By Elliot Owen
Bay Area Reporter
He was among the first physicians to identify AIDS in 1981 and helped create one of the largest private AIDS clinics. Last week Dr. Marcus Conant’s years of activism and medical accomplishments were honored by UC Berkeley’s School of Public Health, which presented him with the 16th annual Public Health Hero Award.
The honor is bestowed upon exceptional leaders committed to safeguarding the health of the human population in significant and innovative ways.
Working as a dermatologist at a Haight-Ashbury clinic in 1981, Conant identified Kaposi’s sarcoma, a cancerous disease that causes tumor-like lesions on the skin, as an opportunistic infection of a highly contagious blood borne virus later called acquired immune deficiency syndrome.
“All of us thought early on this was going to be some disease where we would find the cause very quickly and fix it,” said Conant in an interview with the Bay Area Reporter. “None of us thought it was going to be a life changing phenomenon.”
Conant then switched to primary care and opened up a clinic in the Castro that would become one of the world’s largest private practices specializing in HIV/AIDS treatment.
“The early years were tough,” he recalled. “At one point, we had 5,000 HIV-positive men at the clinic. Everyday, literally, we saw patient after patient who was dying. Most doctors didn’t want to take care of these patients. They were afraid of it.”
In 2010, Conant closed the clinic due to rising costs and complications caused by health insurance companies. During the nearly three decades his practice was open, Conant treated almost 8,000 AIDS patients. He has also contributed to the development of many of today’s cutting-edge HIV/AIDS treatments.
While his notable achievements include an exhaustive list of scientific endeavors, those who know Conant see him as much more than just a really good doctor. He’s an activist.
“He’s an incredible doctor but he could recognize that it didn’t stop there. He just can’t help but teach,” said Dr. Donald P. Francis, executive director at Global Solutions for Infectious Diseases. Francis, who presented Conant with the award last Wednesday during a gala at the Hotel Nikko in San Francisco, has worked with Conant on AIDS research and prevention since 1985.
“AIDS was fatal,” said Conant. “These patients were all dying. It became important to get out of the clinic and down into the community. Instead of being an academic physician, writing papers and studying things, I went out to educate doctors and patients about the disease.”
In 1982, Conant founded the Kaposi’s Research and Education Fund, a nonprofit organization that would later become the San Francisco AIDS Foundation.
He facilitated monthly informational meetings with his patients in the waiting room of his clinic, discussing infection, diagnosis, progression, treatment and research of the HIV virus. The meetings were open to the public and soon grew in size. After being moved to an auditorium, Conant welcomed up to 1,500 people at a time. The Conant Foundation was later founded in 1989 to support the expansion of these meetings and today remains a valuable resource for HIV/AIDS patients and their caregivers.
Conant, 75, is no stranger to politics, either. In 1987, he served as co-chair of the California AIDS Leadership Committee to formulate the state’s first policies in response to the AIDS epidemic.
“The CDC was told to do nothing by the Reagan administration,” Francis said, referring to the Centers for Disease Control and Prevention, “so the response for prevention, care, and education had to come from state level. Marcus was on the state AIDS task force and worked with me to make a very logical response plan.
“He shook things from the bottom. San Francisco and the state of California came forth in a way that led the nation and hopefully other parts of the world in being more forthright about HIV,” Francis said.
As antiretroviral treatment become widely available in the mid-1990s, HIV/AIDS dropped from the leading cause of death among people ages 25-44 to the third-leading cause of death a year later. By 2010, HIV/AIDS had dropped to the seventh-leading cause among the same age group.
When asked how the virus can be eradicated, Conant said that the answer is simple.
“It is now unequivocally shown that if you treat somebody with highly active antiretroviral therapy and you get their viral load undetectable, they are no longer infectious to their sexual partner. If you can identify everybody that’s positive and put them and keep them on treatment, we can stop this epidemic.”
So then, he says, there’s one problem with the San Francisco Department of Public Health’s “test and treat” strategy, which operates under the premise that by expanding testing methods, diagnosing early, and treating HIV-positive people quickly and consistently, the community viral load will drop and with it the rate of transmission.
“We’re not testing everybody,” said Conant, “only the people that want to be tested. The trouble is that there’s lots of people who don’t want to be tested or don’t know they should be tested. Every time someone comes in contact with the health care delivery system – test them.”
While being diagnosed with HIV today is no longer a death sentence and available treatments are becoming incrementally better, Conant admits an HIV vaccine is a long way off.
“It’s not going to happen in the foreseeable future,” Conant said. “We’re just beginning to find little places where the virus is consistently vulnerable. It’s very, very early.”
After closing his San Francisco practice in 2010, Conant moved to Manhattan where he still sees a few patients for private pay and others for free. His line of work seems to have taken little to no toll on him.
“He looks tired sometimes,” said Francis, “but he generally always looks forward.”