Hooked on ID with Melanie A. Thompson, MD
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HIV captured me during my first clinical rotation in medical school, early in the Plague Years, around the same time that AIDS was getting its name from CDC.
My first patient with AIDS was a young Black adolescent, barely young enough to qualify for the pediatric ward at Grady Hospital. He had been hospitalized for unremitting fevers, sweats and weight loss that we finally diagnosed as due to disseminated Mycobacterium avium complex (DMAC). He stood out, not just because he was basically an adult in a sea of children, but also because he was gay, closeted, scared and alone. He told no friends or family about his attraction to men, but he had been having sex with men, mostly older men, for years. He had no visitors. He died weeks later with a diagnosis of DMAC. We did not have a test for HIV, and AZT was 5 years away. He was the first of so many — too many — young people who died of AIDS before we had anything to offer them, except our love and understanding. Fast forward to 2021 in Atlanta, where young men and women are still dying of AIDS. So much has changed, and yet so little.
The complexity of this new syndrome and the enormity of the social justice issues it raised were compelling to me. I joined one of Atlanta’s leading HIV practices, but I always felt I needed to do more. The AIDS Research Consortium of Atlanta (ARCA) arose from desperate times when, other than AZT, life-saving HIV treatments were only experimental. A stalwart group of HIV treaters banded together to bring HIV clinical research to our patients across Atlanta. ARCA became one of 18 Community Programs for Clinical Research on AIDS sponsored by the National Institute of Allergy and Infectious Diseases and would go on to conduct more than 400 clinical trials of investigational drugs for treatment and prevention; diagnostic assays for HIV, sexually transmitted infections and viral hepatitis; and epidemiologic studies in collaboration with the CDC and the state of Georgia.
Once we had potent therapies to treat HIV, we needed ongoing guidance for HIV care providers surfing a rapidly changing landscape. Serving on many guidelines panels over the years has been a privilege but also an important part of my ongoing education. I currently sit on the International AIDS Society USA and the HHS antiretroviral guidelines panels and co-chair the HIV Medicine Association (HIVMA)/Infectious Diseases Society of America HIV Primary Care guidance panel.
I became involved in HIVMA because clinical care and research required yet another kind of action to optimally translate scientific breakthroughs into meaningful change. HIVMA has taught me an enormous amount about being a clinician-advocate for evidence-based policies on Capitol Hill and in local and state government at home.
The trifold practices of clinical care, research and policy have intersected and balanced each other throughout my career. To me, there is no more rewarding field than HIV medicine, with the challenges it poses to care for patients and to change the world just a tiny bit in the process.
— Melanie A. Thompson, MD
Infectious Disease News Editorial Board Member
Prinicipal investigator, AIDS Research Consortium of Atlanta
Former chair, HIV Medicine Association