Poll shows Kentucky health-care providers often fail to discuss HIV testing with patients

A new poll suggests that most Kentucky health-care providers follow guidelines for discussing HIV screening with their patients, despite the the importance of early treatment to prevent its progression to AIDS.

Although the Centers for Disease Control and Prevention recommends routine HIV screenings for most patients, just 32 percent of Kentucky adults aged 18 to 64 report discussing HIV testing with their medical provider, according to the Kentucky Health Issues Poll.

About 40 percent of Kentucky adults reported they had never been tested for HIV. It’s estimated that 4,500 Kentuckians are living with HIV infection and it is estimated nationally that one in five people who have HIV do not know they do.

“It made headlines earlier this month when a little girl - the second person in history - was cured of HIV. As exciting as this development was, for most people, HIV remains a life-long condition that must be managed through medication to keep it from progressing to AIDS. The CDC’s recommendations are meant to improve the overall population health by detecting HIV so treatment can begin,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll.

“It appears that Kentucky providers are either not adhering to the routine screening recommendations or not communicating this message clearly to patients,” she said.

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points

Syphilis epidemic rising in the Canada and U.S.

The resurgence of syphilis has risen dramatically over the past 20 years in the United States and Canada --- from 177 cases in 1993 to 1,750 cases in 2010. It is temporarily shutting down the porn industry in Southern California.

Adult Production Health & Safety Services (APHSS) sounded the alarm about "recent unsubstantiated rumors of syphilis among adult performers." The usual annual testing for syphilis is in September, but because of the alarm the agency opened up their semi-annual syphilis testing immediately.

Other sexually transmitted diseases, such as gonorrhea and chlamydia, are also on the rise. According to Huffington Post, "Syphilis infection rates jumped by 18 percent from 2010 to 2011, and there was also a five percent increase in chlamydia and 1.5 percent increase in gonorrhea cases." And truthfully, the syphilis outbreak cluster among California porn performs is not surprising because of their business. But sexually transmitted diseases are spreading on a worldwide basis --- with Canada and the United States no exceptions.

APHSS has since called for a temporary moratorium on adult film production until all performers get tested for syphilis, and the non-profit AIDS Healthcare Foundation is also expected to hold a news conference Monday morning in response to the possible outbreak.

"I think it's just a general indicator of what's happening in terms of sexual activity," said Dr. Howard Njoo of the Public Health Agency of Canada, director general of PHAC's Centre for Communicable Diseases and Infection Control. The majority of syphilis cases are among men, accounting for 90.5 percent of all reported cases in 2010. But according to Njoo, the dynamics of the disease are different from other STDs. Gonorrhea and chlamydia are attacking the younger people while syphilis is attacking the older ones. People who are age 30 and older are accounting for approximately 73 per cent of all the reported syphilis cases in 2010. Huffington Post reports that, "Syphilis is a bacterial STD that initially manifests itself in sores or sometimes presents no symptoms. If the infection isn't treated immediately, people who have syphilis can go on to suffer rashes and lesions, hair loss and flu-like symptoms like muscle aches, fevers, sore throats and fatigue. Without treatment, syphilis could last for years and go on to damage internal organs and cause stillbirths. If caught early, the infection is easily treated with antibiotics such as penicillin."

By Nancy Houser

More breakthroughs lately in fight against HIV/AIDS

It has been an inspiring season of breakthroughs in the fight to prevent the spread of HIV and AIDS. Earlier this week, the Food and Drug Administration approved the pill Truvada, "a preventive measure for healthy people who are at high risk of acquiring HIV through sexual activity, such as those who have HIV-infected partners," reports Matthew Perrone for The Associated Press.

Just two weeks ago, the agency also approved the first over-the-counter HIV test that can be used at home. "I think the combination of self-testing and a medicine that you can take at home to prevent infection could mean a whole new approach to HIV prevention that is a bit more realistic," said Dr. Demetre Daskalakis of New York University's Langone Medical Center.

In the meantime, a research team at the University of Nebraska Medical Center is making progress to develop a weekly or twice-monthly injection that would help manage patients with HIV. The long-acting injection "would be a substantive improvement over daily and sometimes more complex regimen of pills," lead investigator Dr. Howard Gendelman told research-reporting service Newswise.

"We actually followed the process exactly as we would with a person — and it worked," he said. "This is all very exciting. Although there are clear pitfalls ahead and the medicines are not yet ready for human use, the progress is undeniable." (Read more)

FDA approves fast, take-home test that detects HIV

A model demonstrates how to use the OraQuick test, which
detects the presence of HIV in saliva.
AP photo by Chuck Zovko.

Soon, taking an HIV test will be no more complicated than swabbing one's mouth and waiting for the results. The Federal Food and Drug Administration last week approved the OraQuick test, which detects HIV antibodies and gives a result in 20 to 40 minutes. 

Orasure plans to start selling the test in October at local pharmacies and online, reports Matthew Perrone for The Associated Press. It is expected to cost less than $60 but more than the one used by health professionals, which costs $17.50.

About 240,000 of the 1.2 million people who are suspected of carrying the HIV virus don't know they are infected. 

The FDA says the test is not 100 percent accurate, but a trial conducted by Orasure showed it only detected HIV in people who have the virus 92 percent of the time. It was 99.9 accurate ruling out HIV in people not carrying the virus. People who test negative should re-test after three months because it can take time for the HIV antibodies to appear. (Read more)

Pharmacies to offer free HIV tests as part of pilot program; no Ky. locations chosen yet

Getting tested for HIV may soon be as easy as going to the pharmacy to get a flu shot or blood pressure check. Pharmacies in 24 cities and rural communities will offer rapid HIV tests free of charge as part of a $1.2 million program. Testing is already available in Washington, D.C., Oakland, Calif., and an Indian health service clinic in Montana. The remaining 17 locations will soon be chosen by the Centers for Disease Control and Prevention.

The test involves swabbing the inside of a person's mouth and preliminary results take about 20 minutes. Makers of the test say it is accurate 99 percent of the time. "If the test is positive for the AIDS virus, pharmacy employees will refer customers to a local health department or other health care providers for a lab blood test to confirm results, counseling and treatment," The Associated Press reports. "The workers are expected to deliver the news face-to-face and give customers privacy."

According to the CDC, there are about 1.1 million Americans who are infected with HIV, but up to 20 percent of them don't know they have it. Since 2006, the CDC has recommended all Americans ages 13 to 64 get tested at least once, but fewer than half of adults under the age of 65 have done so. (Read more)

Check HIV status Pregnant women Advised

A mother living with HIV has advised pregnant women to go for Voluntary Testing and Counselling (VTC) to know their HIV status to help protect their unborn babies against HIV infections.

She said if she had taken advantage of such an opportunity, she would have protected her child from getting infected.

The 32-year-old mother was speaking at a programme on prevention of HIV as part of a behavioural change project, organised by the Technical Support Unit of the Ghana AIDS Commission in the Eastern Region for students of the Victory Vocational Institute in Koforidua.

The programme was aimed at protecting the students against HIV infection.

She said she was a strong woman who never knew her HIV status until she gave birth to her first child about four years ago.

The woman said 10 months after delivery, her baby developed a boil under the armpit and was taken to hospital but after several treatments without success, the medical officer called for HIV test and the baby was found to be HIV positive.

She was also encouraged to take the test which later proved positive.

She encouraged all women to know their HIV status so that they could seek early treatment and protect their children and the future generation from HIV infections.

Ms Golda Asante, Technical Co-ordinator of the Ghana AIDS Commission, in charge of the Eastern Regional branch, advised the students to concentrate on their education and avoid going to town without permission to engage in activities that could expose them to acquiring HIV.

She said the target of the Eastern Regional branch of the commission was to achieve zero infection of HIV and the total elimination of mother-to-child transmissions.

The woman informed the students that they could access VTC on HIV in all government hospitals in the region and those who test positive could be put on the Anti-Retroviral Therapy to sustain them for the rest of their lives.

More Americans dying from hepatitis C than from AIDS

More people are dying in the U.S. from hepatitis C than from AIDS, a new report from the Centers for Disease Control and Prevention says. More than 3.2 million Americans have the hepatitis virus, which can cause chronic infection of the liver and eventually lead to liver failure.

Hepatitis C death rates climbed to almost 5 per 100,000 in 2007, from fewer than 3 per 100,000 in 1999. In the same time period, the HIV-AIDS death rate dropped to slightly more than 4 per 100,000 from more than 6 per 100,000.

"The declines in HIV reflect the accomplishments in building a public health response to the epidemic that improved screening and provided means of access to effective treatment," said Dr. John W. Ward, director of the Division of Viral Hepatitis at the CDC and author of the study. A similar program for hepatitis C would be similarly helpful, he said.

The disease is most commonly spread by exposure to infected blood. Intravenous drug abuse is the most common method of transmission, reports MedicineNet.com.

Ward said there is now a treatment "that was about 70 effective at clearing the virus from the body, but, he said, most infected people are unaware of their condition and do not receive treatment," reports Nicholas Bakalar for The New York Times. (Read more)

Get tested, get treatment, Bluegrass HIV Coalition encourages

Today is World AIDS Day and health advocates are asking Kentuckians to get tested and get treatment.

Hundreds of Kentuckians are diagnosed with AIDS each year, reports Mary Meehan of the Lexington Herald-Leader. Minority populations are hit particularly hard, with black men nearly 10 times more likely to die of AIDS than non-Hispanic white men. Black women are almost 23 more times more likely to die from the infections, compared to non-Hispanic white women.

Though people are still dying, AIDS is not a widely-discussed disease, in part because of its past association with homosexual activity. Mark Johnson, member of the Bluegrass HIV Coalition, said AIDS can be hard for people to talk about.

In addition, the infection is often seen as treatable, in part because of people like Magic Johnson, who has had the infection more than 20 years but is still in good health. What people don't see "is the often expensive regimen of drugs that is needed to keep the worst of the disease at bay, the side effects of those medicines or the ultimate end of what is still an incurable disease," Meehan reports. (Read more)

Dec. 1 is World AIDS Day; 1.2 million Americans are thought to be infected, but only 1 in 5 know it

Friday is World AIDS Day, an opportunity to learn the facts about the virus and show support for people living with it.

In the United States, there are 1.2 million people living with the HIV infection, which leads to AIDS. Of those who are infected with the virus in the U.S., only one in five know they have it, the Centers for Disease Control and Prevention report. Each year, about 50,000 Americans become infected. About 1,700 Kentuckians were diagnosed with HIV between Jan. 1, 2005 and Dec. 31, 2009; Kentucky ranks 19th in the country for the number of people who have the HIV infection.

Since the epidemic began, nearly 594,500 people have died with AIDS in the U.S. Between 1981 and 2007, more than 25 million people have died from the virus around the world.

Secretary of State Hillary Rodham Clinton spoke of the epidemic in a Nov. 8 address at the National Institutes of Health. "The fight against AIDS began three decades ago in June 1981. American scientists reported the first evidence of a mysterious new disease," she said. "Thirty years later, we ... know a great deal about the virus itself. We understand how it is spread, how it constantly mutates in the body, how it hides from the immune system. And we have turned this knowledge to our advantage."

Most at risk are gay, bisexual or other men who have sex with men. The CDC estimates that though this population accounts for just 2 percent of the U.S. population, it accounted for 61 percent of all new HIV infections in 2009. But heterosexuals and people who inject drugs can also contract the disease. Heterosexuals account for 27 percent of new cases. Another 9 percent of people who contracted the virus did so by using injected drugs.

Blacks accounted for 44 percent of new HIV infections in 2009, though they only represent 14 percent of the U.S. population. In 2009, the rate of new infection was 6.5 times greater for black men than it was for white men.

People can now be tested for the infection using a saliva sample and have the results in just 15 to 20 minutes. To find an HIV/AIDS prevention and service provider by county, click here.

Monday, June 27 is National HIV Testing Day

Kentuckians are being encouraged to find out their HIV status on Monday, June 27, National HIV Testing Day.

About 1,700 Kentuckians were diagnosed with HIV between Jan. 1, 2005 and Dec. 31, 2009. About 1 in 3 Kentucky adults under the age of 65 have been screened for HIV, the Foundation for a Healthy Kentucky notes. Christian, Hopkins and McLean counties have the highest rate of HIV testing, with 45 percent of adults being tested. Montgomery County has the lowest rate at 24 percent. For more county-specific information, click here.

The earlier that HIV is discovered, the better the treatment works, but early detection is not commonplace in Kentucky. By the time they are tested for HIV, 30 percent of Kentuckians already have full-blown AIDS. Though at one time 100 percent of Kentuckians infected with HIV died within five years, now 82 percent are alive after the same time period.

Kentucky ranks 19th in the country for the number of people who have the HIV infection that leads to AIDS. "Health officials say that at least one new HIV infection is discovered each day in Kentucky," Mary Meehan of Lexington Herald-Leader recently reported. National HIV Testing Day was founded by the National Association of People Living with AIDS in 1995. To find a testing site, click here.

On 30th anniversary of AIDS detection, it is no longer a death sentence, but Kentuckians die because they delay testing

Though life expectancy for people living with AIDS has improved, the disease "remains a serious health threat, with Kentucky's minorities and poor being affected in disproportionate numbers," reports the Lexington Herald-Leader's Mary Meehan.

Part of the problem is the stigma associated with the disease, which was first reported by the Centers for Disease Control and Prevention 30 years ago yesterday. It is especially problematic in rural parts of the state. "We have clients in rural areas of Kentucky who hide their medication so if something happens to them, their family members won't find out," said Mark Royse, executive director of AVOL, an education- and support-based organization for people living with AIDS.

The stigma is associated with the perception of the disease, which in turn prompts people to avoid being tested. "AIDS was marginalized early on as a 'gay' disease," said Dr. Robert Crosby, an AIDS researcher and chairman of the department of health behavior in the University of Kentucky's College of Public Health. "Later, it was associated with drug users, promiscuous heterosexuals or people who live in other countries, such as Africa. "The point to drive home is that a lot of people think of Africa or China or India when they think of AIDS," Royse said. "This issue is still very real here at home."

Kentucky ranks 19th in the country for the number of people who have the HIV infection that leads to AIDS, according to the Kaiser Family Foundation. "Health officials say that at least one new HIV infection is discovered each day in Kentucky," Meehan reports. Nationally, about 20 percent of people who have HIV don't know they are infected.

The earlier people discover they have HIV, the better the treatment works, but early detection is not commonplace in Kentucky. By the time they are tested for HIV, 30 percent of Kentuckians already have full-blown AIDS. Still, that diagnosis is no longer a death sentence. Though at one time 100 percent of Kentuckians infected with HIV died within five years, now 82 percent are alive after the same time period. However, there has been a spike in infection among 18- to 24-year olds, despite early education to avoid unprotected sex. "They say, 'That person doesn't look like they have AIDS'," so decide to have unprotected sex with that person, said Jessica DuMaurier, in charge of the HIV program at the Lexington-Fayette County Health Department. (Read more)

CDC names top 10 public health achievements in past decade, including tobacco control; Ky. still leads nation in tobacco use

The Centers for Disease Control and Prevention have named the top 10 public health achievements of the last decade. They include controlling infectious diseases like AIDS and tuberculosis; fighting tobacco use; improving motor-vehicle safety by having safer vehicles, roads and driving; reducing heart disease and death; and improving public safety preparedness following Sept. 11, 2001.

The 10 were not ranked. "Others include improvements in vaccine-preventable diseases, better maternal and infant health, better cancer prevention, improved occupational safety, and the aggressive steps that have led to fewer childhood lead poisonings," reports Bill Hendrick of WebMD Health News.

"Americans are living longer, healthier and more productive lives than ever before thanks in part to extraordinary achievements in public health over the past decade," CDC Director Thomas R. Frieden said in a press release. "Continued investments in prevention will help us and our children live even longer, healthier and more productive lives while bringing down health care costs."

The report shows the improvements have saved billions of dollars nationwide. Fortifying food with folic acid, which reduced neural tube defects like spina bifida, has alone resulted in a savings of $4.6 billion in the past 10 years. Preventing motor vehicle crashes could save $99 billion in medical and lost work costs each year. Preventing lead exposure in children could save $213 billion each year.

While tobacco control has advanced nationally, and Kentucky's smoking rate has dropped slightly, the state continues to lead the nation in tobacco use, at 25 percent of adults. While about two dozen Kentucky communities have passed smoke-free laws, a statewide ban has never gotten anywhere in the legislature. The number of states with comprehensive smoke-free laws increased from zero in 2000 to 25 states (plus Washington, D.C.) in 2010.

Motor vehicle safety has improved, a trend that has been noted in Kentucky. The number of traffic-related fatalities in Kentucky has decreased for the past six years. In 2010, 759 people died on Kentucky roads compared to 791 the year before. This year so far, 220 people have died in traffic-related accidents compared to 237 last year. Nationwide, the death rate related to motor vehicle accidents went from 14.9 per 100,000 people in 2000 to 11 per 100,000 in 2009. (Read more)

Number of HIV/AIDS cases is increasing in Louisville area

The number of newly diagnosed AIDS and HIV cases in Louisville is increasing even as the fear of the deadly disease wanes. The number of newly diagnosed cases in Jefferson County rose from 80 in 2005 to 107 cases in 2008, The Courier-Journal's Laura Ungar reports. The number of new HIV cases increased from 136 cases to 154 in the same period.

"People think it's a disease of the past. Unfortunately it's very much alive," said Janet Mann, director of program development for AIDS Interfaith Ministries of Kentuckiana.

"People think: All I have to do is take a few pills every day. But it still kills people ... and it affects quality of life," said Bobby Edelen (left, by C-J's Kylene Lloyd). Edelen has lived with the disease that causes AIDS for 21 years. "Every day is not a picnic."

Complacency, drug use and lack of education are causing the numbers to increase, health officials say. But while numbers rise, there is less money to deal with the growing need. HIV/AIDS funding to the Kentucky Department of Public Health dropped from $11 million in 2008 to $9.4 million in 2010.

There is still no cure for HIV/AIDS, but there is medicine that can "keep people somewhat healthy by preventing the virus from reproducing or by blocking it from entering cells," Ungar reports. But people respond to medicine in different ways. "Taking meds for HIV is similar to cancer patients taking chemotherapy. Some are able to take it. Some are deathly sick," Edelen said. (Read more)