Health & Wellness

‘It’s Going to Get Worse’

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Gilead taps UH to help fight rising HIV/AIDS rates in the South.

By Marene Gustin

For the first time since the influenza epidemic of 1962–’63, the life expectancy of Americans decreased for a second consecutive year in 2016.

Although this decrease was fueled largely by the opioid epidemic, it also marked the first one-year drop in life expectancy since 1993, during the worst of the AIDS crisis. And experts say the latter statistic could be an omen.

The rate of new HIV infections is increasing in Southern states (including Texas), and it now rivals levels from the 1980s, according to the Centers for Disease Control and Prevention (CDC). In Texas, where an estimated 86,000 people are living with HIV, there were 4,493 new diagnoses recorded in 2016.

“And I absolutely think it’s going to get worse,” says Samira Ali, assistant professor and HIV researcher at the University of Houston’s Graduate College of Social Work (GCSW).

Doug Brooks

In December, Gilead Sciences, Inc., tapped GCSW as one of three coordinating centers for the drug company’s unprecedented 10-year, $100 million “Commitment to Partnership in Addressing HIV/AIDS in Southern States,” also known as the COMPASS Initiative.

“A group of us from Gilead traveled around the Southern states to listen to patients and stakeholders about how we could make a difference,” says Doug Brooks, senior director for community engagement at Gilead Sciences, which has long been at the forefront of HIV/AIDS prevention and treatment.

“We found that what was needed in these regions was a three-pronged approach: capacity building and shared knowledge; well-being, mental-health, and trauma-informed care; and awareness, education, and anti-stigma campaigns,” says Brooks, who previously served as director of the Office of National AIDS Policy under the Obama administration. “But as significant as our commitment is, we cannot solve this crisis alone without comprehensive access to care.”

Following an invitation-only request for proposals, Gilead Sciences selected Emory University’s Rollins School of Public Health, the Southern AIDS Coalition, and GCSW to participate in the COMPASS Initiative.

“We will be providing flow-through grants for community-based nonprofits, and providing technical assistance,” says GCSW’s Ali. “Am I excited about the initiative? Certainly—but I’m also sad that we’re still fighting this 30 years later.”

So what is causing the increase in new HIV infections in the Lone Star State?

“It’s several things: racial inequity, poverty, stigma, and sub-par sex education in public schools,” Ali says, adding that immigration status also plays a role.

“I’ve done a lot of work on the ground for ten years, and what I hear is that there is a lack of resources,” she adds. “In Texas, support for community health is not a priority.”

Ali cites recent cuts to federal initiatives such as the Affordable Care Act and the Children’s Health Insurance Program, as well as the non-expansion of Medicaid in Texas. She says she hears from many who are forced to choose between paying for healthcare and buying groceries.

“And we hear from young people that they don’t know about AIDS, or how you get it, and that it is treatable,” Ali says.

In Texas and the other eight states studied by Gilead, HIV/AIDS disproportionately affects people of color and the LGBTQ community. Infection from drug use has declined, while transmission among men who have sex with men is on the rise.

Due to a lack of affordable health care and the stigma surrounding HIV/AIDS, many people still don’t get tested, Ali says.

In 2015, the CDC recommended that all patients, not just those at high risk, receive HIV tests. In 2017, state Representative Gene Wu (D-Houston) authored House Bill 717, which would have required healthcare providers who take blood samples to conduct HIV tests unless patients opt out. But Wu’s bill didn’t make it out of committee.

Brooks agrees that while additional medical advances may be on the horizon, testing and prevention remain critical.

“Researchers around the world are looking for methods of intermittent dosing,” Brooks says, adding that this would eliminate the need for daily medication to combat HIV. “That will be the next big thing, but we still need to stop the increasing rates of new infections.”

This article appears in the February 2018 edition of OutSmart Magazine. 

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Marene Gustin

Marene Gustin is a regular contributor to OutSmart magazine.

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