Sidney Hardgrave is the
Executive Director of the Douglas County AIDS Project, a not-for-profit institution dedicated to
educating people about AIDS and helping patients with
How did the AIDS epidemic begin?
There are lots of theories about how HIV originated, but most likely it came to
America when international air travel became common. As people were able to have relationships
across continents, HIV came to the U. S. and other countries where it had not been before. HIV
probably originated in Africa, although cases of AIDS in Europe as early as 1930 have led some
to believe that it originated there. Either way, AIDS is most likely a mutation of a similar virus
that occurs in apes and monkeys. Scientists are not sure how the virus crossed over to
When was AIDS identified as a disease?
AIDS was identified in the United States around 1986 when we started
calling it HIV. Prior to that, clusters of gay men would die with similar symptoms, and the general
public believed it was some sort of "gay cancer. " Even the medical profession
thought it was a deadly disease that afflicted only gay men until 1986. When HIV was identified, it
was also recognized that it crosses barriers of sexual preference
How much progress, or lack thereof, has been
I think we have made extraordinary progress, especially in
research. In20 years we have made more progress than in the last 60. In that time we
have identified the virus, discovered how it replicates and developed treatments to help keep AIDS
from reproducing inside the body, allowing people with HIV to lead longer, healthier lives. In 1988
a person with a positive HIV diagnosis would live three to five years. Now, some HIV-positive
people have been living for more than 25 years without developing
How has AIDS and its treatment changed since you
started working at the Douglas County AIDS Project?
I started working
here when a new class of drugs called protease inhibitors was developed. Initially the only
medication was a drug called AZT, which wasn't very effective in some cases. In the four years I
have worked here, ten new protease inhibitors have been developed to help stop the replication
of the virus. Right now AIDS patients have a larger and more effective pool of treatment options
than ever before. When I started, two of our clients died within three months. Thanks to the advent
of these inhibitors, it was two and a half years before another client died. Today, more people
also recognize AIDS asa significant problem, and because of this, funding has increased, allowing
us to conduct more prevention programs to stop its
What services does your program provide to patients
with HIV/AIDS, and what does it do to prevent the spread of AIDS?
primary service to people with HIV/AIDS is case management. We help clients find resources,
including doctors, pharmacies and housing, and we even provide career counseling to patients who
have lost their jobs because of their diagnosis. We maintain support groups for clients and
their families, and we help patients sign up for any health benefits they qualify for, such as
Medicaid. We also help clients with emergency funds when they can't afford to pay for drugs or
As far as prevention goes, we have a twofold approach.
First, we promote community awareness through displays, brochures and other items. We also have
community speakers who talk to groups about HIV/AIDS. Our second approach focuses on at-risk
populations. We work one-on-one to see what we can do to lower their risk for contracting HIV.
We also provide materials to help stop the spread of HIV.
many clients do you serve?
We serve about 50 clients and their
families at anyone time. We also aid countless people through talks delivered to
How do you fund all these services?
Most of our funding comes from the Kansas Department of Health and
Environment, which receives federal grants from the Center for Disease Control, and the Ryan
White Care Act, which provides grants for case management. We also get money from the United Way,
private grants and community-based fundraising.
what do you do?
Most of my work is pulling together
resources, applying for grants and writing reports. I also coordinate fundraising, manage personnel
and provide support for the staff. I also manage financial records and handle public
Volunteers are essential. We were founded by
volunteers eleven years ago and run by them until 1993. Their role has changed, but they are
still very important. There are 90 volunteers who do everything from office work to direct client
interaction. They are also critical in our education programs, since most of our speakers are
volunteers. Everything we do involves them; we could not manage without
How does the AIDS epidemic in Third World
countries compare with the problem in developed nations, and how will it impact the
The epidemic in the Third World is a whole different picture.
We are fortunate to have a good quality of life and easy access to health care and treatment. The
Third World has no health care network and barely any government funding. For example, our clients
pay up to $2000 a month for medication; in sub-Saharan Africa the average person pays $12 a year
for healthcare. They could barely buy a day's worth of HIV treatment, let alone a whole regimen.
There is hardly any HIV/AIDS education because of cultural barriers, stereotyping and a severe lack
HIV is not a high priority as far as African governments are
concerned, despite the fact that in some areas one in three adults has it. Each year hundreds of
thousands of kids are orphaned as a result of this terrible virus. By 2010 the average
life expectancy in sub-Saharan Africa will drop from 70 years to 33 as a result of HIV. Skilled
workers are dying faster than they can be replaced, and even teachers are dying, resulting in
African children not being able to take the place of skilled workers. All the progress Africa has
made this century will be negated as more and more skilled workers succumb to the disease. As a
result, the African economy may collapse, causing financial instability across the globe. There is a
big push in the developed world to send more resources to Africa for prevention and treatment, but
even then it would probably take 20-30 years for recovery to
Has public perception of the epidemic changed?Do
people think AIDS is under control?
I think the perception has
changed in a way that is both good and bad. It's good because the public does not fear HIV-positive
people. Prior to the discovery that AIDS was a sexually transmitted disease, HIV patients were
isolated from friends and family fearful of catching the disease. People have realized it is safe
to be around HIV-positive patients.
Another perception that has changed is the
view that HIV-patients are frail, and that an HIV diagnosis is a death sentence. Now since you see
people with HIV who still appear healthy, people no longer associate HIV with death. My concern is
that people don't see HIV as a crisis anymore, so they are more lax about protecting themselves.
My biggest concern is young adults who have never lived in a world without
AIDS. When I was 25, AIDS was just emerging, and we were more cautious. Young people today have
never known a world without HIV, and don't protect themselves against it. The population under 25
accounts for 50%of all new AIDS diagnoses. Another concern is that young adults having unprotected
sex assume that if they do contract HIV, all they have to do is take a pill to have it under
control. It's not that easy, they don't understand that using the drug cocktails we have today
requires the patient to take over 30 pills at very strict intervals. Their lives revolve around
taking the drugs.
How effective are the drug cocktails to
keep HIV under control? Will they continue to work in the future, or will HIV develop
Science is in a race to stay ahead of the virus. Right
now medication can keep it in remission, but HIV replicates over a million times a day, and every
time it replicates with medicine in the system, it can develop a resistance. We have 15 different
drug cocktails, and even now some patients aren't responding. If someone contracts HIV from a
person with a resistant virus, their virus is also resistant. Scientists are racing to discover new
treatments and preserve the precarious balance between medicine and the disease. If they fail, we'll
be right back where we started. We're all crossing our fingers that that doesn't
Are you planning to continue the battle against HIV,
or do you have other plans for the future?
I don't have any immediate
plans, and even if I did make a career change, the passion would still be there, be-cause I don't
believe that once you've learned ... once you've seen lives touched ... you can't just walk away. I
would definitely continue working to fight AIDS in some way.
I would love to
work myself out of a job, but I don't see that happening soon. Young adults today can tell you all
about AIDS and its effects, but they don't always take precautions. I'm trying, but I don't see my
task completed anytime soon.
This piece has been published in Teen Ink’s monthly print magazine.