by Haven: Cornell’s LGBTQ Student Union.