The Surprising Region Where HIV Is On The Rise + 4 More Facts About AIDS In America Today

The Surprising Region Where HIV Is On The Rise + 4 More Facts About AIDS In America Today

Over the past 30 years, the face of HIV/AIDS has changed immensely. Different areas of our country and new populations are at risk now more than ever before — but no one’s really talking about it.  (Photo by Getty Images)

When it comes to stopping the spread of HIV/AIDS, and treating people who have already come into contact with the virus, we’ve gained a lot of ground in three decades.

When the virus was first identified, experts would have never thought we’d have as many treatments as we do or might even (one day) see a cure, says Susan Koletar, MD, director of the Division of Infectious Diseases at The Ohio State University Wexner Medical Center. “I’ve been working on HIV and AIDS since it first became a problem around 30 years ago, and I’ve watched it go from a devastating, life-threatening disease, to a chronic illness that can actually be treated and managed,” she tells Yahoo Health.

But HIV/AIDS is far from eradicated — even in America. While the UN recently reported that, worldwide, new cases of AIDS have hit a plateau, there’s a lot we don’t realize about the condition and its reach in the United States. In honor of World AIDS Day, here are some facts that will surprise you about the disease in America.

1. Cases of HIV/AIDS are on the rise in the Bible Belt.

We tend to think of HIV/AIDS as problem in metropolitan areas, but there’s another region where the disease is a larger issue. Filmmaker Hannelore Williams — who followed HIV/AIDS sufferers to get a better picture of the condition today for her new docu-series, Dirty 30 — was shocked to discover that the south is a key hot spot for HIV/AIDS. “In the Bible belt, there are huge rising numbers,” she says. “When I found Baton Rouge, Louisiana was number one nationally in AIDS cases per capita, I had to film there. And the reason for those big numbers are that Louisiana incarcerates more people than any other state.”

 Williams says AIDS in the prison system is an under-the-radar concern. “Not only is there unprotected sex among men, but drug use in the prison system is another major problem we’re not talking about,” she says. “They’re sharing needles — but how do they get them? Why is this happening?” The demographic most affected here is black men — which may put another group at risk, too.

2. Women, especially young black women, are the group at notable risk.

When these men leave the prison system, they might unknowingly spread the disease to their partners. “I found out that my demographic, young black women, have the highest rising number of new diagnoses in the United States,” says Williams. “We can connect this to the sheer amount of people filtering through the prison system, particularly black men, but when you look at ‘at risk’ groups with poverty issues and drug epidemics, people of color tend to suffer most. 

And not just people of color, but women in general are at great risk. “Although the most frequently infected persons acquiring HIV are young gay men, especially young black men who have sex with men, women still account for 25 to 30 percent of people with HIV in the US,” says Susan E. Cohn, MD, MPH, a Professor of Medicine in the Division of Infectious Diseases at Northwestern University Feinberg School of Medicine. “In some areas including the Northeast and the South, the percentage of women among those infected with HIV maybe even higher.”

3. Scientists are working on contraceptive and emergency treatment options for HIV/AIDS.

Soon, there might be better contraceptive options for women with HIV, or for women who have partners with the virus. “We are currently performing clinical trials,” says Cohn. “We have studied birth control pill and Depo-methoxyprogesterone (Depo-Provera), and are now starting a study of the pharmacokinetic interactions of a hormonal vaginal ring in the setting of several popular HIV medications.” Ultimately, Cohn says scientists are envisioning a vaginal ring that would release hormones to prevent pregnancy, while also releasing anti-HIV medications to prevent transmission of HIV to uninfected women around the world.  

Related: Are IUDs Right For You?

Additionally, researchers are attempting to streamline post-exposure prophylaxis (PEP) for those who have come into contact with the virus, something Williams, the Dirty 30 fimmaker, found many people don’t realize. “If you take PEP within the first 48 to 72 hours, it reduces the chances of getting HIV pretty dramatically,” Williams tells Yahoo Health. “Right now, it’s most readily available to healthcare workers and officers who come into contact with the disease most frequently.” But it’s an option, and recommended, for HIV-negative persons who encounter HIV for any reason.

4. Although there are treatment options for those infected, that doesn’t mean it’s not still “a death sentence” for some.

One of the most common lines you hear about HIV/AIDS is that it’s “no longer a death sentence.” While that might be the case for some, it’s still a dangerous issue for a lot of demographics. “That it’s not a death sentence anymore, I find that to be a shallow response,” says Williams. “There are definitely treatment options for people who can afford it, and for those who the drugs are effective in. For many, they’ve tried several treatments, and they haven’t worked.” Williams points to the hundreds of HIV-infected people who still died in New York City last year. “This is a place with awesome access to healthcare, when you look at it from a global perspective,” she says.

Cohn agrees, the disease is not as locked down as people believe. “Although the currently available anti-HIV medications are easier to take and are often effective if taken as directed, only about a quarter of everyone infected with HIV in the U.S. have suppressed HIV viral loads, she says, pointing to recent research that estimates only 19 percent of HIV-infected individuals in the country have an undetectable viral load — the goal of HIV treatment. “There are many stages where people drop out of the cascade of care,” Cohn says. “More than 20 percent of people with HIV are undiagnosed, perhaps never tested, and are still unaware of their HIV infection and hence may be inadvertently be spreading the infection to their sexual partners.”

But that’s not the only problem, says Cohn. Even when someone gets tested, they may not return for their results, or choose not to go for HIV care. Also, many people in HIV Care may not be given HIV medications, or they may choose not to take them consistently. If this is the case, they won’t ever achieve undetectable viral loads. Lastly, people who have suppressed their illness may simply get burned out from their treatments. “They might decide not to take their medications consistently, or they may lose their health insurance and then not have access to HIV medications, which can cost upwards of 30,000 dollars per year without applying for Obamacare or other health plans that cover medications like ADAP (AIDS Drug Assistance Program),” Cohn explains. 

Cohn says getting people on treatment plans, and helping them stick to them, is something we still need to work on as a country. “It is so important to support all the people who are able to adhere to their HIV meds, and to devote additional resources to help those who are out of care or who are not adherent with HIV meds,” she says. “That is how we can finally make a dent in lowering the new transmissions of HIV within the U.S., which is still greater than 50,000 new HIV infections a year.”

5. We’re still not talking enough about HIV/AIDS.

Unfortunately, although we’re still seeing thousands of new cases a year, HIV and AIDS feels like less of a talking point with the advent of new technologies and treatment options. “We still see preventable cases of people who are presenting with classic illnesses associated with HIV, and that’s what always surprises me,” says Koletar. “Because of fear, lack of knowledge, or stigma, people don’t get tested and they can’t have access to life-saving treatment options. There are still people who are not being proactive about their health.”

Williams agrees that talking about a condition that carries a stigma is tough — and so, we’re not doing it enough. My sister’s father passed away from HIV/AIDS complications, and we never really talked about it beyond condolences,” she says. “Especially if it’s associated with things like sexuality and addiction, it’s hard to talk about.”

However, opening up a dialogue is huge. “I think here in the U.S., we’ve become complacent,” Williams explains. “Ultimately, it’s our personal responsibility to take charge of our own health. And if you come into contact with HIV, don’t avoid the issue.

“Say, ‘Look, this is what happened.’ Learn the communication skills to stop the spread of the virus. Get tested, always wear a condom. Do your part.”

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