HIV and AIDS cases are on the rise in Kentucky; officials blame lack of education and increase of heroin use

Despite readily available information and awareness about practicing safe sex, and avoiding sharing needles, HIV and AIDS cases are on the rise in Kentucky. And the reason, say officials, is ignorance and an increase in heroin use, Mary Meehan reports for the Lexington Herald-Leader. Mark Royse, executive director of AVOL, which serves clients with HIV and AIDS in 72 Kentucky counties, said "his nonprofit routinely offers support services, including housing assistance, to about 400 families affected by HIV and AIDS."

Lauren Kirk, HIV and AIDS outreach specialist for the Lexington-Fayette County Health Department, "said a lot of the people they see are young and were born after the AIDS epidemic was at its lethal peak," Meehan writes. Another specialist, John Moses, told hr that the health department is seeing more young people with HIV. Part of that surge, he said, is from the use of shared needles as heroin use in Kentucky is on the rise." Heroin drug deaths in Kentucky increased by 550 percent in 2012, John Cheves reports for the Herald-Leader.

Another problem is that many people refuse to get tested, because discussion of HIV and AIDS includes talk of sexuality, homosexuality and drug abuse, Meehan writes. Royse told her, "It is a perfect storm of things we don't like to talk about." Royse said "a 'silence-is-better' policy is especially prevalent among Latinos and blacks, who account for the majority of new infections in Kentucky. He's concerned that if people stop talking about HIV and AIDS and become complacent, the infection will continue to spread." (Read more)

The state Cabinet for Health and Family Services, in its annual report from June, 2012, said 8,513 Kentuckians are diagnosed with HIV, with 7031 men and 1,482 women. Most of the cases are in urban areas, with 3,849 in Jefferson County and 1,099 in Fayette County. Of those cases, 4544 are classified as from men having sex with men (MSM), 917 as injection drug users (IDU) and 425 as people who reported to having engaged in both MSM and IDU.

The overall total of HIV and AIDS cases includes 21 boys under 13 years old, 107 between ages 13-19, and 1,269 between ages 20-29. For women, it includes 13 girls under 13 years old, 39 between ages 13-19, and 203 between ages 20-29. (Cabinet graphic: Newly diagnosed HIV cases in 2010 for Kentuckians ages 20-29 years old accounted for 32 percent of all new cases, even though that age group only makes up 13 percent of the total population)

Kentucky ranks 25th in HIV infections. In 2010, the state had 85 new HIV cases for people ages 13-24, accounting for 25 percent of all new cases in the state, which is higher than the national average for that age group of 21 percent. The average age of Kentuckians diagnosed with HIV went down from 37.1 years of age in 2006 to 35 years of age in 2010. To read the full report click here.

Free HIV testing available from health departments and community-based health groups in June; key to AIDS prevention

In honor of National HIV Testing Day on June 27, community-based organizations and local health departments are hosting free HIV testing throughout the month of June. HIV is an infection that can lead to AIDS, and early screening and detection of HIV are critical to fighting the disease, avoiding further health complications and ensuring it isn't unknowingly transmitted to others.

“Routine testing ensures HIV-positive individuals are made aware of their status early before the disease progresses to AIDS,” said Dr. Stephanie Mayfield, commissioner of the state Department of Public Health, which is promoting the HIV testing and awareness events through mini-grants. “Testing remains one of the most critical and effective strategies for preventing transmission, ensuring good health outcomes, keeping service costs low and keeping infected individuals healthy.”

About 20 percent of people with HIV don't even know they are infected, which is very problematic because these individuals are believed to transmit HIV to more than half of the people who become newly infected each year, and one-third of the people is diagnosed so late that they develop AIDS within one year, says the federal Centers for Disease Control and Prevention.

In 2010, 32 percent of Kentucky's 7,751 HIV cases led to an AIDS diagnosis within 30 days of the initial infection, says a Cabinet for Health and Family Services release. This highlights the importance of routine testing, which the CDC recommends for everyone, regardless of risk factors, especially for all people age 13 to 64.

"A delay in diagnosing HIV is a life and death issue, with many individuals receiving a concurrent diagnosis of HIV/AIDS upon initial testing. Early intervention and linkage to care is critical to enhance the quality of life and reduce costs for treatment,” said Gayle Yocum, HIV/AIDS prevention section supervisor, in the CHFS release.

In Kentucky, HIV disproportionately affects racial minorities, particularly the African-American and Hispanic populations. Although African-Americans represent 7 percent of the state’s population, they account for 34 percent (2,884) of new HIV infections. Individuals who are at a higher risk for infection should be tested at least annually, including those with multiple sex partners, injection drug-users and their sex partners, people who exchange sex for money or drugs, men who have sex with men and sex partners of someone with HIV, says the CDC.

Kentucky testing sites

The Department of Public Health's statewide network of HIV testing sites provide risk reduction counseling and helps individuals develop a behavior-change plan to reduce the risk of getting or spreading HIV. Here's a list of the statewide events providing free HIV rapid testing in the next two weeks:

◾ June 17, free testing and education, 10:30 a.m. to 2 p.m., Salvation Army of Bowling Green, 400 W. Main Ave., Bowling Green.
◾ June 20, afternoon gospel fest, noon to 5 p.m., New Beginnings Church, 4127 Flintlock Drive, Louisville.
◾ June 22, church health fair, 10 a.m. to 5 p.m., Faith Fellowship, 727 S. 15th Street, Louisville.
◾ June 25, free testing, 11 a.m. to 3 p.m., 2106 St. Louis Ave., Louisville.
◾ June 28, free testing and education, 10 a.m. to 3 p.m., Housing Authority of Bowling Green, 247 Double Springs Road, Bowling Green.
◾ June 28, neighborhood test fest, 10 a.m. to 4 p.m., Nia Center, 2900 W. Broadway, Louisville.
◾ June 29, free testing, 11 a.m. to 1 p.m., Walgreens, 110 Town Center Dr., Lexington.
◾ June 29, free testing, 11 a.m. to 1 p.m., Crossings, 117 N. Limestone, Lexington.
◾ July 3, free testing, 8 p.m. to midnight, The Bar Complex, 224 E. Main Street, Lexington.

Click here for more information about HIV and AIDS, about the National HIV Testing Day/Month Campaign or other programs and services.

Poll shows Kentucky health-care providers often fail to discuss HIV testing with patients

A new poll suggests that most Kentucky health-care providers follow guidelines for discussing HIV screening with their patients, despite the the importance of early treatment to prevent its progression to AIDS.

Although the Centers for Disease Control and Prevention recommends routine HIV screenings for most patients, just 32 percent of Kentucky adults aged 18 to 64 report discussing HIV testing with their medical provider, according to the Kentucky Health Issues Poll.

About 40 percent of Kentucky adults reported they had never been tested for HIV. It’s estimated that 4,500 Kentuckians are living with HIV infection and it is estimated nationally that one in five people who have HIV do not know they do.

“It made headlines earlier this month when a little girl - the second person in history - was cured of HIV. As exciting as this development was, for most people, HIV remains a life-long condition that must be managed through medication to keep it from progressing to AIDS. The CDC’s recommendations are meant to improve the overall population health by detecting HIV so treatment can begin,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll.

“It appears that Kentucky providers are either not adhering to the routine screening recommendations or not communicating this message clearly to patients,” she said.

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points

Kentucky Parent Survey: We could do a lot better on school meals, we're very much in favor of more health education

Fewer than 10 percent of Kentucky
parents report that their child has ever
walked or biked to school.

When asked, only about one in four Kentucky parents describe the meals served at their child's schools or day care centers as being nutritious. Fewer than 10 percent report that their child have ever walked or biked to school. And an overwhelming majority want information about sexually transmitted infections, human anatomy, abstinence education, birth control methods and condom use taught in Kentucky's high schools.

These are just a few of the surprising results from the first Kentucky Parent Survey conducted by the Foundation for a Health Kentucky, a random telephone survey of 1,006 parents of children under 18. The survey assessed the views of parents, step-parents, grandparents, foster parents and other legal guardians of children in Kentucky. The term "school" was used broadly in the survey as included (2 percent of total surveyed), as well those in pre-school and day care. The study took on nutrition, physical activity and health education.

Eighty-eight percent of parents reported that it was "very important" that meals at schools meet a minimum standard for nutritional value. Only about 1 in 4 parents currently thought their schools were meeting that standard. Only 11 percent are concerned that their younger children are getting too many "celebration-related" treats at their school.

While parents in the state reported that a little more than half (52 percent) of school-age children took physical education classes, that class was not a daily occurrence but met between one and four times a week. Only about 1 in 3 students took a daily course in P.E. That leaves 14 percent without a planned daily class during the school year.

On the topic of health education, parents reported that half of school-age children in the state took health classes, but again not daily. According to the FHK, "The Kentucky Parent Survey included a series of questions about dating relationships and sexual health to determine support for covering those topics...
At the middle school level, more than 8 in 10 parents would favor teaching communication skills (99 percent), human anatomy (91 percent), abstinence education (85 percent), and information about HIV and sexually transmitted infections (84 percent). At the high school level, more than 8 in 10 would favor teaching communication skills (99 percent), information about HIV and sexually transmitted infections (97 percent), human anatomy (97 percent), abstinence education (94 percent), birth control methods (87 percent), and condom use (84 percent)."

Future reports in the FHV series will address access to safe and effective health care for children, children's health behaviors and family routines and the places where parents turn for information on raising healthy kids.

More breakthroughs lately in fight against HIV/AIDS

It has been an inspiring season of breakthroughs in the fight to prevent the spread of HIV and AIDS. Earlier this week, the Food and Drug Administration approved the pill Truvada, "a preventive measure for healthy people who are at high risk of acquiring HIV through sexual activity, such as those who have HIV-infected partners," reports Matthew Perrone for The Associated Press.

Just two weeks ago, the agency also approved the first over-the-counter HIV test that can be used at home. "I think the combination of self-testing and a medicine that you can take at home to prevent infection could mean a whole new approach to HIV prevention that is a bit more realistic," said Dr. Demetre Daskalakis of New York University's Langone Medical Center.

In the meantime, a research team at the University of Nebraska Medical Center is making progress to develop a weekly or twice-monthly injection that would help manage patients with HIV. The long-acting injection "would be a substantive improvement over daily and sometimes more complex regimen of pills," lead investigator Dr. Howard Gendelman told research-reporting service Newswise.

"We actually followed the process exactly as we would with a person — and it worked," he said. "This is all very exciting. Although there are clear pitfalls ahead and the medicines are not yet ready for human use, the progress is undeniable." (Read more)

FDA approves fast, take-home test that detects HIV

A model demonstrates how to use the OraQuick test, which
detects the presence of HIV in saliva.
AP photo by Chuck Zovko.

Soon, taking an HIV test will be no more complicated than swabbing one's mouth and waiting for the results. The Federal Food and Drug Administration last week approved the OraQuick test, which detects HIV antibodies and gives a result in 20 to 40 minutes. 

Orasure plans to start selling the test in October at local pharmacies and online, reports Matthew Perrone for The Associated Press. It is expected to cost less than $60 but more than the one used by health professionals, which costs $17.50.

About 240,000 of the 1.2 million people who are suspected of carrying the HIV virus don't know they are infected. 

The FDA says the test is not 100 percent accurate, but a trial conducted by Orasure showed it only detected HIV in people who have the virus 92 percent of the time. It was 99.9 accurate ruling out HIV in people not carrying the virus. People who test negative should re-test after three months because it can take time for the HIV antibodies to appear. (Read more)

Pharmacies to offer free HIV tests as part of pilot program; no Ky. locations chosen yet

Getting tested for HIV may soon be as easy as going to the pharmacy to get a flu shot or blood pressure check. Pharmacies in 24 cities and rural communities will offer rapid HIV tests free of charge as part of a $1.2 million program. Testing is already available in Washington, D.C., Oakland, Calif., and an Indian health service clinic in Montana. The remaining 17 locations will soon be chosen by the Centers for Disease Control and Prevention.

The test involves swabbing the inside of a person's mouth and preliminary results take about 20 minutes. Makers of the test say it is accurate 99 percent of the time. "If the test is positive for the AIDS virus, pharmacy employees will refer customers to a local health department or other health care providers for a lab blood test to confirm results, counseling and treatment," The Associated Press reports. "The workers are expected to deliver the news face-to-face and give customers privacy."

According to the CDC, there are about 1.1 million Americans who are infected with HIV, but up to 20 percent of them don't know they have it. Since 2006, the CDC has recommended all Americans ages 13 to 64 get tested at least once, but fewer than half of adults under the age of 65 have done so. (Read more)

More Americans dying from hepatitis C than from AIDS

More people are dying in the U.S. from hepatitis C than from AIDS, a new report from the Centers for Disease Control and Prevention says. More than 3.2 million Americans have the hepatitis virus, which can cause chronic infection of the liver and eventually lead to liver failure.

Hepatitis C death rates climbed to almost 5 per 100,000 in 2007, from fewer than 3 per 100,000 in 1999. In the same time period, the HIV-AIDS death rate dropped to slightly more than 4 per 100,000 from more than 6 per 100,000.

"The declines in HIV reflect the accomplishments in building a public health response to the epidemic that improved screening and provided means of access to effective treatment," said Dr. John W. Ward, director of the Division of Viral Hepatitis at the CDC and author of the study. A similar program for hepatitis C would be similarly helpful, he said.

The disease is most commonly spread by exposure to infected blood. Intravenous drug abuse is the most common method of transmission, reports MedicineNet.com.

Ward said there is now a treatment "that was about 70 effective at clearing the virus from the body, but, he said, most infected people are unaware of their condition and do not receive treatment," reports Nicholas Bakalar for The New York Times. (Read more)

Get tested, get treatment, Bluegrass HIV Coalition encourages

Today is World AIDS Day and health advocates are asking Kentuckians to get tested and get treatment.

Hundreds of Kentuckians are diagnosed with AIDS each year, reports Mary Meehan of the Lexington Herald-Leader. Minority populations are hit particularly hard, with black men nearly 10 times more likely to die of AIDS than non-Hispanic white men. Black women are almost 23 more times more likely to die from the infections, compared to non-Hispanic white women.

Though people are still dying, AIDS is not a widely-discussed disease, in part because of its past association with homosexual activity. Mark Johnson, member of the Bluegrass HIV Coalition, said AIDS can be hard for people to talk about.

In addition, the infection is often seen as treatable, in part because of people like Magic Johnson, who has had the infection more than 20 years but is still in good health. What people don't see "is the often expensive regimen of drugs that is needed to keep the worst of the disease at bay, the side effects of those medicines or the ultimate end of what is still an incurable disease," Meehan reports. (Read more)

Dec. 1 is World AIDS Day; 1.2 million Americans are thought to be infected, but only 1 in 5 know it

Friday is World AIDS Day, an opportunity to learn the facts about the virus and show support for people living with it.

In the United States, there are 1.2 million people living with the HIV infection, which leads to AIDS. Of those who are infected with the virus in the U.S., only one in five know they have it, the Centers for Disease Control and Prevention report. Each year, about 50,000 Americans become infected. About 1,700 Kentuckians were diagnosed with HIV between Jan. 1, 2005 and Dec. 31, 2009; Kentucky ranks 19th in the country for the number of people who have the HIV infection.

Since the epidemic began, nearly 594,500 people have died with AIDS in the U.S. Between 1981 and 2007, more than 25 million people have died from the virus around the world.

Secretary of State Hillary Rodham Clinton spoke of the epidemic in a Nov. 8 address at the National Institutes of Health. "The fight against AIDS began three decades ago in June 1981. American scientists reported the first evidence of a mysterious new disease," she said. "Thirty years later, we ... know a great deal about the virus itself. We understand how it is spread, how it constantly mutates in the body, how it hides from the immune system. And we have turned this knowledge to our advantage."

Most at risk are gay, bisexual or other men who have sex with men. The CDC estimates that though this population accounts for just 2 percent of the U.S. population, it accounted for 61 percent of all new HIV infections in 2009. But heterosexuals and people who inject drugs can also contract the disease. Heterosexuals account for 27 percent of new cases. Another 9 percent of people who contracted the virus did so by using injected drugs.

Blacks accounted for 44 percent of new HIV infections in 2009, though they only represent 14 percent of the U.S. population. In 2009, the rate of new infection was 6.5 times greater for black men than it was for white men.

People can now be tested for the infection using a saliva sample and have the results in just 15 to 20 minutes. To find an HIV/AIDS prevention and service provider by county, click here.

Monday, June 27 is National HIV Testing Day

Kentuckians are being encouraged to find out their HIV status on Monday, June 27, National HIV Testing Day.

About 1,700 Kentuckians were diagnosed with HIV between Jan. 1, 2005 and Dec. 31, 2009. About 1 in 3 Kentucky adults under the age of 65 have been screened for HIV, the Foundation for a Healthy Kentucky notes. Christian, Hopkins and McLean counties have the highest rate of HIV testing, with 45 percent of adults being tested. Montgomery County has the lowest rate at 24 percent. For more county-specific information, click here.

The earlier that HIV is discovered, the better the treatment works, but early detection is not commonplace in Kentucky. By the time they are tested for HIV, 30 percent of Kentuckians already have full-blown AIDS. Though at one time 100 percent of Kentuckians infected with HIV died within five years, now 82 percent are alive after the same time period.

Kentucky ranks 19th in the country for the number of people who have the HIV infection that leads to AIDS. "Health officials say that at least one new HIV infection is discovered each day in Kentucky," Mary Meehan of Lexington Herald-Leader recently reported. National HIV Testing Day was founded by the National Association of People Living with AIDS in 1995. To find a testing site, click here.

Number of HIV/AIDS cases is increasing in Louisville area

The number of newly diagnosed AIDS and HIV cases in Louisville is increasing even as the fear of the deadly disease wanes. The number of newly diagnosed cases in Jefferson County rose from 80 in 2005 to 107 cases in 2008, The Courier-Journal's Laura Ungar reports. The number of new HIV cases increased from 136 cases to 154 in the same period.

"People think it's a disease of the past. Unfortunately it's very much alive," said Janet Mann, director of program development for AIDS Interfaith Ministries of Kentuckiana.

"People think: All I have to do is take a few pills every day. But it still kills people ... and it affects quality of life," said Bobby Edelen (left, by C-J's Kylene Lloyd). Edelen has lived with the disease that causes AIDS for 21 years. "Every day is not a picnic."

Complacency, drug use and lack of education are causing the numbers to increase, health officials say. But while numbers rise, there is less money to deal with the growing need. HIV/AIDS funding to the Kentucky Department of Public Health dropped from $11 million in 2008 to $9.4 million in 2010.

There is still no cure for HIV/AIDS, but there is medicine that can "keep people somewhat healthy by preventing the virus from reproducing or by blocking it from entering cells," Ungar reports. But people respond to medicine in different ways. "Taking meds for HIV is similar to cancer patients taking chemotherapy. Some are able to take it. Some are deathly sick," Edelen said. (Read more)