Thursday, June 25, 2015

Staying Alive and In Awareness

All this week COP 24/7 is doing a 360 in recognition of National HIV Testing Week 2015. Now in its third decade, HIV and AIDS has lost its headline making, as well as, stunning visuals that once dominated global news cycles. Gone are the news video of hospital wards filled with young gay men dying of a then "mysterious" disease. Gone is the rush to define what the "gay plague" was and
exactly how it was transmitted and who plus how clinicians would treat these suffering individuals. Gone are the massive marches, screeds from activist changed to federal buildings, calls for those infected to be quarantined, and government officials dumbfounded to explain to a waiting public on
its response to this modern day health dilemma.

And with today's Supreme Court's 6-3 ruling that the subsidies afforded to those enrolling via the federal exchange no matter whether the respective states have set up state exchanges have been ruled as legal will continue to assist those newly diagnosed either link or be retained in care.

Moving forward this platform can take a look back while understanding just how far we've come with a pipeline of medicines, weighty HIV/AIDS infrastructure, massive funding apparatuses fueling the next waves of closing the care gap through new interventions and prevention methods.

Yet amazingly with all this progress we are still facing 50,000 new infections yearly in the US with the CDC quantifying the disproportionate impact in communities of color and recently we witnessed HIV infections soar in Austin, Indiana due to IDU users using works that caused a viral outbreak that sent their local health officials into overdrive to deal with the situation.

Arkansas mirrors national statistics with ADH reporting a plateau in infections among MSM's, with the exception of continuing new infections among young black men 18-24 whom represent 1% of the states population but account for 50% of the new cases. Many of these cases also have consisted of dual infections of other STI's such as Syphilis which is most common. Added to this situation is also health literacy, homophobia, stigma, and socio-economic conditions that further complicate knowing their status as a priority.

Current trends project that one in 16 Black men not to mention one in 32 Black women are going to be diagnosed with HIV in their lifetime. Although there have been both prevention and interventions deployed in the state to target this population, undoubtedly the continuing infection rates begs the question as to the marginal impact on changing any behavior. Consequently, with the emphasis now moving toward linkage and retention in care, assessments demonstrate that the "information viral load" within this community is still relevantly low and challenging at best.

30 Years and Counting: Treatment As Prevention

In 1987, a drug called AZT became the first approved treatment for HIV disease. Since then, approximately 30 drugs have been approved to treat people living with HIV/AIDS, and more are under development. Including the highly controversial use of PReP that warrants such conversations, especially in Arkansas where there has been extremely low dialogue about prescribing the drug or strategies to assess its impact on both those using it as part of their daily regimen or those seeking it due to their negative status.

Although the ARV pipeline has grown significantly, according to a April 2013 Report to the Arkansas General Assembly spearheaded by the Arkansas Minority Health Commission and Arkansas HIV/AIDS Minority Task Force which cited in its interim study that, "there was no virtually no information available about attitudes and practices related to HIV testing among Arkansas patients and health care providers."

Hence COP 24/7 continues to highlight the Arkansas timeline around this health dilemma and inquire about the responses from the states public health officials. In the meantime, if you need FREE HIV testing, counseling, insurance information or linkage to care navigation check out or our testing locator badge in the margin of this platform.

You may have heard these drugs called many different names, including:
  • "The Cocktail"
  • Antiretrovirals (ARVs)
  • Highly Active Antiretroviral Therapy (HAART or ART)
There are currently five different "classes" of HIV drugs. Each class of drug attacks the virus at different points in its life cycle—so if you are taking HIV meds, you will generally take 3 different antiretroviral drugs from 2 different classes.

This regimen is standard for HIV care—and it’s important. That’s because no drug can cure HIV, and taking a single drug, by itself, won’t stop HIV from harming you. Taking 3 different HIV meds does the best job of controlling the amount of virus in your body and protecting your immune system.

Taking more than one drug also protects you against HIV drug resistance. When HIV reproduces, it can make copies of itself that are imperfect—and these mutations may not respond to the drugs you take to control your HIV. If you follow the 3-drug regimen, the HIV in your body will be less likely to make new copies that don’t respond to your HIV meds.

Harm Reduction in the HIV Mix

There are now approximately 200 needle exchange programs in the US, predominately on the eastern seaboard and the west coast, and in New Mexico and several other scattered states; comparatively few are in southern states. And Arkansas is among those states that has a paraphernalia law that is apart of a disconnect of understanding the actual "connection" of IDU and the complexities of HIV and Hep C, even as the state is now offering Hep C testing services.

 Despite the lack of addressing the issue in this state, the programs have been successful at lowering the rate of HIV and hepatitis C infections: According to the World Health Organization, “Needle exchange programs substantially and cost-effectively reduce the spread of HIV among [people who inject drugs] and do so without evidence of exacerbating injecting drug use at either the individual or societal level.” Put another way, these programs are useful in stopping the spread of disease and don’t lead to more drug use, typically.

Still, they remain controversial in some places. For example, needle exchanges are illegal in North Carolina, where Tessie Castillo is the communications and advocacy coordinator at the North Carolina Harm Reduction Coalition, headquartered in Durham. “We have a very strong abstinence-only culture in this country,” Castillo says, “especially in the south.”

Increasingly, though, other aspects of harm reduction are not so contentious. Most notable is the improved access to Narcan, which is now used throughout the country by drug users as well as law enforcement agents, and prescribed by physicians and, in some states, pharmacists. Massachusetts’ program has worked especially well; since 2006, health officials there have been distributing intranasal naloxone to those likely to witness an opioid overdose — outreach workers, homeless shelter operators and drug users and their family members. The program was credited with reversing more than 1,800 overdoses from heroin, prescription painkillers and other opiates, according to a 2013 Boston Globe article.

To date, “26 states have passed naloxone laws, which have really helped,” says Katherine Neill, PhD, of the Baker Institute at Rice University, in Houston. “And Good Samaritan laws — which mandate that you can’t get in trouble for calling authorities [for help] if you witness an overdose — have been enacted in at least 20 states.” (To see what the laws are in your state, click the map at For more information on services related to IDU use call 501-379-8203.

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