CLEVELAND, Ohio -- Today marks World AIDS Day, observed internationally to remember those lost to the HIV/AIDS epidemic and raise awareness about the disease.
In one of Ohio's most populous counties, health professionals are working to ensure people living with HIV have the services they need. Cuyahoga County's "Ryan White HIV/AIDS Part A" program has provided health services to those who do not have adequate insurance or financial resources since 1996.
Zach Levar, grant supervisor for the Cuyahoga County Board of Health, said one silver lining of the pandemic was learning how providers could reach more people through telemedicine.
"Clients that may not have wanted care in person might have found it a little bit more convenient to FaceTime with their doctor and check in with them that way," Levar explained. "Our clients have definitely appreciated it, we've heard anecdotally that different clients that may have been out of care are now linked to care because they've been able to access via telehealth."
Twenty-one percent of Ohioans who have been diagnosed with HIV live in Cuyahoga County, according to state data.
Levar said in honor of World AIDS Day, the county Board of Health has launched its first newsletter dedicated to HIV-related news and resources. It also plans to launch a social media campaign to help fight the stigma associated with HIV/AIDS.
Services the Ryan White program provides in the Greater Cleveland area include help applying for housing and benefits support, mental health resources, and group education for people recently diagnosed. Levar said the Board of Health has received two grants focused on HIV care and prevention, to help connect with at-risk residents.
"We've started working with the state to figure out who is not in care and trying to figure out ways to best reach those individuals," Levar outlined. "Figure out what their barriers are, really meet them where they are, and get them engaged in care, so that they can achieve the best health outcomes for themselves."
The two grants, totaling about $2 million, were awarded by the Health Resources and Services Administration and the Centers for Disease Control and Prevention.
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World AIDS Day is Dec. 1, dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV.
Thousands of people live with H-I-V/Aids in Arizona. More than 80% of those who were diagnosed with the virus in 2020 were linked to care, according to the Arizona Department of Health Services.
Anthony Petro, associate professor of religion and women's, gender and sexuality studies at Boston University, cited progress in how to medically treat the disease and noted how we speak about it has also changed. Petro said some diseases, such as HIV/AIDS, take on a set of political and moral meanings which can affect societal and even scientific views.
"When you think about public health itself, it is the application of medicine to a public and that depends upon us knowing who the public is that we care about," Petro explained.
Petro noted the early years of the AIDS epidemic brought questions about whether the imagined "American public" included certain groups such as queer people, sex workers and IV drug users. He recalled in the absence of "state support," local activists helped advance the movement. He contended it was only when medical researchers decided it was a virus, it gained a level of "prestige" and funding started to flow.
Petro added today, access to reproductive and transgender health care are issues currently walking that moral-political line.
President-elect Donald Trump has picked Robert F. Kennedy Jr. to lead the Department of Health and Human Services. Petro acknowledged Trump's selection has concerned public health experts as Kennedy has expressed a level of suspicion about whether HIV truly causes AIDS. He has instead suggested recreational drugs called "poppers" could be the real reason, which the medical community said is false.
Petro, like others, stressed a lot of work is still needed, related to HIV prevention and treatment.
"To hear someone today in 2024, thinking about those kinds of conspiracy theory approaches to thinking about HIV and AIDS, is certainly troubling, but it is not new," Petro outlined. "And I think we do have a very good infrastructure for HIV/AIDS care."
Petro reminded people about pre-exposure prophylaxis, or PrEP, which is the use of antiretroviral medication to prevent HIV. Most private insurance and Medicaid programs are required to cover PrEP services without co-pays or deductibles, according to the Centers for Disease Control and Prevention.
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Today is National HIV Testing Day. First observed in the U.S. in 1995, anyone who is sexually active is urged to get tested to know their HIV status.
The federal government underscores the importance of testing to show self-value, compassion and respect. According to the Centers for Disease Control and Prevention, almost 14,000 Hoosiers are living with HIV, the virus that causes AIDS.
Alan Witchey, president and CEO of the Damien Center, an HIV/AIDS resource in Indianapolis, said the blood test is free and confidential, and insurance is not required.
"Nobody has to know that you're coming, and you can either make an appointment or you can just walk in," Witchey explained. "It's just a quick finger prick; you will have your results in 20 minutes."
He added testing for other sexually transmitted diseases can be performed at the same time. A positive test result will alert the Damien Center staff to connect the person to support services and the clinic. For a negative result, medication is available for HIV prevention. The services are available at little to no cost.
The Centers for Disease Control and Prevention said 100,000 cases of AIDS, the condition which mutates from an HIV diagnosis, were reported in the U.S. between 1981 -- the first reported case -- and 1989. Since then, the invention of life-extending medications has lessened the public's urgency to get tested.
Witchey emphasized HIV is still growing and spreading, even as other epidemics have evolved.
"Even though you don't hear about HIV as much anymore, it is still here," Witchey pointed out. "And a lot of people still have this misconception that HIV is a death sentence, or they won't be able to afford the medications even if they are HIV-positive."
"Ending the HIV Epidemic in the U.S." is a federal program with the aim of lowering new HIV infections nationwide by 75% by next year and at least 90% by 2030. Funding will be used to zero in on locations with the most frequent HIV transmission.
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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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