"those infected with HIV - who get treatment and adhere to that treatment - can live long and relatively normal lives."
The adherence part is the most interest bit of the story. The adherence to HIV medications is ~93%, much greater than the adherence to almost every other drug or behavioral treatment. If diabetes patients or cardiac patients had adherence rates anywhere near that high then the life expectancy of the average American would be dramatically higher.
There are lots of different variables that influence adherence, including but not limited to:
- expected or actual efficacy
- regimen complexity
- knowledge, commitment, and ability
- doctor-patient relationship
My understanding is that with HIV a lot of money has been spent on actually implementing the adherence research in order to reduce the spread of the disease, whereas for most other diseases no one really cares. I think getting diagnosed with HIV also encourages some people to grow up a little bit in a way that getting diagnosed with high blood pressure or whatever doesn't, though maybe less so now that infection vectors are changing.
It might also be worth noting that adherence with HIV medication is also motivated by simple fear: if you don't take it, you will die. Painfully, from secondary infection.
Diabetes (type 2) and cardiac disease are scenarios where people can still kid themselves to a certain extent.
The adherence part is the most interest bit of the story. The adherence to HIV medications is ~93%, much greater than the adherence to almost every other drug or behavioral treatment. If diabetes patients or cardiac patients had adherence rates anywhere near that high then the life expectancy of the average American would be dramatically higher.