The human immunodeficiency virus may not be viewed as the major threat that it once was, but testing is still as important as it ever was.
According to Christine Schuyler, commissioner of human services for the Chautauqua County Health Department, the perception of HIV has changed significantly since it was first discovered in 1981.
"When HIV was first discovered it was considered a major health threat," said Schuyler. "But, right now, it seems to me that the perception is that HIV is no longer a major threat."
More effective means of treatment and prevention have contributed to the change in perception, Schuyler said.
"People are living longer, but HIV itself is a virus, and when you talk about someone being infected you're saying that someone has that virus in their body and that they can pass that virus to other people," said Schuyler. "That virus attacks the body's immune system, so over time, people who are infected with HIV become less able to fight off germs that we're exposed to every day. Many of these germs don't make us sick, but they can be life threatening for someone whose immune system is not up to par."
Because people can live with HIV with no symptoms for up to 10 years, the spread of the virus by people who don't know that they have it is now one of the biggest threats, said Schuyler.
"There is data that shows that as many as one in five people could be infected with the virus and not know it, and the HIV test is the only way to find out if you have HIV," said Schuyler. "In September of 2010, a state law went into effect that states that HIV testing must be offered to everyone between the ages of 13 and 64. That doesn't mean that the test is mandated; it means that offering the test is mandated."
According to Schuyler, 2009 data for Chautauqua County shows that the newly diagnosed case rate was 6.7 per 100,000 people.
"That's well below both state and the national average, and our levels here remain stable," said Schuyler. "It's everywhere, and I'm sure we have many that aren't diagnosed. But, we've changed our emphasis to early HIV diagnosis. So, HIV is no longer the death sentence that it once was."
There are still misconceptions about how the disease is spread. Avoiding risky behavior and abstinence are ways to prevent infection, said Schuyler.
"It is spread through direct contact with infected blood, semen, vaginal fluids, breast milk, unprotected sex, sharing needles or syringes. Women with HIV can pass it on to their babies during pregnancy. And, people at a higher risk are those who are exposed to blood or body fluids at work such as health care workers," said Schuyler. "It is not spread through saliva, and unfortunately there are people who still think you can get HIV through kissing."
It is also possible to pass HIV through sharing needles during tattooing and body piercing. So, Chautauqua County's Sanitary Code details regulations on tattooing and body piercing that are enforced by the Environmental Health Division, which licenses and certifies artists and operations.
Acquired Immunodeficiency Syndrome, AIDS, is a late stage of HIV.
"Because of new medicine and treatments that help prevent the progression of the disease, people are able to live longer, healthier lives with HIV or AIDS," said Schuyler. "However, AIDS can have very serious health consequences, can interfere with quality of life and there is no cure. I think we need to remember that it's out there, and that this disease, which was once viewed as being a disease that only homosexuals, promiscuous people or drug addicts were at risk for contracting, is really a risk for everyone. In fact, data shows that heterosexuals are where there has been much more of an increase in newly diagnosed cases."
According to Schuyler, people's next best defense to abstinence is avoiding unprotected sex. Another option is to get tested to ensure one is not carrying the disease and then practicing monogamy.
The Chautauqua County Health Department offers free and confidential sexually transmitted disease and HIV testing by calling 800-604-6789.
"If someone tests positive the physician or organization that administered the test is required to make an appointment for follow-up care so that we can immediately get them into treatment and care," said Schuyler. "The Chautauqua County Health Department contracts with Erie County Medical Center's Immunodeficiency Services Clinic to provide access to high-quality medical treatment, case management services, and support to people living with HIV or AIDS, which is available in our Jamestown and Dunkirk offices."
The Jamestown office is located at 110 E. Fourth St. and can be reached by calling 661-8111. The Dunkirk office is located at the Graf Building, 319 Central Ave. and can be reached by calling 363-3660.
TESTING IS IMPORTANT
Last year, Evergreen Health Services, formerly AIDS Community Services of WNY, Inc., changed its name to better represent the broad range of health care services offered by the agency.
According to Laurie Matson, director of Southern Tier Services for EHS, the change mostly had to do with an increased need for services related to chronic illnesses. However, the agency still offers HIV and AIDS services including a free, confidential, 10-minute rapid HIV test as well as linking those who test positive with the appropriate level of health care.
"We encourage testing for a couple of reasons, and one is that the best way to prevent the spread of HIV is to know what your own status is," said Matson. "Knowing your status works two-fold: you can take extra precautions to keep people around you safe and the other part is that if you test positive you can receive treatment. People who are in treatment tend to have less of a contagion factor because the whole purpose of treatment is to decrease the amount of virus in your blood. The less virus you have floating around in your body, the less you have to pass on to others."
EHS has been offering the test since 2005, and about half of the people who take the test do so because somebody has told them that it is available and that they've gone through it, Matson said. However, word of mouth has not been effective enough to ensure that everyone gets tested. But, those who have tested positive for HIV at EHS are entered into the comprehensive care coordination program.
"EHS care coordination utilizes a process that includes assessment, advocacy and referral, to assure that individuals are connected to medical care, housing, entitlements, mental health, addiction treatment and other services," said Matson. "We ensure that people are getting the right medical insurance, are getting into the right medical care and any other linkages they may need."
Walk-in testing is available from 10 a.m. to 3 p.m. on Mondays, and by appointment Tuesday through Friday. EHS is located at 111 W. Second St. in Jamestown. For more information call 664-7855 or visit evergreenhs.org.
In November, Chautauqua Opportunities, Inc. announced that it received a $130,000 grant to help Chautauqua County residents living with HIV and AIDS to find permanent housing. According to COI's official press release, persons living with HIV and AIDS who live in permanent supportive housing are more likely to manage their health care effectively and therefore reduce overall medical expenses.
Josiah Lamp, deputy director of housing and community development for COI, said that safe and affordable housing for vulnerable persons living with HIV and AIDS is the first step toward the goal of helping them achieve self-sufficiency, which would give them the means to manage their health care needs, improve skills and build assets. The program aims to provide those living with the disease a stable residence and medical home so that individuals can manage their health and live a more productive, quality life.
For more information call the Jamestown office at 661-9430 or the Dunkirk office at 366-8176. Or visit chautauquaopportunities.com.