Another Kind of AIDS Crisis

Another Kind of AIDS Crisis

In contrast, others show deep disturbances of the white matter of their brains, the deep connective nerve tissue responsible for motor coordination and executive function—the region that allows us to make a plan and to follow through on it. A high-level executive assistant I’ll call Martina—diagnosed HIV-positive 22 years ago—tells me she has finally gone on disability recently, unable to juggle her own pared-down schedule, much less someone else’s. An MRI revealed significant changes in her white matter, which are likely irreversible—a possibility that devastates her. “I feel awful,” she says. “Lately my husband has been saying, ‘You know what? I think I need to take over the bills.’ For him to say that, I must be getting worse.”

For those trying to hold down jobs, even minor cognitive disturbances can change lives dramatically, according to experts and patients alike. And studies show patients with minor deficits have trouble remembering to take their medications, which can lead to more serious problems like drug resistance and even early death. “We’re not talking about people who look like advanced Alzheimer’s disease,” says Dr. Grant, the lead CHARTER researcher. “But nevertheless they can have an effect on everyday functioning, which can be serious.” Plus, as Dr. Simpson puts it, “it’s scary as hell.”