On World AIDS Day, Worcester advocates say HIV remains a worry – Worcester Mag
The World Health Organization estimates that Acquired Immune Deficiency Syndrome, commonly called AIDS,has claimed as many as 48.6 million lives.
With Dec. 1 marking World AIDS Day, there’s still work to be done, say advocates who work with those infected with or at risk of the human immunodeficiency virus, also called HIV.
“Over the years, due to advancement in treatment and supportive services, a lot of times maybe people construe that HIV is not that much of an issue,” said Lamar Brown-Noguera, community relations manager of AIDS Project Worcester.
The organization, which provides services for those infected with HIV or whose lives are affected by the virus, has planned a World AIDS Day event set for Dec. 1, 5:30 p.m. at Union Station in Worcester.
Here’s what to know about HIV and AIDS now.
Anyone can get it, but risk is growing for some groups
HIV.gov notes that in the U.S., gay and bisexual men, and other men who have sex with men are the population most affected by HIV, with the Centers for Disease Control and Prevention reporting that of the30,635 new HIV diagnoses in the U.S. in 2020, 68%, or 20,758, were among gay and bisexual men.
Other trends of concern include:
“People of color, women of color — Black women, especially, LGBTQ people face more impact overall,” said Brown-Noguera. Brown-Noguera said an increase is also seen in spread through heterosexual transmission.
“For a long time, we’ve been given the idea that it’s more of a LGBTQ issue, because they share the larger population of individuals affected,” Brown-Noguera said. “But, it is a society-wide issue.”
Brown-Noguera said if a person is possibly exposed to HIV, an emergency medication, known as post-exposure prophylaxis, or PEP, can combat the HIV virus within 48-72 hours of a possible infection.
“If you go to an emergency room and explain, ‘I feel I have been exposed to HIV,’ you may have ended up there whether it is due to sexual assault, a broken condom, whatever the case may be,” said Brown-Noguera.
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“PEP is a medication for the after-the-fact situation,” said Brown-Noguera, who said a blood sample may also be taken, as part of regular clinical testing for HIV.
Why the emergency room? Brown-Noguera said to use PEP, time is of the essence. “If you start taking PEP within a reasonable time, it could prevent an actual infection from happening. It affects the cycle of the HIV timeline.”
There’s a medication to reduce risk of HIV infection
Pre-exposure prophylaxis, commonly called PrEP, is a prescription medication to prevent getting HIV. The Centers for Disease Control and Prevention notes that PrEP can reduce the risk of HIV from sex by about 99% and HIV from intravenous substance use at least 74%.
The Department of Public Health states that HIV-negative people at high risk of HIV use PrEP should use PrEP, including:
- Men who have sex with other men
- Transgender women who have sex with men
- People who are in an ongoing sexual relationship with someone who is HIV-positive
- People who inject drugs and share injection equipment
PrEP is usually covered by health insurance. Programs can help with the cost of the medicine, deductibles or co-pays. For more information, contact the PrEP Drug Assistance Program (PrEPDAP) at 617-502-1737 or visit crine.org/prepdap.
“Don’t shy away from showing up at AIDS Project Worcester,” Brown-Noguera said. “We have a good package of testing, and available preventative and post-preventative interventions, such as PrEP and PEP.”
At-home tests can give a different results from clinical tests
“If you do your test at home, come back in for a clinical test,” Brown-Noguera said.
The reason: at-home tests typically run an accuracy rate of 70-80%, Brown-Noguera said. At-home tests measure the presence of antibodies, a protein the body produces in response to a harmful presence, including a bacterial or viral infection.
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If a person has been infected very recently, it may take a few days for the body to produce enough antibodies for a positive result, Brown-Noguera said. “Maybe you got infected a few days ago, and there are not enough antibodies to detect,” Brown-Noguera said.
A so-called fourth-generation test, which requires a blood test, can identify both HIV antibodies and antigens, substances that prompts the body to produce antibodies.
This test is generally considered the most reliable test for HIV. The antigen specific to HIV is called p24. Brown-Noguera notes that test results can take several days.
A person who is infected with or who transmits HIV through sexual activity may also be vulnerable to contracting or passing on other sexually-transmitted diseases.
More:STDS: What they are and what to know about them
Frequently called STDS, these diseases can take the form of bacteria, viruses, or parasites. Blood and urine tests are available at AIDS Project Worcester, as well as urine tests, to detect STDs.
Recently, Brown-Noguera said AIDS Project Worcester added swabbing, including of the throat, anus and vagina, also used for detecting sexually-transmitted diseases.
Antiretroviral therapy consists of medications to reduce and suppress the amount of HIV virus in a person’s body. These are the medications that allowed many people with HIV to live longer, healthier lives, and it’s important to start them as soon as possible after an HIV diagnosis.
Brown-Noguera said many people remain confused about how these medications work to reduce the spread of HIV. They can reduce viral load, the amount of a virus in a person’s body, to a very low level, keeping the immune system functioning against illness. A negative or undetectable viral load means a person has a low-enough viral load that a blood test can’t detect it.
HIV medicine can make the viral load so low that a test can’t detect it, known as undetectable viral load.
Brown-Noguera said, “That is what it is called treatment as prevention.” Even for someone with an undetectably low viral load, Brown-Noguera said, “We still say, practice safe sex.”
These medications do not constitute a cure for HIV. Currently, there is no cure. A person taking the medications must continue taking them to keep their HIV viral load low enough to stay healthy.
It’s still important to reduce risk
As a bloodborne pathogen, the main routes of transmission are sexual activity, intravenous substance use, and in pregnancy, from mother to baby.
For anyone at higher risk for HIV, the state Department of Health recommends several steps to reduce risk:
- Get tested every three to six months for HIV/STDs and talk with your sex partners about their HIV/STD status
- If your sex partners are HIV-positive, have sex when they have an undetectable viral load
- Have lower-risk sex (oral, mutual masturbation, etc.) instead of, or more often than, anal or vaginal sex
- Limit your number of sex partners
- Use condoms for anal or vaginal sex
Brown-Noguera stresses that help is available, and knowledge is key.
“We do need people to remain aware, and remain educated. HIV doesn’t pick or choose who it impacts. It is something for all of us to be consistently educated around.”