Living With AIDS And
The New Drug Therapy -
'A Jail Of Pills'
Rocky Mountain News
Scripps Howard News Service
DENVER ( -- Jack Biderman has gone from expecting to die in 1985 to clinging to hope in 1998. A big reason: the 62 pills he pops every day at rigidly precise intervals. If he misses one, he's told, he might die.
So for anyone who thinks the new drugs are magic bullets for AIDS and the virus that causes it, Biderman says, think again.
Those who hear him speak at Denver-area junior high schools on behalf of the Colorado AIDS Project know his story well.
"All I've got to do is take out the pills and show them," says Biderman, 44, of Denver.
Living with AIDS and HIV, even if these drugs ultimately work for many, is not like living the good life. It's more like living inside a jail of pills.
They call the regimen "triple combination therapy" because it involves taking three powerful anti-HIV drugs at once.
One is the new class of drugs called protease inhibitors. Others are "neucleoside analogs" such as the original AIDS drug AZT.
The third group is for disease "prophylaxis" to prevent the opportunistic infections that accompany AIDS.
This is the grind Biderman must follow seven days a week -- perhaps for the rest of his life:
He begins gulping pills at 6 a.m. He takes more at 7, 8, 8:30 and 9. Breakfast is between 11 and noon. He must carefully space his meals between medication or, doctors say, he might reinvigorate the sleeping HIV.
Then it begins again: pills at 2 p.m., 3 and 4. Dinner's at 5. The pills start again at 7 and continue hourly until 11. That's when he has to go to bed to be up in time for the 6 a.m. pills.
If Biderman or people like him take a weekend off without their vials of drugs -- AIDS literature calls it a "drug holiday" -- they are taking a grave risk that the virus will come roaring back.
Patients also must avoid alcohol. It can weaken their immune systems and induce them to take risks with their medications.
Biderman isn't risking anything now. He doesn't drink or do anything else that might make him forget his five dozen pills a day.
"It's real hard work," he says.
The pills cost $15,000 a year, paid for by special state AIDS drugs reimbursement programs.
The pills have other costs for this avuncular former restaurateur with twinkling brown eyes.
Side effects range from nausea to dry mouth. He must stay out of of the sun or wear a ball cap and 30-factor sun block everywhere. He drinks 120 ounces of water a day to prevent kidney stones. And still he worries.
Recently, Biderman felt a pain in his side and wondered if his spleen were infected. When he can't find the right word, he often jokes about dementia, a condition that consumes many AIDS victims.
A Rhode Island native who moved to Colorado in 1971, Biderman says he does not know how he got HIV.
Maybe it was after he left his wife in 1985 and had sex with men.
Maybe it was during some of those wild days when too many drugs were being passed around by too many people.
Biderman was still a child of the '60s when he got word in 1985 that he had HIV, the virus that causes AIDS. He did what perhaps most would do. He had received a death sentence, but he was free, had money in the bank and felt healthy.
"I partied hard," he says. "I had sex, protected sex, but sex. I traveled."
He bartended across the nation, getting the most out of his moments.
He didn't stop until 1989, when Biderman says he suddenly realized, "I'm still alive."
Unfortunately, he was out of money, had maxed out his credit cards and had no clue what to do.
That's when it hit him: Maybe he could live with HIV.
Biderman became a different man, obsessed with health. He quit drinking, smoking and doing anything else with risk.
He meditates every morning, imagining "a little Pac-Man character racing around my body eating the evil virus." He says he knows the meditations work but can't prove it.
Biderman began to proselytize against the very behaviors that caused his condition.
It all seemed to be working. He was beating HIV.
Then in 1993 -- right on schedule, according to current medical theory -- Biderman developed AIDS.
More precisely, he got an AIDS-defining illness called pneumocystis carinii pneumonia, or PCP, a parasitic lung infection that is one of the great killers in the AIDS epidemic.
He was going to fight it as hard as he possibly could.
That first meant beating back the PCP with antibiotics, then waiting to see if medical science could devise something that could handle the AIDS virus.
That may have happened 22 months ago. Doctors began treating tens of thousands of HIV patients with protease inhibitors. Though the drugs often reduce the virus to almost undetectable levels, the immune system does not return to normal.
For now, however, his life is consumed with trying to make the new drugs work. And he's doing something he thought of only rarely before -- getting a paying job again.
Biderman is coming to terms with the disease in other ways.
He never told his family he had HIV until 1994 because of "fear of rejection."
"My mom said, 'What did you think, we would turn away from you?' "
He says his family has grown much closer.
As for a social life, Biderman says it really doesn't exist.
The pills, the speeches, the meditation, the doctors, have pretty much taken care of that, he says.
Still, he says, it is "better than being dead."

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