Texas HIV/AIDS Advocates Promote Testing on World AIDS Day

This year's World AIDS Day comes a little more than three decades after the first cases of what became known as AIDS were reported-it was then an unavoidable death sentence, but an early diagnosis today can mean a near normal life span for those with the virus.

In the last few years, the number of people with HIV in Texas has gone up due to better treatment. Yet a stigma attached to the virus continues, and advocates contend it's particularly acute in Texas and the South. Many with the disease don't know they have it, and that leads to a late diagnosis and delayed treatment. And the outcome in those cases the outcome isn't as good.

"I think we've come a long way on several fronts and not nearly far enough on others," said Raeline Nobles, director of AIDS Arms in Dallas. "There continues to be a lot of new HIV infections out there every year and there continue to be a lot of people living with HIV who don't know they are infected."

"That's the bad news," she added. "Trying to find folks and get them linked into medical care is a priority. That's seen some measure of success, but there's more work to be done."

The Texas Department of Health and Human Services indicates there are roughly 65,000 people living with HIV in the Lone Star State, an increase from approximately 48,000 in 2004. State health officials attribute this increase to better treatment, but spokesperson Chris Van Deusen told EDGE that 35 percent of these cases were diagnosed late.

"That shortens the expected life-span," he said. "The later you start treatment the more complications there will be. At the same time you have someone without treatment who is potentially spreading the virus."

Nobles stressed HIV can be treated even if it is diagnosed late.

"We've had patients with two t-cells," she noted. "Even folks with two t-cells can be built back up to near normal levels."

Nobles recounted the complications with efforts to get at-risk people tested.

"The stigma of HIV is still very strong in Texas and North Texas particularly," she Nobles. "We are a part of the South and we don't always like to talk about such things as sex and drugs and those kind of issues. Because HIV involves both of those things, the stigma is very strong."

Continuing the Mantra: Get Tested
Three decades into the epidemic, Nobles stressed there is still a lack of education around HIV in Texas and elsewhere.

"People get infected and they don't know they are infected," she said. "They just go through their lives until they get sick. Then it becomes a crisis for them."

In addition to providing testing and treatment, Nobles' group works to get the word out that there acute symptoms aren't necessarily evident when a person becomes infected with HIV. "You may wake up and have a sore throat, but that goes away," said Nobles. "If you've had an unsafe encounter either sexually or with IV needles or tattoo needles or piercing needles you need to be tested. You need to be tested several times a year and it has to become an everyday fact of life rather than being dirty and shameful."

Reaching Rural Texas
Outreach as well as treatment remains more accessible to urban residents. But Texas is a particularly rural state that presents a unique set of challenges to HIV/AIDS service providers.

Nobles said the funding has been targeted to the areas with the highest concentration of incidents-Dallas, Houston and Fort Worth. It means suburbs and other areas don't get the attention that they probably need, but reaching rural Texas remains a bigger problem for HIV/AIDS service providers and others who combat other chronic diseases.

"Texas has large rural areas where there are no testing sites- there are no hospitals," said Nobles. "People in the rural areas are really at a disadvantage as far as education and to having access to the medical treatment and testing that can save their lives."

Many rural residents who are diagnosed with HIV relocate to places where services are available, but this is not possible for everyone.

Minorities Remain Particularly Hard Hit in Texas
While more people are living longer with HIV, the rate of new infections is particularly high for members of some minority communities.

African Americans make up about 12 percent of Texas' population, but they comprise roughly 38 percent of people living with HIV in the state.

Van Deusen outlined state health officials' efforts to make progress in this area. These include a program with the Texas Department of Criminal Justice to help inmates with HIV who are being released connect to service organizations so they can continue treatment. The department also sponsors an African American women's summit on HIV and STDs that draws formal and informal leaders from around the state to develop leadership skills and share strategies on how to reduce HIV and STD rates.

"Nationally, the only demographic group that continues to see an increase in the number of HIV diagnoses is young gay African-American men," said Van Deusen. "We're trying to reach black gay men in urban areas by making more resources available for testing, counseling and linking them to care, as well as supporting leadership development in those areas."

A Meaningful World AIDS Day
Goals for World AIDS Day were set high this year: no new infections. Undoubtedly, it will take more time to reach that goal, but both service providers and public health officials hope to use events to bring the epidemic back into the headlines.

"People with HIV aren't in the headlines as much," said Van Deusen, noting people living longer with HIV often means less attention around the epidemic and a growing lack of knowledge and complacency. "The less people hear about it the less concern there is. That's something we continue to struggle against. The mantra of testing, testing, testing is something we've been saying for a long time."

Nobles said while the events surrounding World AIDS Day are important, a lot can be done on an individual level to make the most of the day. She suggested reaching out to friends who are at-risk and stressing the importance of getting tested. Nobles further stressed that help is available-and it's usually free.

"If we all reached out to one person and talked to them, and told them how they can get some help and stay healthy, we would do so much to decrease the stigma of the disease," she said. "We all know these folks, we just have to let them know that we care about them and want them to live a safe, long and healthy life."