Hepatitis C (HCV) continues to cause high mortality, with American Indians and Alaskan Natives (AI/AN) having the highest mortality rate amongst any race or ethnicity, at more than double the national rate. However, data indicates there is reason to be optimistic: Mortality rates among Indigenous populations are dropping and several Indigenous communities now have their own HCV elimination programs. Read more about these HCV elimination efforts.
Ed Morales (he/him), MD, is an Infectious Diseases specialist at Vivent Health in Green Bay, Wisconsin. Dr. Morales is part of a team that provides medical and HIV care in Brown, and neighboring, counties. Dr. Morales says he is inspired to strive for excellence in patient care, to study and learn more, so he and his team can better care for and better serve their patients. To his colleagues, Dr. Morales noted that daily, there are challenges to meet the personal, social, and medical needs in treatment and prevention in our communities. He hopes that his colleagues will continue to take up and meet these challenges with dedication, compassion, and kindness.
Coronavirus safety measures impacted access to HIV prevention and care services, compounded with already low HIV screening rates in ambulatory care settings, and thus increased the risk of missed opportunities for HIV testing for those who accessed care, yet are unaware of their HIV status. However, there are ways to address these shortfalls and improve HIV prevention services, including HIV screening.
Despite the several hundred million visits made annually to physician’s offices, community health centers, and emergency departments, HIV testing occurred at extremely low rates in 2020. Across the nation, some programs shut down various HIV-related services and faced challenges accessing support necessary to provide HIV prevention and care. According to Wisconsin Department of Human Services Harm Reduction Section, HIV testing at some community-based organizations and local health departments was significantly reduced during the months of March-July 2020, by at least 50% compared to previous years. Across the nation, over 650,000 fewer HIV screening tests were conducted in 2020 compared to 2019. Meanwhile, ambulatory care “dropped precipitously” between December 2019 and June 2020, according to a presentation at the 2021 Conference on Retroviruses and Opportunistic Infections (CROI). An article published in November 2020’s Morbidity and Mortality Weekly Report found that young people (13-19 years old), in particular, are less likely to know their HIV status and have the lowest viral suppression rates of any age group.
However health care system adaptations can help address these shortfalls. Client-centered, culturally responsive, and linguistically appropriate HIV services is a crucial element to advancing HIV prevention and care. Providing routine, confidential HIV testing and counseling for youths and adults is another critical step in ensuring people know their HIV status and can access necessary care. Meanwhile, home testing, home sample collection, and telemedicine options have allowed for the continued provision of HIV services in many clinics and health departments during the pandemic. Implementing clinical decision supports and training & accountability measures can also help increase HIV testing. Additionally, one study revealed that providers without recent training on HIV stigmas are more likely to display biased behavior, posing an additional barrier to HIV prevention and care efforts. Ongoing education efforts can help overcome potential bias and provider-centered stigma-reduction intervention can help advance HIV prevention and care goals. MATEC-WI will continue to work towards increasing the number of HIV providers who are effectively educated to prevent, diagnose, treat and manage HIV infections, including educating providers on HIV stigmas and biases.
HIV & COVID Resources
- NASTAD published an article on the availability of generic PrEP and how they expose precarious funding scenarios HIV prevention programs face.
- WHO releases report highlighting progress on reducing HIV, viral hepatitis and STIs and need for renewed efforts to reach 2030 targets.
- CDC announces appointment of Dr. Leandro Mena as new Director of the Division of STD Prevention.
Hosted by NAHEWD
2021 National Sexual Health Conference
October 6-8, 2021