Wesley Thompson was afraid.
It was the late 1980s and he was an openly gay man starting his career as a physician assistant in the Raleigh-Durham area. He was scared to treat HIV patients. What if people thought he had it?
The first time an HIV-positive patient asked him to treat the disease, Thompson referred him to another provider. He did the same with the second.
But the third patient confronted him: Dont you know me? he asked Thompson.
Though emaciated, the young man was vaguely familiar. Thompson realized theyd dated years ago.
It was a moment that changed him forever. Thompson took the man under his care and started learning more about treating HIV and AIDS. Within weeks, the man died in his arms. But Thompson would go on to specialize in care for patients with HIV and AIDS.
He worked in the Raleigh-Durham area for 10 years and has been practicing in the Charlotte area for 15 years. He now sees patients at Rosedale Infectious Diseases, a Huntersville practice.
Ive never looked back, said Thompson, 52.
Over the years, Thompson has seen how the stigma around the disease may not have changed much, but treatments have improved and his patients are living much longer.
And hes seen other Charlotte-area HIV care providers move on to other fields, with few new peers filling the void. The American Academy of HIV Medicine found in a 2008 survey that almost one-third of clinicians who participated planned at the time to leave HIV medicine within the next 10 years.
This is my passion, he said. Its hard to know where I stop and start, where my work stops and starts, because I so feel like I am doing what Im meant to do.
Thompson, a North Carolina native, knew he wanted to go into medicine when he was 5 years old. He was fascinated by his pediatrician. Thompson earned an undergraduate degree from Wake Forest University in 1982. At Duke University, he earned another undergraduate degree, his physician assistant certificate and a masters degree.
As he was growing up, hed thought seriously about healing people abroad as a medical missionary. Little did he know his mission work would be in his backyard.
The South has had the highest rates of HIV infections in the country. The virus is commonly spread through unprotected sex, sharing drug needles or being born to an HIV-positive mother. HIV attacks cells that help the body fight disease.
An HIV infection can progress into AIDS acquired immune deficiency syndrome in which a persons immune system is severely compromised.
In North Carolina, about 35,000 people were living with HIV in 2010, including those who may be unaware of their status, according to state figures. Almost 4,500 people in Mecklenburg County were reported to be living with the virus in 2010.
When he began his career, an HIV-positive diagnosis was seen as a death sentence. He felt like all he did was attend funerals. People were not surviving this, he said.
He remembers telling patients they had 18 months left to live. Thompsons goal then was death with dignity.
But treatments continued to advance, and now hes telling young adult HIV patients they can live to see their 70s with medication.
Chelsea Gulden White thought she was counting down days. In 2003, she found out she was HIV positive before her senior year in college. She was also pregnant.
She recalls how uncomfortable she felt seeking treatment. Then she met Thompson. He really did have a way of making it a little bit more normal, Gulden White said.
Thompson put her at ease with assurances that she would live another 20 years, or even longer with new developments in medicine.
And he told her it was possible for her baby to be born without the virus. Months later, Gulden White gave birth to a healthy, HIV-negative baby. She now works with the Regional AIDS Interfaith Network (RAIN), where she has recruited Thompson to speak to support groups.
Problems with alcohol
Along with his achievements, there were also times when Thompson stumbled.
His partner, Trey, was battling leukemia some years ago. Although Trey had a successful stem-cell transplant, the couple faced big medical bills. Thompson became a workaholic and wouldnt take vacations or days off. He took on extra work to save money for the next set of bills.
But his job was emotionally draining, too. He must constantly convince his anguished patients that their lives are still worth living. Many of them barely have enough money, food or housing.
I have to make sure that Im there for my patients, he said, and when they leave theyre uplifted and they know that theyre supported.
In the past, he sometimes turned to alcohol to handle the stress.
Thompson was convicted of driving while impaired in 1993, and again in 2005. Concerned about alcohol use, the North Carolina Medical Board ordered him to enter the North Carolina Physicians Health Program, according to a consent order between Thompson and the board. An assessment found that he had continuing problems with abusing alcohol, according to the document. He went through treatment for problems with alcohol dependence.
The state Medical Board did not find that his patient care was affected, and the Physicians Health Program determined he can safely practice as a physician assistant, according to the consent order. In April, the board placed Thompson on a two-year probation.
The end result is Im at a better place, he said.
The stigma remains
One aspect of HIV that Thompson hasnt seen change very much: the stigma.
The practice where he works sees patients who may have been HIV positive for years, some from out of the county, some even from out of the state. Many of them make the trip to get care discreetly.
I have patients that cant say HIV; they talk about their House In Virginia H-I-V, he said.
Thompson fights this stigma by taking active community roles outside his clinical work. He sits on the countys Quality Management Committee for the federal Ryan White Program, which provides funds for HIV care.
He works with organizations like RAIN to help with education or outreach. He does educational lectures for patients or providers locally and nationally; hes already done more than 50 lectures this year.
Everybody knows Wes, said the Rev. Debbie Warren, founder, president and CEO of RAIN.
Finding the joy
Looking back on his years in HIV care, the first word that comes to Thompsons mind is joy.
Instead of funerals, he now goes to weddings and baby showers.
I will not regret these years, he said. I feel honored and humbled to have been able to serve this population. It has been my privilege.