The public drama has long since worn off, but there is nothing routine for the individual who discovers he or she is HIV positive.
In the U.S. Virgin Islands another 30 to 40 people get that bad news every year.
Some learn when they develop symptoms that send them for testing. Some learn when the Health Department contacts them to come in for testing because a person with whom they have been sexually intimate has tested positive. Some learn when they take the test as part of their first doctor’s visit after becoming pregnant.
Always, the diagnosis is “life-altering,” said Gritell Martinez, director of the HIV/AIDS program at the VI Health Department. It’s all the more tragic because the spread of the disease is highly controllable.
“Sometimes I think that people walk around with their head in the sand,” she said.
Despite massive awareness and education campaigns both locally and internationally, many people remain either ignorant or heedless of the dangers of risky sexual behavior and intravenous drug use.
The territory began keeping statistics in 1983, just a few years after the discovery of Acquired Immune Deficiency Syndrome, which can result from the Human Immunodeficiency Virus. Since then, 975 people in the Virgin Islands have tested positive for HIV/AIDS, Martinez said. Of those, 666 were positive for full blown AIDS, which often, eventually, proves fatal.
“The care (of the disease) is advancing,” Martinez said, and “I know in terms of the services we provide and how we provide them, it’s getting better.”
She is less sure of progress in actually arresting the spread of the virus. New cases do seem to have leveled off over the last five years, though there’s been no recent significant drop.
According to the most recent published report, as of Dec. 31, 2011, there were 579 people in the territory living with HIV/AIDS.
Not surprisingly, teens and young adults continue to be hardest hit, and the department conducts a lot of education in the schools in an attempt to reach this population.
This week hundreds of students are scheduled to attend workshops as part of the 2013 National Women and Girls HIV/AIDS Awareness Territorial Conference. Monday’s session will be at St. Croix Educational Complex, Wednesday’s, at Charlotte Amalie High School on St. Thomas. Both are from 9:30 a.m. to 12:30 p.m. and open to students from any private or public high school.
“I encourage my staff to be as real as possible” when speaking to students, or to any group, Martinez said. The department has slides and graphics and “we show them what (the virus) can do to their bodies” including how it can damage fertility.
Martinez said health workers are seeing a trend they can’t explain: HIV/AIDS is slightly on the rise in the over-50 population. Attempts to identify a cause are purely speculative at this point. It may be a case of complacency, of mid-life changes in partners, of risky behavior driven by mid-life crisis, or something else.
It may take a study to determine, she said. But in the meantime, she has some advice: “Practicing safe sex is not only for teenagers or for young people, it’s for everyone.”
Another trend in recent years is geographic.
For consistency in record-keeping, a person who tests positive is included in the numbers for the jurisdiction in which he/she first tests positive. So native Virgin Islanders who are living elsewhere when they test positive are not included in the VI totals. And people from other countries or from other U.S. jurisdictions who first test positive in the territory – whether they are longtime residents or recent arrivals – are included in the VI totals.
The most recent figures show that of 39 new cases reported in 2011, a little less than a third involved people who were born in the Virgin Islands. The numbers break down to: 12 from the V.I., 10 from Hispaniola (Haiti and the Dominican Republic); eight from the U.S. mainland and Puerto Rico; five from other Caribbean islands; four from elsewhere.
Once a person tests positive, the Health Department’s role expands from prevention to include treatment.
“People who have tested positive really need to get care,” Martinez said. “The virus is replicating in their body” and AIDS can develop. “It’s not a cold. It’s not going to go away.”
A person who ignores HIV is putting his own health at risk as well as others.
“If you’re living in denial, then you’re passing the disease on to someone else,” she said.
Martinez has been fighting HIV/AIDS for years. She grew up on St. Thomas and graduated from Sts. Peter and Paul High School. She got her bachelor’s degree in Illinois, then returned home and earned her master’s degree in public administration at the University of the Virgin Islands.
After working at Catholic Charities in the Virgin Islands for 11 years, as a case manager and later as assistant to the director, Martinez took a job with Health. She was the coordinator for a special HIV program funded by a three-year grant, and then, in December 2008, she became head of the HIV/AIDS division.
