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Noon Edition

Advancements in Prevention, Treatment Change Outlook of HIV/AIDS

Monday marked the 26th Annual World AIDS Day, a day to show support for people living with HIV/AIDS and to remember those individuals who have died from the disease.

Monday marked the 26th Annual World AIDS Day, a day to show support for people living with HIV and AIDS and to remember those individuals who have died from the disease.

The World Health Organization estimates that more than 39 million people have died from HIV-related causes worldwide and, by the end of last year, 35 million people were living with the virus.

As advancements are made in prevention and treatment, an HIV diagnosis is not necessarily the death sentence it once was. A regimen of antiretroviral drugs can suppress HIV and stop the progression of the disease.

On this episode of Noon Edition, experts discussed education, statistics, and the stigma around HIV and AIDS.

Statistics

Positive Link is a program by IU Health Bloomington Hospital that provides prevention and holistic services to south-central Indiana residents living with HIV or AIDS. Jill Stowers, the Clinical Lead Manager of Positive Link, says they serve about 200 infected individuals.

"By and large, over 70 percent of our folks are living on less than $20,000 a year," Stowers says. "So while we're trying to address their health status, there are so many other issues facing them."

She says Positive Link takes a broad approach to clients in many aspects of their lives, from nutrition to housing, so they can focus on their health.

Brian Dodge, a professor in the IU School of Public Health whose research focuses on the behavioral science of sexual health, says many instances of HIV and AIDS take place in disenfranchised communities.

"The fact that we still have large numbers of people globally, domestically and even locally here in Indiana who are affected by HIV, particularly in disenfranchised and marginalized communities, I think there's still social justice issues and access to treatment and care issues that are just as relevant today as they were in 1981," Dodge says.

Indiana State Department of Health data shows that at the end of 2013, slightly more than 11,000 Indiana residents had HIV or AIDS. Each year, about 500 new cases of HIV are reported to the ISDH.

"While I think the people that we have doing the work in Indiana are doing incredible work, the numbers are not going down the way we would like to see them go down," says Andrea Perez, director of the Division of HIV/STD/Viral Hepatitis in ISDH.

Most newly reported cases in Indiana are adults between the ages of 20 and 40, Perez says. Data reveals a growing population of African Americans becoming infected by the virus. A majority of newly reported diagnoses of HIV and AIDS in women are African Americans.

Dodge says reports from the Centers for Disease Control and Prevention suggest this is the changing face of HIV, not only in Indiana, but nationally.

"Rates across a number of different risk groups over time have stabilized or gone down, but the one group who continues to skyrocket really astronomically are black man and, in particular, black men who have sex with men and, in particular, those who are low-income or in poverty," Dodge says.

Unemployment and previous incarceration are predictors of HIV that are concentrated in disenfranchised communities, he says.

Positive Link targets their prevention and care efforts toward the at-risk communities.

"We're very specific in trying to reach the highest risk populations, to reach people who are the least likely to have access to medical care, the least likely to have access to services," Stowers says.

Education

Younger generations have grown up knowing AIDS as a chronic disease.

"They didn't live through those days of seeing their entire circle of friends or loved ones and family members die from the disease," Dodge says.

As AIDS has become less traumatic for patients and the disease has developed into a condition from which people don't necessarily die, Stowers says people in their twenties don't fully grasp its scope.

Perez says the ISDH provides the data necessary for service providers and researchers to understand the demographics and educate the public.

Statewide assessments of sexuality and health education show varying scenarios in different parts of the state.

"We're still struggling with these issues and the schools are such an obvious place where we want that sort of education to take place, but unfortunately that's not necessarily always the case," Dodge says. "Or sometimes it would actually be better if it wasn't because they're not always giving scientific, medically accurate, age appropriate information that they should."

Stigma

The stigma associated with HIV and AIDS diagnoses hasn't totally disappeared.

"We've come leaps and bounds in terms of where we were at in the earliest days of the HIV epidemic, but I think we do still have a long ways to go," Dodge says.

He says common stigmas deal with having HIV, taking medication and being a survivor from a generation where many people died from the disease.

Stowers' says that while there is still stigma associated with the virus, it has evolved over the years.

"We see a lot more institutionalized stigma that hasn't necessarily gone away," Stowers says. "We don't see a lot of outward anger. It's not the eighties anymore and it's not in that same manner."

Perez says eliminating the existing stigma may play a part in the elimination of HIV and AIDS. She says one of the most important things people can do for the cause is to be willing to talk about the issue.

"It has gotten a lot better, but a lot of the progress that we are not making I think goes back to stigma in many ways," Perez says.

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