Tag Archives: CDC

One Million Dollars in Prevention

     Last year, I wrote an article for Wyattevans.com entitled, “The Quiet Invader within Native Americans.”  In it, I reported the unfortunate and harsh reality that HIV testing, treatment and care are not reaching Native Americans the same way as they are other U. S. citizens. 

     Fortunately though, much-needed assistance is on the way.  According to The Associated Press, The Indian Health Service (IHS)–the federal Native-American health care organization—and the U.S. Centers for Disease Control and Prevention (CDC) are awarding up to $1 million to Native-American tribes and organizations for HIV care and prevention.  The funding may also be allocated to organizations like Two-Spirit, a Native-American LGBTQ group.

     The grant comes at a time when HIV-positive Native Americans have poorer survival rates compared with other races and ethnicities.  The mission of IHS is three-pronged:  to decrease transmission of the virus, reduce the number of new infections, and increase education and discussion about HIV in the Native-American community.

     Rear admiral Sarah Linde, MD, the IHS acting chief medical officer, stated, “IHS data shows that as many as 26 percent of the American Indian (AI) and Alaska Native (AN) people living with HIV infection do not know it.” 

    And according to Lisa Neel–a program analyst at the HIV Program for IHS, there are an assortment of reasons why.  “Poverty, which limits access to doctors and can put health concerns on the back burner for those struggling to feed themselves, is an all too common problem for Native Americans.”

     Neel also states, “That compared with other racial and ethnic groups, American Indians and Alaska Natives have higher poverty rates, have completed fewer years of education, are younger, are less likely to be employed, and have lower rates of health insurance coverage.”

     Often, this results into individuals not getting tested; therefore, scores are oblivious that they are in fact HIV-positive.  Tragically, this results in some of those infected not getting needed treatment until their HIV advances to the point that they experience symptoms.

     Neel is concerned that “cultural stigma faced by some gay and bisexual Native American men could also be discouraging testing and treatment,” and cites the higher rates of alcohol and drug use among all American Indians and Alaska Natives.

     She concludes, “Although alcohol and substance abuse does not cause HIV infection, it is an associated risk factor because of its ability to reduce inhibitions and impair judgment.  Compared with other racial/ethnic groups, AI/AN tend to use alcohol and drugs at a younger age, use them more often, and in higher quantities, and experience more negative consequences from them.”

     The funding will be distributed over the course of five years, with up to $200,000 being granted per year.  To receive funding, tribes and nonprofits must apply by August 28

Just How Many “Undetectables” Are There?

     Get a load of this encouraging new development:  recent research has indicated that the Centers for Disease Control and Prevention (CDC) may have overstated the size of the U.S. HIV population, while significantly underestimating the share that has a fully suppressed viral load (undetectable).  Researchers utilized HIV lab reporting to estimate prevalence of the disease in New York City and 19 other jurisdictions. 

     Next, they used previously published data to construct a revised HIV treatment cascade, or the HIV Care Continuum.  This cascade refers to the descending proportion of individuals living with HIV who have been diagnosed, are retained in medical care, have been prescribed antiretrovirals (ARVs), and are virally suppressed.

     Before going further, let’s fully understand what being undetectable is–and means.  First and most importantly, it does NOT signify that you are cured of the virus.  What it does mean, according to Melissa Dahl’s article entitled, “What Does It Mean to Have ‘Undetectable’ HIV,” is that “the anti-retroviral treatment is working, and that the amount of HIV in the blood is so low that even the best available tests don’t pick it up.  As it is usually defined now, to have an undetectable viral load means that there are fewer than 20 copies of the virus in one milliliter of blood.  Compare that to those who have just been diagnosed and not yet treated, whose tests show millions of copies in the same sample size.”

     Dahl adds, “The very latest research is showing that it is highly unlikely for people with an undetectable viral load to transmit the virus to a sexual partner—even without the use of a condom.”

     Now, back to the care continuum.  In 2011, the CDC estimated that 1.2 million Americans were living with HIV.  Poz.com states, “The U.S. care continuum estimate, which also refers to 2011, has long stated that 86 percent of the American HIV population has been diagnosed, 40 percent is engaged in care, 37 percent has been prescribed ARVs and 30 percent is virally suppressed.  These figures are frequently cited as troublesome barometers of the dismal job the U.S. health care system is doing taking care of HIV-positive individuals.”

UNDETECTABLE 1

     But as stated in the first paragraph, recent research has indicated that in fact, viral suppression rates have been steadily rising among HIV-infected Americans.  Poz.com continues, “Researchers used 2009-2013 data from the Medical Monitoring Project, covering 23,125 HIV-positive people, to estimate the proportion of those receiving HIV medical care who had a fully suppressed virus.”

     From 2009 to 2013, the portion of individuals who had a fully suppressed virus at their last viral load exam rose, from 72 to 80 percent.  The largest increases were seen among 18-to-29-year-olds, whose viral suppression rate rose from 56 to 68 percent; 30-to-39-year olds (62 to 75 percent); and blacks (64 to 76 percent).

     Poz.com adds, “The researchers in this new study estimated that, in fact, the CDC’s HIV prevalence estimate for 2011 was 25.6 percent too high, that the true number of Americans living with the virus was 819,200—or somewhere between 809,800 and 828,800.”

     Now, thanks to the improving surveillance of CD4 and viral load test results throughout the nation, the CDC can better make more accurate estimates of the number of those who are undetectable.  And, an official revision of the national HIV viral suppression rate should come later this year.

HIV/AIDS

Breaking:  HIV Is Killing Fewer Blacks

     HIV is losing a critical bout in the long and grueling boxing match called AIDS.  And this victory for persons of color certainly is a cause for celebration. 

     According to Michael Smith, writer for the health media outlet MedPage Today, the Centers for Disease Control (CDC) has reported that that the mortality rates of blacks in the U.S. fell substantially between 2009 and 2012.  During that time, the number of deaths fel1 by 18 percent. 

     However, the number of deaths remained higher among HIV-infected blacks  than among HIV-positive individuals of other racial and ethnic groups–although the gaps seem to be narrowing. 

     Consistent features of the U.S. HIV/AIDS epidemic have been ethnic and racial disparities:  each year, blacks have been making up almost half of all new diagnoses despite being only 14 percent of the population.  And cases have been soaring amongst some subgroups, including black MSM (men who have sex with men). 

    According to Smith, the CDC stated that this new data illustrate that decreases in mortality between 2009 and 2012 were seen in all groups but were “greater and more consistent among blacks than among other races/ethnicities.” 

     The CDC calculated two rates—the rate per 1,000 individuals living with HIV and the rate per 100,000 population.  In 2012, the CDC reported, “an estimated 8,165 deaths occurred among black persons living with HIV, which was 48% of the total mortality among people with HIV.  That was 1.5 times the 5,426 deaths among whites and 3.2 times the 2,586 deaths among Hispanics or Latinos. 

     “But overall, the number represented an 18% decline in the number of deaths among blacks from 2008 through 2012. 

     “The death rate per 1,000 blacks living with diagnosed HIV fell from 28.4 in 2008 to 20.5 in 2012—a 28% decline—but the rate remained 13% higher than for  whites and 47% higher than Hispanics or Latinos, the agency said. 

     “The 28% decline among blacks was greater than the 22% drop seen among all people living with HIV.” 

     Though this is encouraging and heartening news, we cannot afford “to rest on our laurels,” so to speak.  And let me put it another way:  before you “get horizontal to ‘Git Busy’,” strap on your favorite “latex raincoat!”

syphilis cells

Breaking:  Gay/Bi Guys Driving Up Syphilis Rates

     The following breaking news is disconcerting and sobering—to say the least.  According to Poz.com, the renowned health, life and HIV media outlet, the rate of primary and secondary syphilis in the U.S. is steadily climbing–with MSM (men who have sex with men) driving a 10 percent increase between 2012 and 2013.   “All told, the rates of syphilis, gonorrhea and chlamydia are all rising among men while either remaining stable or dropping among women.”  These stats are included in the Centers for Disease Control and Prevention’s (CDC) annual report entitled Sexually Transmitted Disease Surveillance. 

     Poz.com continues, “The CDC estimates that the United States sees almost 20 million cases of STDS each year, with half of them among young people ages 15 to 24.  The price tag?  Nearly $16 billion in health care costs. 

     “Since STDs are often not reported to the CDC, the figures of STDs do not paint a full portrait of the various nationwide epidemics.  They can, however, give a sense of the rate of change in new infections.” 

     In 2013, there were 17,375 reported cases of primary and secondary syphilis—a rate of 5.5 per 100,000 persons.  This translates into a 10 percent increase compared to 2012–and represents the largest jump since 1985. 

     According to Poz.com. “The increase was driven entirely by MSM, who accounted for about three quarters of the total number of cases in 2013.  An estimated half of MSM with syphilis are HIV positive.” 

     The media outlet added, “This is of particular significance considering that syphilis can increase the likelihood of both transmitting and contracting HIV.” 

    Therefore, my advice to you:  always wrap it up—and securely–before “gittin’ yo’ groove thang on.”