As World AIDS Day approaches on Tuesday, Dec. 1, it’s a fitting time to assess the state of infection in the U.S. Virgin Islands. The territory has made notable strides in the last year to suppress HIV in infected patients and prevent it from potentially progressing to AIDS, but there are still major roadblocks to ending its transmission.
According to the V.I. Department of Health, there were 172 new cases of HIV infections reported between 2008-2014; the number of new diagnoses reported each year remains steady. By the end of 2014, there were 608 people living with HIV in the territory with 182 of them receiving active medical care. That means 426 of these people were not in active care.
Seeking medical care is essential to suppressing the infection, said Dr. Tai Hunte-Ceasar, the Territorial Infectious Disease Specialist and Medical Director of the Communicable Diseases Division Clinic at the V.I. Department of Health. Antiretroviral medications help lower the viral load in the body, which prevents the infection from developing into AIDS and they decrease the likelihood of transmitting it to others. There is still no cure for HIV or AIDS.
“Once you get on a regime that controls the infection, it no longer destroys the immune system, so you can live a normal life,” Dr. Hunte-Ceasar said.
In the past year, there has been a 2 percent increase in the number of HIV patients who reached viral suppression, bringing the total to 19 percent of all 1,061 cases reported from 1983 through 2014. The other 81 percent could be on their way to viral suppression or developing AIDS, but that data is unavailable.
Nearly 70 percent of people receiving medical care in the territory have achieved viral suppression. The V.I. is short of the national goal for 80 percent viral suppression.
In the last year, the largest increase in HIV incidence rates was seen in the 45 to 54 age group. Between 2010 and 2013, the largest increase was for people between ages 35 and 44.
“People in these age ranges just don’t get tested, since they aren’t in the highest risk group, which is adolescents and young adults,” Dr. Hunte-Ceasar said. “They think because of their age they’re safe, but they still need to use protection.”
Mirroring long-standing national trends, homosexual men are still the highest risk group for HIV transmission in the Virgin Islands.
“One of our biggest issues here is men who are having sexual relations with other men and who are also involved in a heterosexual relationship — this is the way many women get the infection,” Dr. Gritell C. B. Martinez, territorial director of the Communicable Diseases Division at the DOH, said.
Sexually transmitted diseases like gonorrhea and chlamydia are growing more common among 14 to 27 year olds. That’s a major concern since having these diseases makes a person more susceptible to contracting HIV.
Besides being a sexually active person, other high-risk groups include drug users, people getting tattoos and people who have had blood transfusions.
Raising Awareness, Fighting Stigmas
Awareness and education are key to halting the spread of HIV, so the DOH has amped up its awareness campaign by creating sobering videos like the newest one titled “I Love You.” (See video link below)
“We’re trying different ways to build awareness, so we’ve started a campaign that uses serious commercials and PSAs. We’re being strategic with how we get this information out to the community, especially the teen population, and we’re targeting all ethnicities that call the V.I. home,” Martinez said.
For the department’s health investigators, secrecy about test results is a real day-to-day issue.
“We wanted to be real with the community — this stuff is really happening. This is how the infection is being passed on, when people live a double life and aren’t honest about their test results with their partners,” Martinez said.
Because the highest risk population for all STDs is 15 to 24 year olds, the DOH focuses on education initiatives in middle and high schools throughout the territory.
Getting Tested and Seeking Medical Care
Dr. Hunte-Ceasar recommends getting tested every year during an annual checkup. A lack of identifiable symptoms can make HIV difficult to spot, since they are generally mistaken as the flu or fatigue from a fever. The virus can remain latent in the body from anywhere from a few months to 10 years without causing any significant ailments.
If diagnosed with HIV, the DOH has case managers and eligibility specialists that can help patients receive the medical care they need. If someone does not have insurance, there is funding available through the Ryan White Part B Program and AIDS Drug Assistance Program (ADAP).
“At the Health Department we really try to remove all financial barriers,” Martinez said. “And, we’re working to become more diligent in making connections between patients and care medical providers to ensure that people are continuing with care despite issues related to substance abuse, mental instability or financial problems.”
“Stigma is still our biggest hurdle and explains why we are failing at lowering transmission rates even more in the V.I.,” Martinez said. “Please, if you’ve been diagnosed, seek medical help — you really can live a long, healthy life.”
The DOH is marking World AIDS Day on Tuesday, Dec. 1 with events on St. Thomas and St. Croix. St. Thomas will host a candlelight vigil at 6 p.m. at Emancipation Garden in Charlotte Amalie. A march and candlelight vigil will be held on St. Croix beginning at 5:45 p.m. at the post office in Frederiksted.
To get in touch with the DOH’s Communicable Diseases Division, contact 340-774-9000 ext. 9661 or 4663. You can also learn more at http://www.getit2zerovi.org/.
Free HIV testing is available at the following locations:
– Old Municipal Hospital Complex on St. Thomas, 340-774-9000 ext. 4661
– St. Thomas East End Medical Center, 340-775-3700
– Charles Harwood Complex on St. Croix, 340-718-1311 ext. 3061
– Frederiksted Health Center on St. Croix, 340-772-0260