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SWFL doctor reflects on nearly 40 years of treating patients with HIV/AIDS

Posted at 2:42 PM, Jun 29, 2022
and last updated 2022-06-29 14:42:08-04

CAPE CORAL, Fla. — September will mark 40 years since Americans first heard the CDC use the term “AIDS.”

By 1992, the agency reported AIDS was the No. 1 cause of death in men 25 to 44 years old - mostly in the gay community.

In the three decades since then, AIDS is no longer a death sentence.

As we wrap up our Pride coverage this week, one Southwest Florida doctor knows those stories well.

Dr. Doug Brust, who works at CAN Community Health Center in Cape Coral, has been on the front lines of HIV and AIDS since the disease emerged in 1981.

“Of course they were afraid,” Dr. Brust said about his patients.

They were afraid because, back then, doctors were only armed with testing.

HIV and its end stage, known as AIDS, began to spread across the US in the early 80’s. The public presumption was that HIV impacted mostly gay men, but others were infected too, including Dr. Brust's best friend, Nancy.

“She got admitted to the hospital. Nobody knew it was HIV” Dr. Brust said about his friend, Nancy. “The guy that infected her - none of us knew he had HIV. He died on the day he was supposed to be married. She didn’t get a test until 1985 and that’s when the testing became available.”

Nancy would be one of the first women diagnosed, which convinced Dr. Brust, who was only a freshman in college at the time, to switch from evolutionary biology to infectious diseases. Dr. Brust dove into what would become a 40-year fight for life.

From New York to San Francisco, Dr. Brust battled HIV - a virus the CDC says peaked in 1985 with as many as 130,400 new HIV cases a year. It was the leading cause of death in men by 1992.

“Cause they just come in and thought they were going to die,” Dr. Brust said. “Because there was nothing you could do for them.”

Dr. Brust said it was frustrating as a new doctor trying to figure out this disease.

“It was really horrible. You get so attached to the people that you know - all your patients were dying,” Dr. Brust said.

The first treatment wasn’t much better.

In 1987, AZT had to be taken every four hours.

Nancy secretly took it, but died in 1994, just two years shy of a new anti-retroviral treatment.

It’s not only the stories of patients who die that stick with Dr. Brust. It’s also the stories of patients who now survive - thanks to medical advancements and treatments you can find right here in Cape Coral. Some of those drugs are so effective, Dr. Brust said it can bring people from the brik of death, calling it the Lazarus effect.

“There was one patient that I have taken care of here, truly near death, almost being sent to Hospice multiple times,” Dr. Brust said. “Today, I still see him and he’s able to walk in here and he was able to go to his son’s graduation.”

Today, HIV is no longer fatal. Treatments are one pill a day.

But a veteran of this historic epidemic remains at his post, now in Southwest Florida.

“One of my major focuses is to normalize HIV,” Dr. Brust said. “Not make it a secret, secret thing. Get tested. Just like if you have diabetes or hypertension. You get your HIV treated. And that is really important.”

Dr. Brust said he wants to see new HIV cases reduced 90% by 2030. Though this is a lofty goal, he said it can be done with testing.

Dr. Brust recommends that everyone, no matter age or gender, get tested at least once in their life.

You can get tested at the CAN Community Health Center in Cape Coral.