STD Awareness: HIV Almost Cured Doesn’t Count
By Dianne Anderson
What once struck fear in the hearts of everyone can now be managed with a simple pill or two a day.
But for all those who lived through the HIV/AIDS terror of the 80s, today’s generation seems to be acting like there’s a cure.
However, it may be more a matter of the definition of a cure.
Currently, there is a campaign out called U=U, meaning undetectable means untransmittable.
“These days with the inclusion of PreP and a prevention approach, and if someone’s partner is undetectable, the chances of spreading the virus have proven to be pretty much zero. People view that as a cure, but it’s not,” said Ismeal Salamanca, Director of Health & Wellness Services with the LGBTQ Center of Long Beach.
If an HIV viral load is low or undetectable, science offers a lot of hope these days to stop the spread.
“U=U means that people living with HIV who achieve and maintain an undetectable viral load—the amount of HIV in the blood—by taking and adhering to antiretroviral therapy (ART) as prescribed cannot sexually transmit the virus to others,” according to the National Institutes of Health.
With so many major medical advances lately, sexually active teens and youth just aren’t as scared of AIDS as the old days. They’re also not afraid of Sexually Transmitted Diseases, which can weaken the immune system and makes it easier to get HIV.
In the meantime, STDs or Sexually Transmitted Infections (STI’s) are hitting Black and Brown communities hard.
Salamanca sees cultural similarities between both communities, having worked in the health field for nearly 20 years. He said the spread of HIV is still disproportionately impacting people of color, stemming from unequal access to care.
People develop AIDS because they stop taking or do not have access to daily medication, leading to pneumonia or Kaposi sarcoma, both of which an otherwise healthy immune system could ward off.
Over the past five years, increased funding at their center has helped expand screening for STI testing, which Salamanca attributes to why more cases are being identified.
Also, the screenings are not all alike. His center offers general screening, and oral and rectal screening. Most providers only offer a simple urine test, which he said misses most cases. Blood tests are typically for syphilis or hepatitis, but gonorrhea or chlamydia are bacteria, which thrives in dark moist places, and detected with swab testing.
The California Department of Public Health (CDPH) recently released its 2018 data on sexually transmitted diseases (STDs). It finds that syphilis, gonorrhea, and chlamydia cases are pushing its highest levels in three decades.
It also found that congenital syphilis cases, syphilis passed from mother to baby, were 14% higher than the previous year and nearly 900% higher than in 2012. Last year alone, 22 babies died from syphilis.
In talking about HIV or AIDS, the stigma still has a chilling effect within the Black and Brown community, but talking and testing are critical for survival.
The Center for Disease Control reports that in 2018, adult and adolescent Blacks/African Americans accounted for 42% of all new HIV diagnoses; Hispanics/Latinos accounted for 27%, compared to whites at 25%.
Lea Morgan, HIV and STD Branch Chief for Riverside County Department of Public Health, said they were out strong on World AIDS Day to let people know STI’s are soaring. It leaves a body vulnerable to get HIV.
“If someone has an STI, the infection is already causing small tears in skin or barrier, then there’s more susceptibility,” she said. “STI’s are opening the door for other STI’s to come in.”
How fast it takes to develop full-blown AIDS depends on the individual immune system, which varies from case to case. When people are not in care, she said it’s more likely that they will develop AIDS.
“Getting people into care is our main goal. When they’re in care and their virus is suppressed, they aren’t as likely to be able to transmit to someone else,” Morgan said.
Riverside County is impacted heavily on the eastern portion where most HIV cases that they’ve seen previously involve mostly older white males around 45 years old who have sex with men. However, that region also has many safety nets in place.
“What we’re seeing now with new data 2016 to 2018 is a younger demographic, men who have sex with men but are men of color, LatinX and African Americans and they are around 30 years old,” she said. “The demographic is changing.”
HIV testing, usually under 20 minutes, is available free through the public health department. If someone comes back positive, she said that’s an opportunity to get their viral load down.
“They can live out the rest of their lives, it’s not a death sentence,” she said.
Nichole Ramirez at Planned Parenthood, Orange County, said the surge in STD’s is at epidemic proportions. All of their health centers within Orange and San Bernardino counties are showing a high impact.
The organization outreaches to educate young people about safer sex, and about condom use to stop the spread of STDs, which has soared in San Bernardino County for several years now. Women with HIV have also escalated.
Their centers offer PreP, which can potentially help someone not contract HIV.
“Anybody can come and get tested for STDs,” she said. “Our doors are open to everybody, regardless of ability to pay or immigration status or insurance. We also take insurance and Medi-Cal.”
They offer a sliding scale fee, and they will never turn anyone away.
STDs are now more potent than ever, often requiring two antibiotics. There is also a high rate of re-infection if both partners aren’t treated at the same time, she said.
“Syphilis has made a comeback, unfortunately. Across the board, there definitely have been significant increases in STDs,” she said. “The most common symptom is there are no symptoms.”
For more info on U=U, see https://www.niaid.nih.gov/diseases-conditions/treatment-prevention