Wednesday, December 18, 2013

SF Chron: HIV Fell 23% in Six Years; Taxis Part of Quick Treatment

An important AIDS story in today's San Francisco Chronicle needs to get some attention from gay and AIDS bloggers and news sites for a number of reasons. First of all, there's this welcomed development of continuing declines of HIV infections (links to my posts regarding decreases in recent years are here). Reporter Erin Allday writes:

Almost 16,000 people in San Francisco are living with HIV, and a little more than 400 new cases are diagnosed every year. The number of new infections has declined in recent years, from 534 in 2007 to 413 in 2012.

Those stats come from the latest Department of Public Health annual HIV epi profile and I'm pleased to see them reported.

Allday's feature in the health section was about getting newly infected persons, especially those with acute HIV symptoms indicating the individual recently sero-converted from negative to positive or high viral loads, immediately on a drug cocktail. How quickly does the local public health care network move in some situations? This fast:

When a patient has been diagnosed with an acute infection, health care workers at the clinic page [Dr. Hiroyu] Hatano or one of her HIV-specialist colleagues. Then they send the patient immediately to the HIV clinic at San Francisco General Hospital - sometimes escorting them there in a cab.

At the HIV clinic, the patient meets with nurses and doctors who can explain the diagnosis and why drug therapy may be helpful. Meanwhile, a social worker gets the patient started on paperwork to help pay for drugs.

Ideally, the patient will take a first dose of antiretroviral therapy in the clinic, and leave with enough of a supply of drugs to last several days, until insurance or federal aid kick in.

"It used to be that (patients) would have an intake visit a couple of days after testing positive, and they'd see a nurse provider a few days after that, and maybe meet their long-term provider weeks after that," Hatano said. "And during all that time they were untreated.

"Now we give them a cup of water and they literally take their first dose in front of me. I literally have a bag of drug regimens that are stored upstairs."

The scariest word in this passage is untreated. We've come so far from the dark times of the 1980s when there were so few drug options and, despite what AMFAR's board president shoe designer Kenneth Cole said recently about gays being so scared back then we were fear-driven into silence, gay doctors and people with AIDS were demanding research and effective treatments.

We now have dozens of drug options and alternative health practices to balance out the treatments' side effects, mountains of global data about the drugs, an industry of care and advocacy, and one of the most crucial components to assisting a newly HIV infected person could be a taxi ride to obtain a supply of pills.

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