Story by Mat Edelson
“My partner is 52. I’m 55,” says Chris Camp. “When we’re together, people are constantly saying things to him like, ‘Oh, it’s great that you and your father spend so much time together.’
“And I’m like, ‘I’m not his father.’”
More than 25 years into his battle with HIV and AIDS, Camp is intimately familiar with his war wounds. The constant discomfort, the fatigue. What’s inside is difficult enough to cope with, but as he sits in Baltimore’s Mount Vernon Park on a beautiful late spring morning, the nattily attired Camp is focused on what the world can see of his illness. He’s clearly annoyed at his weathered appearance, the awkward comments, and really, who can blame him?
In one sense, HIV has been kind to Camp: It hasn’t killed him. The same can’t be said for the scores of people in his community who were diagnosed around the same time—1986—as Camp. His address book became a memorial to those men. Unwilling to erase their names and their memories, he chose instead to draw a red line through each lost friend’s entry, annotated with their date of death. In time, page after page became his personal testimony to an epidemic built on suffering.
By the grace of providence and medication, Camp survived. But to say he’s thrived? Even he’s not sure. “I feel like I’ve aged quite rapidly,” says Camp, and at first glance it’s hard to disagree. A tremor in his left hand, deep pouches under his eyes, a head full of snow white, well-kempt hair… he could easily be mistaken for a grandfatherly type by the gaggle of youngsters wandering by on a morning field trip.
What’s happened inside his body since his HIV diagnosis a quarter-century ago is just as debilitating. Three bouts of pancreatitis. Fourteen kidney stones. Diabetes. Triglyceride and lipid issues. Not that Camp, a full-time HIV/AIDS counseling trainer for public health officials, is complaining: Anything but. “Every time I came in to see my doctor for a checkup he’d ask me how I was doing. I’d say, ‘Fine.’ One day he finally said, ‘I want to stop you. Tell me what your “fine” means.’”
So Camp told his doctor his definition of “fine”: Ever-present bloating, nausea, cramping—and lots of understandable worrying. Camp pats his rounded paunch, which seem physiologically at odds with his thin arms and legs. “I have this stone of a stomach, filled with visceral fat that I can’t get rid of,” he says, referring to a common side effect from HIV antiretroviral therapy that redistributes fat away from the limbs and toward the gut. “All of this [visceral] fat is the biggest risk for heart attack and played into my getting diabetes.”
Given Camp’s ongoing battle and the devastating nature of HIV’s history, it’s easy—and somewhat logical—to assume that everyone aging with HIV is facing a day-to-day struggle. But as public health officials are learning, the prognosis for HIV-positive boomers and elders is far more complex—and perhaps for some, far more hopeful—than many might expect.
According to the CDC, by 2015, half of everyone diagnosed with HIV in the U.S. will be 50 or older. In raw numbers, that’s likely to be around 600,000 people. In one sense, this older boom in survivorship is an incredible public health success story.
Consider: Before 1996 and the introduction of drug combinations that suppressed HIV, many people believed that an HIV diagnosis equaled a death sentence, and that they wouldn’t live through their 30s, let alone to 50.
The data backs up that perception. Hopkins epidemiology doctoral student Nikolas Wada, MPH, crunched figures from the Multicenter AIDS Cohort Study (MACS), which has been following nearly 7,000 HIV-positive and HIV-negative homosexual and bisexual men at four sites including Johns Hopkins since 1984. Wada found that pre-1996, the median age of death from all causes for the HIV-positive men he observed, using age 35 as a baseline—was only 43 years old—with the vast majority of deaths, 94 percent, coming from AIDS-related causes.
In the real world, that often meant that by the time men were showing any symptoms and finally went to a doctor’s office, their infections had been raging for years, their immune systems effectively destroyed, and their life expectancy at diagnosis a mere year and a half. “In the last three years of the ’80s, I lost 175 friends. It all happened so quickly,” recalls John Crockett, who was diagnosed with HIV in 1987 and thought he’d die within months. “I can remember going to a funeral home in the morning, and going back in the evening to be in the same room with a different body.”
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