HIV/AIDS Prevention and Testing in Austin, Texas
HIV/AIDS in the U.S.A.
The HIV epidemic is happening. Right now. You know this. You’ve probably heard about it in the news or read about it in a biology class. Although approximately two-thirds of the world’s population living with AIDS resides in sub-Saharan Africa, the infection may be closer to you than you think.
The U.S. epidemic is very much a topic of importance in the healthcare field today. HIV — human immunodeficiency virus — is contracted through blood or sexual fluids and the virus causes AIDS — acquired immunodeficiency syndrome. AIDS weakens the human body’s immune system and cannot be cured. Contrary to popular belief, people in the U.S. still die from the severity of the infection and symptoms. In 2014, 6,721 people died from HIV/AIDS, and “HIV remains a significant cause of death for certain populations” (Centers for Disease Control and Prevention [CDC], 2017).
The spread of infection is concentrated in numbers for specific demographic regions and/or ethnic populations. One such area in the southern United States is Austin, Texas. The number of people living with HIV in the Austin-Travis county area has increased more than 40 percent since 2006 (Ayala-Talavera, 2014). In 2010, Austin ranked third for the highest rate of HIV infection in Texas with 2009 HIV infection rates at 265.6 cases per 100,000 people or 0.266 percent (Bernier, 2010). More recently, the Texas State Department of State Health Services released the 2016 Texas HIV Surveillance Report to show the city is fourth for the total number of HIV and AIDS diagnoses but is no longer included on the list for counties with the highest new cases of HIV diagnoses in 2016 (Texas Department of State Health Services, 2017). What does this mean for Austin? Well, despite the now 178.1 cases per 100,000 people living with HIV today, Austin has worked hard to lower its rate of new cases of infection per year (Texas Department of State Health Services, 2017). In response to these numbers, the city’s goal for combating the spread of HIV is to provide affordable testing and treatment to as many residents as possible.
Demographics
Although Austin has decreased its numbers of new cases per year, the rate of infection and insufficient treatment still has a detrimental impact on minority communities, as shown in the figures above. A 2017 study of racial disparities among patients living with HIV in Texas supports the national trend that African Americans with HIV have higher mortality rates when compared to other racial groups (Nduaguba, Ford, Wilson, & Lawson, 2017). A conclusion of this study adds that further research may be helpful in providing adequate care for African American communities to reduce these higher mortality rates and other racial disparities (Nduaguba et al, 2017). Why is it that the minority communities in Texas are the same ones across the nation that are suffering from the HIV epidemic? In Austin, you can see that only certain neighborhoods have cases of over 1,000 persons living with diagnosed HIV. This is because “many of the populations most affected [by the HIV infection] tend to have limited social mobility; thus, partner selection tends to concentrate transmission patterns and amplify spread within defined geographic areas” (El-Sadr, Mayer, & Hodder, 2010). The spread of infection is a real threat for the members of those communities, yet it is almost unavoidable. But ethnic communities are not the only groups suffering from the risk of HIV infection.
The LGBT+ community is at the highest risk, especially when comparing the rate of infection for homosexuals to that of heterosexuals. From 2007 to 2010, the annual number of HIV infection increased and male-to-male sexual contact accounted for 65% of all HIV diagnoses reported in 2011 (Wejnert, et al., 2013). Figure 4 shows that transmission through male-to-male sexual significantly increased to 71.7% in 2015. In 2016, the CDC reported that gay and bisexual men made up the most affected population and accounted for 67% of all HIV diagnoses and 83% of diagnoses among males (CDC, 2017). As a result, informing these populations of HIV awareness and prevention tactics has been a priority for Austin’s health department and many local nonprofit organizations.
Prevention and Testing
Many cities have adopted a “Getting to Zero” initiative. The goal is to reduce the number of new HIV infection cases to zero. Here in Austin, the Public Health Department funds an HIV Prevention program which offers free confidential and anonymous counseling and testing for HIV. The program includes a Mobile HIV Testing unit, the Red Ribbon Program, and condom distribution locations. More information for the program’s available locations and services can be found here and a list of other testing locations can be found here.
Nonprofits also play a large part in giving people the proper prevention information, testing facilities, medication needed to fight the risk of infection, and other methods of support for those diagnosed with HIV. Some of these organizations include AIDS Services of Austin, Project Transitions, Austin Outreach, and Kind Clinic. From personal volunteering experience, I am most familiar with the process of testing and giving preventative care at the Kind Clinic.
In 2017, I volunteered with the Kind Clinic as a “Navigator” of insurance and helped patients receive fully covered preventative medication, Truvada®, for pre-exposure prophylaxis (PrEP). The clinic, a program of Texas Health Action, provides post-exposure prophylaxis (PEP) in addition to PrEP, testing services for both HIV and STI, general wellness exams, and gender care. The clinic’s ability to provide fully covered HIV PrEP to every patient astounded me the most. To add some perspective: one bottle of Truvada® contains 30 tablets (one-month supply) and each bottle costs approximately $1,300. This is roughly $15,600 a year a patient would need to spend on PrEP if he or she does not have insurance. Yet, regardless of race, ethnicity, income, gender, or sexuality, the clinic guaranteed PrEP access at absolutely no cost for an appointment, any services, or even the medication itself. As a Navigator, I had the pleasure of meeting a diverse number of people and guiding them through the application process for third-party assistance. My time with the clinic felt valuable and impactful, and knowing that each patient I interacted with was getting the care they needed was a fulfilling job. I believe that with the growth of nonprofits like Kind Clinic, Austin moves one step closer to Getting to Zero.
The best thing you can do to help get Austin’s HIV case number to zero is be aware of a sexual partner’s HIV status, get tested regularly, and spread awareness! Having an honest, open conversation with your partner about HIV status can protect both parties from the risk of spreading infection. As stated by the Austin Department of Public Health, “knowing your status empowers you to make informed decisions,” meaning it only benefits you to get tested! If regular testing is preferred, be sure to get tested every 3 months — the earliest that a test can detect HIV infection from a potential exposure. And if you know of anyone who may need guidance to find testing, prevention, or treatment centers, knowing who and where to direct them to is beneficial not only to them, but to the city of Austin as well.
Bibliography
AIDSvu. (n.d.). Austin. Retrieved February 22, 2018, from https://aidsvu.org/state/texas/austin/
Ayala-Talavera, M. (2014, February 03). HIV/AIDS cases on the rise in Austin. Retrieved February 22, 2018, from http://kxan.com/2014/02/03/hivaids-cases-on-the-rise-in-austin/
Bernier, N. (2010, December 1). Austin Has Third Highest HIV Infection Rate in Texas. Retrieved February 22, 2018, from http://kut.org/post/austin-has-third-highest-hiv-infection-rate-texas
Centers for Disease Control and Prevention. (2017, November 29). HIV in the United States: At A Glance. Retrieved February 22, 2018, from https://www.cdc.gov/hiv/statistics/overview/ataglance.html
Centers for Disease Control and Prevention. (2017, December 18). HIV/AIDS Basic Statistics. Retrieved February 22, 2018, from https://www.cdc.gov/hiv/basics/statistics.html
El-Sadr, W. M., Mayer, K. H., & Hodder, S. L. (2010). AIDS in America — Forgotten but Not Gone. New England Journal of Medicine,362(11), 967–970. doi:10.1056/nejmp1000069
Nduaguba, S. O., Ford, K. H., Wilson, J. P., & Lawson, K. A. (2017). Trends in Racial/Ethnic Disparities Among Patients Living with HIV in Texas, 1996 to 2013. Journal of Racial and Ethnic Health Disparities. doi:10.1007/s40615–017–0450–1
Texas Department of State Health Services. (2017). Texas HIV Surveillance Report: 2016 Annual Report(Rep.). Austin, TX.
Wejnert, C., Le, B., Rose, C. E., Oster, A. M., Smith, A. J., & Zhu, J. (2013). HIV Infection and Awareness among Men Who Have Sex with Men–20 Cities, United States, 2008 and 2011. PLoS ONE,8(10). doi:10.1371/journal.pone.0076878
