Tuesday Mar. 21
2:00 – 3:30 p.m. ET || 1:00 – 2:30 p.m. CT || 12:00 – 1:30 p.m. MT || 11:00 – 12:30 p.m. PT
The discovery of over 200 new HIV diagnoses in Indiana’s small, rural Scott County over the course of 2015 was a major wake up call for many about the dangers of ignoring the HIV prevention needs of people who inject drugs. The massive number of new cases in Scott County coupled with the ongoing epidemic of injection drug use in rural America significantly changed the political landscape around HIV prevention in the past few years, leading the Centers for Disease Control and Prevention to identify 220 other counties that could be vulnerable to similar HIV “outbreaks.”
The situation in Scott County led to substantive policy change in December of 2015 when the Republican-led Congress quietly reversed their stance on a federal ban barring funding from being spent on syringe access programs (SAPs) – a change that had long been sought by HIV prevention advocates. How do we holistically address the needs of these communities beyond SAPs? How do we best involve affected communities within these responses?
Join Treatment Action Group, Harm Reduction Coalition, Indiana Minority Health Coalition, and Project Cultivate for a webinar that will consult with some local and state leaders in the response to the situation in southern Indiana, and discuss with Harm Reduction Coalition how best to implement a comprehensive and community-led response to HIV, Hepatitis C, and injection drug use in rural America.
HIV Prevention Research and Policy Coordinator, Treatment Action Group
Dr. Carrie Ann Lawrence
Assistant Researcher, Indiana School of Public Health – Bloomington
Project Director, Project Cultivate
Director of Public Policy & Engagement
Indiana Minority Health Coalition
Deputy Director of Planning and Policy
Harm Reduction Coalition
Of the 1,080 HIV-positive people or hepatitis interviewed by the Aides association, nearly 30% report having been discriminated against during the past year in their emotional, family, sexual and medical lives, according to this published survey On the eve of World AIDS Day. Nearly half of them said they had been rejected in their emotional, family and sexual lives, and almost a quarter had been discriminated against in the medical community.
Precariousness also emerges as a major source of discrimination, notes the association for the defense of the sick in its report 2016 entitled “HIV / hepatitis (VHV), the hidden face of discrimination”.
Inequalities in access to care
One in ten respondents (all serologs: HIV, hepatitis C, etc.) said they were confronted with the refusal of care during the last 24 months and, “not surprisingly the dentists, the most frequently cited” association. By 2015, a “testing” in dental and gynecological offices was already pointing this finger at this phenomenon. In 2016, Aides’ VHV survey shows that 23.6% of people living with HIV and 27.3% with hepatitis who have been discriminated against have been dismissed by caregiver.
Despite increasing use of antiretrovirals, no reduction in end-stage liver disease risk was observed among patients coinfected with HIV and viral hepatitis during a 15-year period, according to an analysis of data from The North American AIDS Cohort Collaboration on Research and Design.
“Patients triply infected with HIV, hepatitis C virus and hepatitis B virus were at particularly high risk, having a 12-fold higher incidence rate of [end-stage liver disease (ESLD)] compared with HIV monoinfected patients, even in the modern ART era,” Marina B. Klein, MD, MSc, FRCPC, professor in the division of infectious diseases at McGill University, and colleagues wrote. “Even after accounting for competing risks of death, CD4 and HIV RNA suppression, we observed no apparent improvement in ESLD rates in our HIV/HCV coinfected population.”
Although patients with HIV who are coinfected with HBV or HCV are at increased risk for ESLD, whether use of modern ART reduced that risk was unknown.