Today is National HIV Testing Day, and doctors and advocates for people living with HIV and AIDS are urging everyone to make sure they know their status by getting tested regularly.
People living with HIV can take medication to suppress their viral load to undetectable levels, at which point, they cannot sexually transmit the virus to someone else.
Dr. Laura Cheever, an infectious disease physician and associate administrator of the HIV/AIDS Bureau in the Health Resources and Services Administration, said about 1.2 million people in the U.S. have HIV according to the Centers for Disease Control and Prevention, but one in eight does not know it.
"For a lot of people, there's still a lot of stigma around HIV," Cheever acknowledged. "They just don't want to know or don't want to have to deal with it. So, it is important to understand that HIV is a highly treatable disease."
Cheever added another reason some people do not get tested is, they assume their primary-care doctor takes care of it at their annual checkup, or when getting blood tests done at an urgent-care clinic or emergency room. But she cautioned most times, HIV testing is not a part of those appointments.
The New Hampshire Department of Health and Human Services receives funding from the Ryan White HIV/AIDS program, as do cities and community-based organizations, to make sure testing and care are available. Cheever pointed out the funds go to providing medical care, doctors' visits, medication, lab work and essential support services, such as transportation or emergency housing.
"You can go to the CDC website, gettested.cdc.gov, and there you can put in your ZIP code and find a place to get tested near you," Cheever explained. "There are many places now where you can go to get free or low-cost testing mailed to your home, so you can do self-testing in the privacy of your own home."
For many people living with HIV, Cheever said treatment is one pill a day, and she added for those who may not have insurance or be able to afford the prescription, the Ryan White program can help.
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North Dakota has joined a handful of states in modernizing laws about the spread of HIV - the virus that causes AIDS - and criminal penalties associated with it.
Gov. Kelly Armstrong has signed a bill that fully repeals a decades-old law, where someone suspected of willfully transmitting HIV could be charged with a felony and face up to 20 years in prison.
Jason Grueneich - the executive director of the group Shine Bright & Live - said that approach is outdated and only creates more stigma.
He said he feels the old laws, while likely well-intentioned, were adopted out of fear at the height of the crisis.
"Ultimately what happened was," said Grueneich, "instead of protecting the public, it hindered public health."
He said there weren't major threats of infected people trying to spread on HIV on purpose. But he added that those at risk were discouraged from getting tested, even as treatments advanced.
Some lawmakers questioned what could happen if there was malicious intent. Bill supporters, including state health officials, pointed to other laws that protect against that - and without unnecessary penalties.
With this repeal, Grueneich said HIV is no longer singled out among other sexually transmitted diseases.
Now, organizations like his can focus more on increasing awareness within communities across North Dakota.
"What we're seeing now is that the few states that have decriminalized or repealed these laws," said Grueneich, "there is an increase in testing."
Health officials note that today, people with HIV given certain medical treatment can achieve an undetectable viral load, meaning they can't transmit the virus sexually.
Grueneich added that keeping criminalization laws in place only paves the way for a person to make false claims against, for example, an ex-partner.
He said it can be very difficult for someone wrongly accused to state their innocence.
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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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