With the territory’s dubious distinction of having the nation’s second-highest HIV infection rate, everyone who is sexually active needs to get tested and find out their status. That’s according to Sandra Phaire, the new director of Virgin Islands Aids Resource and Education (VICARE), who spoke to the Rotary Club of St. Croix Thursday at Gertrude’s Restaurant.
A founding member of VICARE, Phaire said too many V.I. men and women are being infected with the incurable, but no longer fatal, disease. Testing is crucial for fighting the disease and preventing its spread, she said. Other strategies to reduce infection rates include education, condom use and abstinence.
Testing positive for HIV means you have the HIV virus, which causes the immune disease AIDS. But Phaire told the group’s weekly lunch gathering that having HIV does not mean you have developed AIDS, or will develop the disease any time soon—especially with new, more effective drug cocktail treatments.
The stigma of the disease makes accurate statistics difficult to come by, Phaire said. While some 800 people have tested positive in the territory, that number may not truly reflect the actual number of infected residents, given that some people fly to the territory from other islands to be tested and Virgin Islanders sometimes go elsewhere for testing out of privacy concerns.
Regardless, Phaire reiterated, the number is too high. "Since January of 2009 we have seen 65 new HIV cases," Phaire said. "That’s a lot in such a small place as this."
Secrecy, the stigma of AIDS and a reluctance to have frank discussions about sex have hampered the fight against the disease, she said.
According to Phaire, the hardest sources of transmission to track are men who have sex with both men and women, and women having sex "on the down-low" with partners whose histories they don’t know. Heterosexual transmission is becoming the most common path, she said. Although the two principle routes of HIV transmission are sexual activity and needle-sharing by drug users, the rate of IV drug use is very low in the Virgin Islands, she said.
Over the past two years, Phaire noted that seven patients have died from the disease in the Virgin Islands. By comparison, the H1N1 flu virus has claimed just one Virgin Islander to date.
While the new drug cocktails may make the disease a manageable chronic condition, they are very expensive and have their own unpleasant side effects. A typical regimen of drugs costs about $1,200 a month, meaning a fully insured HIV patient with a 20 percent co-pay will pay more than $200 out of pocket every month.
For uninsured HIV patients, treatment is available on St. Croix through the Frederiksted Health Center, paid for by federal funds from the Ryan White Act. So far, there has been enough funding for every patient requesting it, she said. St. Thomas’ East End Medical Center provides HIV care for St. Thomas and St. John.
With funding from the Centers for Disease Control and Prevention, VICARE offers free testing Monday through Friday at their offices on Queen Street in Christiansted. Starting in December, they will also be open for testing two Saturdays a month. Phaire said the test takes 20 to 30 minutes.
According to Phaire, VICARE must rely on community support to pay for any programs in the school that talk about condom use and safe sex, because of federal rules forbidding use of federal money to teach about any method of disease prevention besides abstinence.
On Dec. 1 in Frederiksted, VICARE will hold a candlelight vigil at dusk for World AIDS Day, to commemorate those who have been lost to the disease. "This year we will have a basket of rose petals and there will be a ceremony where anyone can take a handful and toss them into the sea in remembrance of a loved one lost," she said.
On Dec. 5, VICARE will hold its 14th annual AIDS Walk, the organization’s biggest fundraiser of the year. Volunteers are encouraged to arrive just after 7 a.m. at the Lawaetz Museum to begin registering people. "Just show up with $10 and be ready to walk," Phaire said. At 7:30 participants will begin a five-mile walk through the forest. To find out more about VICARE, the services it offers and how you can help, go to www.vicareinc.org.