Although HIV diagnosis rates have remained stable for the past few years in Virginia, concern grows that rural counties are seeing a disproportionate number of new cases.
Several factors are cited as possible causes, including lack of available education and testing and increased intravenous drug use in rural populations.
HIV — Human Immunodeficiency Virus — is one that infects white blood cells and causes a gradual deterioration of immune function. AIDS, or Acquired Immunodeficiency Syndrome, is the name given to late stage HIV infection.
It is characterized by severe suppression of the immune system, which leaves the body vulnerable to a host of normally manageable diseases, infections and cancers. People became aware of HIV and AIDS in the 1980s after outbreaks appeared among gay men in California and New York.
HIV/AIDS was officially recognized as a new health crisis. Stigma and fear surrounded the disease until breakthroughs in treatment in the 1990s. Modern treatments including antiretroviral drugs have reduced the death rate.
Ann Rhoades, director of HIV Surveillance in Virginia, said HIV diagnosis rates have been steady although the agency is particularly concerned about the disease in rural areas.
“After the Indiana outbreak we have been watching rural areas more closely,” she said. “Urban areas have a lot of available testing, and there are needle exchange and education programs in place. We need to have education and testing available to our rural populations because there is a stigma attached to HIV sometimes people in small communities aren’t willing to get tested.”
Locally, a handful of new HIV diagnoses have occurred since 2011. Madison County reported no new cases, neighboring Greene reported six new cases and Orange County reported eight.
Since 1989, Fredericksburg Area HIV/AIDS Support Services has been working throughout the Central Virginia counties of Caroline, Culpeper, Fauquier, King George, Madison, Orange, Prince William, Rappahannock, Spotsylvania, Stafford and Westmoreland to empower and advocate for HIV-infected residents.
The private nonprofit organization offers a variety of services including education, emotional, medical and financial support.
FAHASS is financed by a combination of federal, state and local programs, including the Ryan White CARE Act. The nonprofit is helping 180 clients throughout the 11-county region. As well as caring for people diagnosed with HIV, FAHASS also works to provide education and free HIV testing to people within the region.
According to community development manager Dan Czajka, the nonprofit believes that education and available testing are the most effective methods for controlling the spread of HIV.
“We’re committed to destigmatizing this disease,” he said. “One of the biggest problems is lack of education; people don’t understand the disease, how it is contracted and how to prevent it.
“Especially in rural areas, there is often a stigma,” Czajka said. “People are reluctant to be tested for fear that they will be labeled. While there are some groups at higher risk, such as homosexual men or IV drug users, HIV doesn’t discriminate. We try to emphasize that everyone should follow the CDC guideline of regular, routine testing of everyone 13-64.
“Unfortunately, doctors often overlook [HIV testing]. Because HIV isn’t viewed as the absolute death sentence that it once was, people have become lax about testing,” he said. “We’ve seen an increase both in Hepatitis C and HIV in younger people that use intravenous drugs.”
Rhona Collins, health department HIV/STD counselor for the Rappahannock-Rapidan District, also believes that education is key to stopping the spread of the disease.
“We need to stop burying our heads in the sand and teach our young people,” she said. “Most of our recently diagnosed cases are in their early 20s. Young people need to be aware of how the disease is transmitted and how to protect themselves. Available testing is also important. As well as local health departments, Community Outreach in Charlottesville and FAHASS both provide free HIV testing.”
Czajka emphasized FAHASS’ commitment to testing.
“We work with local health fairs, community groups and faith based organizations,” he said. “Any group that wants to offer testing, we do confidential rapid testing. Unlike older test methods, now we can get results as quickly as 20 minutes. With rapid testing we can get a diagnosis and a quick start to treatment, drastically improving the outcome.”
FAHASS and the health departments both work to identify HIV positive individuals, get them into treatment and keep them in treatment.
As part of the Thomas Jefferson Health District, the Greene County Health Departmentat 50 Stanard St. in Stanardsville offers HIV/AIDS testing. For more information, call (434) 2262.
Free confidential HIV and STD testing is available to Madison County residents the first, third and fifth Fridays of every month at the Health Department at 401 N. Main Street, Madison.
The Orange County Health Department also offers regular HIV testing the second, third, fourth and fifth Mondays of every month or by appointment.
For more information contact the Madison County Health Department at (540) 948-5481 or the Orange County Health Department at (540)672-1291