World Aids Day - HIV consultant on treating patients in 1990s

We spoke to Heather Leake Date, a consultant pharmacist for HIV and sexual health at the Royal Sussex County Hospital for more than 20 years, trustee for the Martin Fisher Foundation, and chaplain for the Sussex HIV Chaplaincy, about her memories on the frontline treating HIV patients in the 1990s.

After coming to Brighton in 1985 to study pharmacy, Heather Leake Date gained an interest in HIV care through lectures from visiting consultants and took up a role as a pharmacist at Hove General Hospital six years later.

On day one, Heather found herself at the grassroots of the fight against HIV, with boxes of clinical trial medications which would later lead to the roll-out of combination therapies to mitigate against the virus.

Heather recalled how, in her first few years at Ward 6 - the first specialist HIV ward in the area, there were an ever-increasing number of patients.

She said: “We had six beds on the ward, but sometimes we would have 12, 18 or even 20 patients either spread elsewhere in the hospital or over at the Royal Sussex County Hospital.

“All you could do was treat the complications as they arose. If somebody had pneumonia because they had a low white blood cell count, unless they took a lower dose of the medicine to prevent it coming back, there was a very high chance that it would come back again very quickly.”

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As HIV weakened the immune system, those living with the virus were susceptible to opportunistic infections.

If a person with HIV has one of these conditions, they can be diagnosed with Aids - the most serious stage of infection.

Heather said: “Some patients would have to be on up to 60 or 70 tablets a day - ranging from treatments for infections, tablets to stop infections from returning, and medication to counter-act side effects from other treatments.”

She said that, as there was no treatment available at the time to help strengthen the immune system of those living with the virus, “it tended to be a one-way journey”.

“At its height, we might have lost three or four people a week,” Heather said.

Despite having the highest number of HIV patients outside of London, it took a considerable amount of time before Brigton had its own dedicated and full-time HIV consultant, with Martin Fisher entering the role in 1995.

HIV specialist Martin Fisher worked in Brighton for around two decades (Image: Paul Harrington)

Heather, who often worked with Martin, said: “He was a legend. He had the same vision of wanting to make Brighton have the best quality of care for HIV patients.”

Martin is credited for introducing initiatives long before they became established elsewhere, such as multidisciplinary teams and patient representatives.

Heather explained that one of Martin’s passions was to ensure people in Brighton had access to the best treatment available.

She said: “Around the time of the start of combination therapy, only 13 per cent of patients were on some form of antiretroviral medication. This was because there were not so many treatments around, but also because many people who wanted the latest and best treatment would go to London.

“Martin wanted to change it so people didn’t need to take that option and instead offer the same treatments that were offered elsewhere.”

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By the end of 1995, patients began being treated in the city with dual combination therapy and by the following year, 43 per cent of patients were on medication.

“We began to see ‘Lazurus patients’ - people who had been in and out of hospital for over a year before going on treatment, but within a few months of going on medication, they never needed to return,” Heather said.

Martin served as an HIV consultant in Brighton for 20 years before his sudden death in 2015, aged 50.

Heather Leake Date has worked as an HIV consultant in Brighton since 1999 (Image: Paul Harrington)

Alongside her work as a consultant pharmacist, Heather also created the Sussex HIV Chaplaincy in an effort to challenge the view that Christians and faith groups were homophobic or discriminatory against those with HIV.

She said: “I was very well aware there were quite a few people from churches who were doing things to help those living with HIV, but the narrative you would get from the media was negative due to national figures making sweeping pronouncements.”

Was her faith ever tested during her time caring for those living with the virus? On the contrary, Heather said her faith is what helped her get through that time.

She said: “Of course it is different for everybody and it was dreadfully upsetting but I am confident that, whoever they are, they are loved.

“None of us know for sure what goes on beyond this life, but I feel sure they are all loved somewhere.”

Reflecting on her more than 30 years working on the frontline in the fight against HIV, Heather said: “It’s about remembering the progress that has been made and the complete change in the prospects for someone diagnosed with HIV now.

“There is always a sadness, though, in remembering those who died beofre there was access to treatment, especially thoe who died just before medication might have saved them.”