Getting tested for HIV isn’t just about your own health. It’s also about helping stop an epidemic. Friday is National HIV Testing Day, and screening sites have been set up across the country.
Since the disease first surfaced in the early 1980s, it has killed more than 35 million people around the world. Today, modern antiretroviral medications can keep people with HIV alive for decades. According to research published late last year, a white gay man in America diagnosed with HIV today at age 20 can expect to live as long as any healthy man in the U.S.
The drugs that keep people alive also lower the amount of the virus in their bodies to undetectable levels. As a result, their risk of transmitting the disease is drastically reduced. This is known as treatment-as-prevention.
But if people don’t get tested and treated, none of these advances will benefit public health. Although infection rates have declined among men who have sex with men from the peak of the epidemic in the mid-1980s, they are now creeping back up, to about 30,000 new infections per year today. And while men who have sex with men still comprise about two-thirds of the estimated 50,000 new annual infections in the United States, HIV does not discriminate. Black, heterosexual women also remain at high risk, for example.
HIV prevention specialists say three things are driving rising infection rates: stigma, complacency, and lack of access to testing and treatment. Minority groups, especially men who have sex with men, are the most severely affected.
One in Six Don't Know They're Positive
More than a million people in the U.S. are living with HIV, but one in six don’t know it, according to the U.S. Centers for Disease Control and Prevention (CDC). This is why testing is so important.
From 2008 to 2010, the number of HIV infections among men who have sex with men grew 12 percent nationwide, according to the CDC. From 2000 to 2011, infections skyrocketed 75 percent in Chicago among men under 30 who have sex with men, Cynthia Tucker of the AIDS Foundation Chicago (AFC) told Healthline.
The CDC recommends that everyone between the ages of 13 and 64 get tested at least once for HIV. Women who are pregnant or are planning to become pregnant should also get tested. At-risk groups, such as men who have sex with men, intravenous drug users, and sex workers should be tested every three to six months.
Younger gay men who have not witnessed the deaths of friends and loved ones to AIDS do not always practice safe sex. They sometimes engage in a practice called “serosorting,” in which they choose partners they believe have the same STI status they do, even if they have no proof.
Tucker said that in some Chicago communities HIV infection rates have reached “epidemic proportions,” especially among blacks and Latinos. For the past three years, AFC outreach workers have been seeking out those at risk at bars, clubs, circuit parties, and balls. Sometimes they hang around until 2 a.m., when the party ends.
Prevention specialists also go online to find those who don’t go out. They create personas on gay hookup apps like Grindr and online dating services like Adam4Adam. They chat up those looking for a date and then encourage them to get tested.
AFC has tested 5,000 young, minority men in the past three years, and 4 percent of them have tested positive. The organization has found treatment for 86 percent of those men.
This month alone, AFC will have tested an additional 5,000 people during its annual “Step Up. Get Tested” campaign. The campaign engages stakeholders across the community, from mom and pop businesses to the Chicago Department of Public Health.
The Stigma Roadblock
There is a stigma surrounding HIV just about everywhere, but it can be particularly strong in some minority communities. The result is that those at risk are discouraged from getting tested because they don’t want to be seen at a testing site, or worse, have to share a positive result with family and friends.
“We have to remember we are releasing them back into a society that is not very forgiving and nice about a person having HIV,” said Anthony Galloway, prevention program manager for AFC.
AFC often reaches those at risk for HIV by encouraging them to take a hepatitis C test first. Hepatitis C can also be sexually transmitted and is a growing problem among gay and bisexual men. When someone agrees to take a hepatitis C test, a prevention specialist can often convince them to get an HIV test at the same time.
AFC also arranges testing at area Walgreens stores for those who don’t want to be seen in a known gay neighborhood or among openly gay people during testing. “There’s one on every corner,” Walker said. “And you could just be there for a flu shot.”
The organization also targets heterosexual black and Latina women who are at high risk by offering testing at social service agencies and employment centers. Additional campaigns using bus stop advertisements and radio spots seek out Spanish-speaking men at risk for contracting HIV.
Infection Rates Rising, Even in San Francisco
Even in a tolerant environment like San Francisco, HIV outreach is crucial. The highest rate of new infections in San Francisco is among older men who have sex with men, not younger men.
Megan Canon, social marketing manager for the San Francisco AIDS Foundation (SFAF), said one in four gay men in the city is HIV-positive. Of its 16,000 residents with HIV, half of them are 50 or older. To that end, SFAF has launched its 474 Castro Project and hopes to open the health center in early 2015.
Other programs for the aging HIV population include the 50-Plus Network, designed to empower older men.
But in San Francisco, infections among young black men remains a problem. The DREAAM Project engages that population to promote HIV prevention, testing, treatment, and overall wellness.
To find a National HIV Testing Day site in your area, visit aids.gov.