Linking patients with care the growing focus of HIV/AIDS prevention

CDC: Maryland has third-highest HIV rate

More than 30 years after the start of the HIV/AIDS pandemic, a diagnosis is no longer a certain death sentence.

Even so, the virus remains a public health issue.

IN FOCUS: Watch ABC2 at 6 p.m. Wednesday as we go in focus with the man who discovered HIV.

According to data released last year by the CDC, Maryland had the seventh highest number of cases in any state or territory in the country with 1,783 new HIV diagnoses in 2011. Those numbers translated to a rate of 30.6 cases per 100,000 population -- the third highest rate among states and territories behind D.C. and the U.S. Virgin Islands.

LINK: http://www.jhsph.edu/research/affiliated-programs/AIDS-linked-to-the-intravenous-experience/_documents/New_HIV_Rankings_for_Maryland.pdf

Joanne Hayes, physician assistant with the Department of Medicine at Sinai Hospital, has worked in the division of infectious diseases for about 25 years and witnessed first-hand the face of the disease and changes in treatment

LINK: http://www.lifebridgehealth.org/Sinai/Sinai1.aspx

In the 1980s and 1990s life expectancy for someone diagnosed with HIV was 2-5 years, according to Hayes. Medical advances have changed that number in the United States.

“Now the expectation is that patients with HIV disease can have a near-normal life expectancy,” Hayes said.

Hayes explained that medicines have become more effective and much easier for patients to handle. Treatments now have lower levels of toxicity and only need to be taken once or twice a day, depending on the type. This translates into fewer or less severe side effects and a regimen that is more easily incorporated into daily life.

“If patients are able to tolerate their medications and remain adherent to their medications, then the expectation is that they will have a normal life expectancy,” Hayes said.

But that doesn’t mean that everyone living with the disease is successfully treated.

Estimates are that out of about 1.1 million people living with HIV, about 82 percent have been diagnosed, 66 percent  have been linked with care and 37 percent are retained in care, according to the federal website dedicated to the disease.

LINK: http://aids.gov/federal-resources/national-hiv-aids-strategy/hiv-care-continuum-initiative-fact-sheet.pdf

“We’re talking about only effectively treating 20 to 25 percent of all of those people who have HIV disease,” Hayes said. “That’s nationwide, but Maryland is pretty close to what’s happening across the nation.”

This scenario is referred to as the care continuum or treatment cascade.

“The challenge is less how do we treat and control, the challenge is how do we identify people who have the infection and link them with care,” Hayes said.

Because of this gap, prevention and delivering care have become the focus for medical and public health officials.

“People still die from HIV. Mortality is lower across the nation and in Maryland, but death still occurs,” she explained. “We still want to prevent HIV in the first place.”

Evidence shows identifying and treating those with HIV/AIDS helps reduce the spread of the virus within the community, according to Hayes.

INTERACTIVE: Maryland HIV case map

“Universal testing really is an important piece of the prevention medicine,” she said.

“People need to understand that even though these medications are very effective and very well-tolerated, prevention of HIV disease in the first place is the most important message, because HIV is not curable and there are complications for HIV that we can’t treat.”

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