NEW YORK – Wednesday was National Youth HIV and AIDS Awareness Day, and this year the focus is on HIV-related health disparities and barriers to achieving viral suppression.
In 2017, about 87% of the young adult clients in the Ryan White HIV/AIDS Program were from racial or ethnic minority groups, and more than 70% lived at or below poverty level.
But according to Dr. Laura Cheever, physician and associate administrator for the HIV/AIDS Bureau at the U.S. Health Resources and Services Administration, about half of all young people living with HIV in the United States don't know they're infected.
She points out there are two critical reasons for young people to get tested.
"People living with HIV need to get onto medication because they can live a near-normal lifespan if they know they have the HIV infection, and second, once they're on those medications, they have effectively no risk of transmitting HIV to someone else," says Cheever.
The Ryan White HIV/AIDS Program funds grants to states, cities and community-based organizations to provide HIV care and support services to low-income people.
Cheever notes that there's been success in reducing the rate of HIV infections among youths in general and especially among young women. But there still are wide disparities in infection rates in minority communities.
"Eighty-one percent of new diagnoses among young people are among men who have sex with men," says Cheever. “About half of those are among African Americans and about a quarter of those are among Hispanic gay men."
She attributes those disparities to limited access to medical care and stigmas associated with HIV, being gay, bisexual or transgender in many minority communities.
Though New York has more cases of HIV than any other state, Cheever says strong political and public-health support for efforts to reduce the spread of HIV have made the state a real success story and a model for other states.
"About 86.5% of all clients that have had at least one visit in New York in a Ryan White HIV/AIDS Program are virally suppressed, which means they're on treatment, they're taking their medication and they're doing quite well," says Cheever.
She adds that we have the tools we need to end the HIV epidemic in this country but more resources are needed to achieve that goal.
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New Mexico activists are tapping today's World AIDS Day, Dec. 1, to announce they'll ask the State Legislature to provide more money for treatment and prevention.
Equality New Mexico Executive Director Marshall Martinez voiced concern that many primary care providers fail to prescribe treatments known as PrEP and PEP, perhaps worried that they are specialized and complex. His group will ask lawmakers to provide more funding to the Department of Health to initiate educational outreach.
Marshall said the treatments significantly reduce risk and the effects of AIDS: "Since the beginning of the epidemic in the '80s, we've never had as powerful of a preventive tool as we have in PrEP."
According to Martinez, the New Mexico Department of Health reports there are between 3,000 and 4,000 people in the state living with HIV.
Federal data show American Indians and Alaska Natives have over twice the rate of HIV infection as their white counterparts. They also are more likely to die from HIV infection.
Nonetheless, Martinez noted the majority of those taking preventive medications are cisgender, white men. He stressed this demonstrates how important it is for the state to reach Indigenous and immigrant communities, starting with funds to train medical providers.
"And then public messaging in those sort-of non-traditional communities and from non-traditional messengers to say, 'Hey, there's this drug called PrEP - it would prevent HIV - you should ask your doctor about it,'" he explained.
It is estimated that since 1981, more than 40 million people have died from AIDS; in some countries, it is still the leading cause of death. Currently, almost 30 million people are using therapies to inhibit HIV and prevent AIDS.
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Today is National Gay Men's HIV/AIDS Awareness Day, and Nevada is one of the 10 states with the highest HIV infection rates.
In 2021, more than 11,000 Nevadans were living with HIV. Recent data show nearly 70% of all new HIV diagnoses in the U.S. are among gay and bisexual men.
Dr. Laura Cheever, associate administrator of the HIV/AIDS Bureau for the Health Resources and Services Administration, said despite progress in care and treatment, there are still many who do not realize they have the disease. HIV today is what she called a "manageable, chronic disease," which can be treated with antiretroviral therapy leading to viral suppression and have no risk of transmitting HIV sexually to someone else.
"In order to live a near normal life span, a person with HIV needs to get on medication and stay on them," Cheever explained. "A lot of people just don't want to deal with the fact that they may have HIV because there is so much stigma still around the HIV diagnosis as well as other issues including homophobia and racism."
Cheever advised getting tested is the first step. For those who test negative, there are ways to prevent future infections. She noted pre-exposure prophylaxis, commonly known as "PrEP," is a great option. According to the Centers for Disease Control, PrEP reduces the risk of getting HIV from sex by 99% when taken as prescribed.
Cheever pointed out like other chronic diseases, HIV disproportionately affects those who are part of minority populations. She added for those looking to receive care or treatment for HIV at low or no cost, you can visit hiv.gov. You can also visit takemehome.org, and enter your ZIP code to see if you are eligible to receive a free, at-home HIV testing kit.
Cheever stressed it is important to realize HIV does not solely affect men who have sex with men.
"It can be transmitted between any two people having sex," Cheever cautioned. "It is disproportionate in the population of gay men in this country which is largely based on sort of historically how it entered this country, but anyone who is sexually active is potentially at risk for HIV."
Cheever added access to health care, education and prevention efforts are all contributing factors in decreasing the rates of HIV.
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Once viewed as an automatic death sentence with the first diagnosis in 1981, HIV today is met with effective treatment options. Today is National HIV Testing Day, which encourages people to get tested to determine if they are infected. Testing is free and confidential at multiple sites around the country.
Alan Witchey, president and CEO of The Damian Center, an Indiana AIDS service organization, said testing for the virus is simple.
"You can come in and get your status in minutes. It's a rapid test," he explained. "It's just a pin prick to your finger and you can get your status in minutes, so it's worthwhile going and finding out."
According to the Centers for Disease Control and Prevention, in Indiana, 540 new cases of HIV were detected as of January 2022 - currently, there are 13,900 people living with HIV in the state.
The agency also says an estimated 1.2 million people in the United States had HIV at the end of 2021. Of those people, about 87% reported being aware they were HIV positive. Witchey admits the urgency and attention to the diagnosis and treatment of HIV and AIDS has faded over time due to medications that help infected people live long and healthy lives, but added it is a misnomer to believe the HIV and AIDS epidemic is over.
"The epidemic is still going on in central Indiana," he said. "We had 300 new cases last year. There are about 1,000 people in central Indiana that are living with HIV and don't know it."
Witchey added often people will get diagnosed later, and they may already feel ill or have side effects related to the disease - which is why it is so important to get an early diagnosis. A 2020 study by 'aidsvs.org' found that 76% of people who developed AIDS had a late HIV diagnosis, which is defined as having an AIDS diagnosis within three months of testing positive for the HIV virus.
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