In 2023, AIDS deaths and HIV infection rates in the United States are not leading the news reports on CNN or the New York Times. Yet, HIV/AIDS continues on to impact the lives of many and our health care system.

Worldwide, some 39 million people were living with HIV in 2022, up from 31.5 million in 2010, the result of new infections and people living longer with HIV due to improved treatments. While there have been significant declines in new infections since the mid-1990s, and 2022 saw the fewest new HIV infections since the late 1980s, there were still about 1.3 million new infections in 2022, or about 3,500 new infections per day. The pace of decline varies by age, sex, race, and region and progress is unequal within and between countries. This data is from KFF, a reputable independent source for health policy research. https://www.kff.org/about-us

During the final weeks of the semester, the VCU Health Sciences Library offers several opportunities to reflect upon the AIDS crisis as experienced nationally and in Richmond through exhibits on loan from The Valentine and the National Library of Medicine, a documentary screening and a virtual experience with the AIDS Memorial Quilt. A companion exhibit from Special Collections and Archives will offer artifacts of Richmond’s public health crisis of the ‘80s and ‘90s. Items from VCU Libraries’ circulating collection focused on the history of AIDS, research efforts and community support will be on display and available for checkout in the library lobby. The display and exhibits will be at the VCU Health Sciences Library through December 1, World AIDS Day, and beyond. 

“We hope through dynamic programming and related exhibits we can encourage reflection, discovery, and awareness of how HIV/AIDS impacted the lives of many,” said Health Sciences Library Deputy Director and Research and Education Department Head Emily Hurst, who organized the exhibits. “The discovery of HIV/AIDS led to panic and concern for health care professions and patients. Today, through a variety of interventions, patients with HIV/AIDS can generally lead longer healthy lives.”

“We hope that the display and related exhibits will serve as an important reminder about the many lives lost to HIV/AIDS as well as the work of dedicated health care professionals.” 

One of those dedicated health professionals at VCU was Dan Nixon, D.O., Ph.D. As a student, a fellow, a self-described “humble virus killer” and the longtime medical director (2005-23) of VCU Health’s HIV/AIDS Clinic he has worked for 30 years in infectious disease with a focus on AIDs/HIV.

Since the earliest stage of the AIDS crisis in the mid-1980s, VCU’s MCV Campus has played a pivotal role in providing compassionate care and offering the best known medical intervention to treat people with AIDS. Established in 1986, VCU’s HIV/AIDS Clinic  https://www.vcuhealth.org/services/hiv-services/about-us  is believed to be the largest health center of its kind in Virginia. Its broad mission is to improve the health and social condition of persons living with HIV and to prevent the spread of the disease. True to its founding principles, the clinic today offers a holistic spectrum of services including mental health and psychiatric counseling, medication management, nutrition and other patient education, support groups and financial assistance for treatment and more.  

When Nixon arrived at VCU as a fellow, he worked alongside the pioneers who shaped HIV care in Central Virginia and founded the clinic: physicians Lisa Kaplowitz, Evelyn Fisher and Tom Kerkering. They were great clinicians and great researchers,” Nixon recalls. “At the time, they were my professors and they were the leaders in the early days of the HIV Clinic.  

“By the time I arrived in 1993, it was a very hard time. Now, we have a large population of people who are living with HIV. Then, we did not have powerful drug combinations yet. 

"We could not control the virus.  

“What we did in clinic, I remember, was see a never-ending procession of opportunistic infections due to the weakened immune system, blood stream, lung, GI infections and retinitis. We couldn’t improve the immune system. We constantly battled those infections. We’d partially control it and then there would be another one and another one. They just kept coming and coming. It was rough.

Reflections on the past

“I liken it to oncology before decent chemotherapy drugs. With the exception of a few individuals, it was a death sentence.”

“The ones who are still with us from the mid-1980s had the advantage of having an immune system that was strong enough to last until good drugs came along. All of the patients of that era…they still remember….Those days are burned into their memories.”

“It was late 1995/early ‘96 that a new class of drugs was developed. They were a game changer. You combined a protease inhibitor with the drugs and you could control the virus. The immune system could slowly heal itself and the patient could come out of risks for these infections. There was hope for the first time that they could survive this and potentially live a normal life expectancy.”

Regimens became more effective and more simple for patients to stay in compliance. “It got easier to take the medicines and easier to stay undetectable,” Nixon said, noting that about 90 percent of the 2,500 patients in the VCU Health clinic today are now undetectable. Medications control the infection of new T cells. The virus cannot mutate. Generally, HIV is not transmissible if the person is undetectable and maintains his or her status with prescribed medications. 

“We learned some lessons in the HIV pandemic that I think some people and some patients remember and some don’t. HIV is completely preventable. If you are an IV drug user, don’t share needles. If you are a man having sex with men, if you wear condoms and get testing, you can put the risk of transmission to zero. Back in the ‘90s, we were still learning this stuff. Yet, we still see newly diagnosed patients.   

“One of the lessons for the students is understanding human nature and understanding that you need to work very hard to communicate with the patient. It cannot be overly technical, it cannot be preachy. You have to say,..I've seen people dealing with what you are dealing with. I want to help you and here’s what we can do.”   

While this disease today, with proper care doesn’t have to be lethal, the reality of the pandemic in its early days was quite different. For students and visitors, the Health Sciences Library exhibits offer an opportunity to learn about the pandemic’s early stages and reflect upon the political activism, stigma and community responses that emerged and co-existed while the medical community valiantly sought remedies and lifesaving treatments. 

 AIDS/HIV exhibits and activities 

• “Voices from Richmond’s Hidden Epidemic,” an exhibit on loan from The Valentine

          Oct. 31, 2023 - Jan. 8, 2024 

          Health Sciences Library, 509 N. 12th St., 

          Health Sciences Library Gallery

Despite the considerable advancements in the realms of medicine and social awareness, enduring misconceptions regarding HIV/AIDS persist today. HIV/AIDS is perceived by many as a relic of the past, characterized by modern treatment options and primarily affecting homosexual Caucasian males. However, statistical data reveals a more intricate narrative, notably, that gay African American males face a staggering one- in-two odds of contracting HIV/AIDS. The prevalence of HIV infection within the Black community of Richmond is compounded by many factors, including poverty, the elimination of sex ed programs in public schools and the ongoing opioid crisis. 

Told through the voices of survivors, caregivers, activists and health care professionals, this project, which was displayed at The Valentine in 2021, offers a distinct perspective on the epidemic in Richmond. The exhibit features photography by Michael Simon with oral histories recorded by Laura Browder and Patricia Herrera. VCU Health is among the sponsors of this exhibit. 

• “Surviving and Thriving: AIDS, Politics and Culture,” an exhibit from the National Library of Medicine

         Nov.  6 - Dec. 16 during open hours 

         Health Sciences Library, 509 N. 12th St.

         Special Collections and Archives Reading Room

This traveling exhibit from the National Library of Medicine focuses on the AIDS epidemic that arose in the United States in the 1980s. As the disease spread, so did fear and confusion. The infectious “rare cancer” bewildered researchers and bred suspicion. Many feared contact with those who were ill. “Surviving and Thriving: AIDS, Politics and Culture” explores human stories in the ever-changing relationship between science and society. nlm.nih.gov/exhibition/surviving-and-thriving/index.html

• “The AIDS Experience: Stories of Resilience,” an exhibit of artifacts from VCU Libraries’ Special Collections and Archives

          Special Collections Reading Room

          Nov. 13, 2023-Jan. 26, 2024

This companion exhibit showcases materials documenting the Richmond AIDS experience. The AIDS Experience will consist of two exhibit cases in the Reading Room and will feature materials that focus on the two themes of the National Library of Medicine exhibit, “Thriving and Surviving.” The Thriving case will focus on society/culture and include photographs, posters and publications from libraries-held collections such as the records of the Richmond Triangle Players and the Fan Free Clinic that will highlight AIDS awareness and community activism and support in Richmond. The Surviving case will  focus on the medical and practitioner-side of the crisis including correspondence, newsletters, reports from nursing organizations and other documents and artifacts.

• World AIDS Day: Explore the AIDS Quilt and Red Ribbon Giveaway  

          Monday, Nov. 27 through Friday, Dec. 1, 2023  

          Health Sciences Library, 509 N. 12th St., Lobby

The National AIDS Memorial, in collaboration with the AIDS Quilt Touch team, has created an interactive platform that features all the panels of the AIDS Memorial Quilt. The first panels of the huge Quilt were stitched together nearly 35 years ago. Now, there are more than 50,000 panels with 105,000 names sewn into its fabric. This digital initiative aims to enable people everywhere to engage with the Quilt and see the expressions of love and the personal narratives woven into each panel.  

Explore this online rendition of the Quilt and search for the names of friends or loved ones who may be commemorated in the Quilt. Help spread AIDS awareness and honor the dead and those living with AIDS/HIV by picking up a free, red ribbon to show your support. 

• RealLife Film Series: The Last One: Unfolding the AIDS Memorial Quilt 

         Thursday, Nov. 30, 2023 12:15 - 1:45 p.m. 

         Health Sciences Library, 509 N. 12th St. 

         Special Collections and Archives Reading Room 

This documentary presents an account of the AIDS epidemic in the United States with a focal point on the AIDS Memorial Quilt. In the 1980s, as AIDS ravaged the gay community, the Quilt project emerged to name and grieve those lost and promote understanding and medical advancement. The film explores the evolution of a public health crisis initially stigmatized as a "gay disease," as it transitioned to disproportionately affect African-Americans, women and youth.  

Following the screening, Suzanne Lavoie, MD, who practices at the Children’s Hospital of Richmond at VCU, will lead a discussion on themes from the film, current research and the exhibits on display. Snacks and drinks will be provided. 

This event is free and open to the public. Registration is encouraged but not required. Snacks and drinks will be provided.