It’s been 30 years since HIV/AIDS cases were first officially reported and while education, treatment and prevention methods have improved dramatically, this disease still lingers, killing over a million people worldwide every year.

“I was training in New York City when AIDS first hit,” said Gilbert Arenas, MD, Sands Family Medicine. “It hit New York hard. That was a very scary and depressing time to work in the medical field. We saw AIDS patients pouring into the hospitals, and we knew they were going to die. Things are different now, medications are so advanced. A person diagnosed with HIV today can almost live a normal life, with the right medications. It’s not the same as it was 30 years ago.”

According to a 2010 United Nations report, new HIV infections have decreased almost 20 percent in the past ten years.

“Even though the number of new HIV infections is decreasing, there are two new HIV infections for every one person starting HIV treatment,” UNAIDS said in the report.

The Richmond County Health Department has reported steadily increasing numbers of people being tested for HIV, along with a decline in the number of cases testing positive.

In Richmond County, 742 people were tested in 2006, with two testing positive for HIV. In 2007, out of the 812 people tested, five tested positive. In 2008, two of the 944 tested were positive for the disease.

In comparison to the 1991-1996 numbers, which averaged 12.5 new cases of HIV in the county every year, it seems education and outreach efforts are working.

From 2006-2008 Richmond County was ranked as 13th highest in the state, out of 100 counties reporting HIV testing figures.

“Usually HIV/AIDS patients diagnosed in this county are treated in Chapel Hill, due to the expense,” said Arenas. “While the numbers in our county are not high, unfortunately we do not have the ability to continue to monitor the patients.”

According to Health Director Tommy Jarrell, African-American females, within the 20-40 age range, are disproportionately affected by the disease in this county. This seems to correlate with national findings, that while African-American men are the most critically affected population, increasing numbers are being reported for African-American females.

According to a 2009 report issued by the Centers for Disease Control and Prevention (CDC), major risk factors causing such disproportionate numbers in the African-American community include: having unprotected sex with men; drug use; poverty; stigma; lack of access to health care; prisons; and possible genetic factors.

The 2010 U.S. Census found that African-Americans in the U.S. makes up 12.6 percent of the population. Those with Hispanic and Latino origins are reported to make up 16.3 percent of U.S. populations. That these relatively small groups make up 27 percent and 50 percent of HIV/AIDS cases in the U.S., respectively, is disconcerting.

Given the fact that the means of HIV transmission doesn’t vary from group to group, and risky behavior is not bound by race, evidence has not been conclusive as to why the numbers spiked so high within minority groups, especially African-Americans.

According to CDC, most new HIV infections are occuring among people under the age of 30.

“I think people are more knowledgeable than ever about the disease,” said Jarrell. “It’s just the “it won’t happen to me” mentality that we are still dealing with.”

Jarrell said that people in the county have become much more open to being tested, which is a good thing.

“With more and more people being tested, we can see that the HIV cases in our county aren’t skyrocketing,” said Jarrell. “The disease hasn’t disappeared, but people are being more safe about their behavior and I think the numbers show that.”

The Health Department offers free HIV testing to everyone, by appointment. Testing is confidential, and requests not to receive mail or phone calls from the Health Department will be honored.

“We do not share this information with the public, and we want to let people know that they don’t have to be afraid that if they make an appointment that we will call or mail them if that isn’t what they want,” said Jarrell. “We will protect our patients’ right to privacy.”

For more information on how to make an appointment for free testing, contact the Richmond County Health Department at (910) 997-8300.

Staff writer Kelli Easterling can be reached at (910) 997-3111 ext. 18, or by email at keasterling@heartlandpublications.com

How is HIV spread?

HIV is spread primarily by:

• Not using a condom when having sex with a person who has HIV. All unprotected sex with someone who has HIV contains some risk. However:
  • Unprotected anal sex is riskier than unprotected vaginal sex.
  • Among men who have sex with other men, unprotected receptive anal sex is riskier than unprotected insertive anal sex.
• Having multiple sex partners or the presence of other sexually transmitted diseases (STDs) can increase the risk of infection during sex. Unprotected oral sex can also be a risk for HIV transmission, but it is a much lower risk than anal or vaginal sex.
• Sharing needles, syringes, rinse water, or other equipment used to prepare illicit drugs for injection.
• Being born to an infected mother—HIV can be passed from mother to child during pregnancy, birth, or breast-feeding.

Less common modes of transmission include:

• Being “stuck” with an HIV-contaminated needle or other sharp object. This risk pertains mainly to healthcare workers.
• Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This risk is extremely remote due to the rigorous testing of the U.S. blood supply and donated organs/tissue.
• HIV may also be transmitted through unsafe or unsanitary injections or other medical or dental practices. However, the risk is also remote with current safety standards in the U.S.
• Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. This appears to be a rare occurrence and has only been documented among infants whose caregiver gave them pre-chewed food.
• Being bitten by a person with HIV. Each of the very small number of cases has included severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
• Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids. These reports have also been extremely rare.
• There is an extremely remote chance that HIV could be transmitted during “French” or deep, open-mouth kissing with an HIV-infected person if the HIV-infected person’s mouth or gums are bleeding.
• Tattooing or body piercing present a potential risk of HIV transmission, but no cases of HIV transmission from these activities have been documented. Only sterile equipment should be used for tattooing or body piercing.
• There have been a few documented cases in Europe and North Africa where infants have been infected by unsafe injections and then transmitted HIV to their mothers through breastfeeding. There have been no documented cases of this mode of transmission in the U.S.

HIV cannot reproduce outside the human body. It is not spread by:

• Air or water.
• Insects, including mosquitoes. Studies conducted by CDC researchers and others have shown no evidence of HIV transmission from insects.
• Saliva, tears, or sweat. There is no documented case of HIV being transmitted by spitting.
• Casual contact like shaking hands or sharing dishes.
• Closed-mouth or “social” kissing

Chart courtesy of Centers for Disease Control and Prevention