HIV-AIDS infection at all-time low, but not in some ethnic groups
SAN FRANCISCO — With infection rates now at an all-time low, the campaign against HIV/AIDS has been gaining ground. But fear of HIV remains among various ethnic groups where infection rates are still high.
This was the main concern addressed in the ethnic media briefing “Closing the Information Gap on PrEP in Underserved Communities” at the World Affairs Council in San Francisco, hosted by New America Media and the San Francisco Department of Public Health.
The briefing reported that HIV rates remain high among African American and Latino gay and bisexual men as estimates from the Centers for Disease Control and Prevention (CDC) indicate that one in two (50%) black gay men, and one in four (25%) Latino gay men, will be infected with HIV during their lifetimes.
This was despite the presence in the United States since 2012 of pre-exposure prophylaxis (PrEP), a medication that prevents HIV-negative individuals from being infected with the virus.
According to CDC, daily PrEP use can reduce the risk of getting HIV from sex by more than 90 percent. Among individuals who inject drugs, it reduces the risk by more than 70 percent.
CDC added that 66.5% of Asian Americans and 43.1% of Native Hawaiian or Other Pacific Islanders have never been tested for HIV.
Low PrEP utilization rates are usually blamed on lack of awareness about the drug, misconceptions regarding its affordability, misinformation about its effects, and stigma about HIV clients as “dirty,” “irresponsible” or “promiscuous.”
Moderated by NAM Executive Director Sandy Close, the briefing brought together navi San Francisco Department of Public Health navigator Michael Barajas; Health Systems Navigator of GLIDE Foundation Jorge Vieto; Determined to Respect and Encourage African American Men (DREAAM) San Francisco AIDS Foundation program coordinator Terrance Wilder; HIV Prevention Program Supervisor of Asian Pacific Islander Wellness Center Tapakorn Prasertsith; Latino Service Manager San Francisco AIDS Foundation Jorge Zepeda; and Deputy Director Denny David of LYRIC, Error! Hyperlink reference not valid.
Barajas confirmed the good news that HIV infections have indeed been low, with San Francisco rates decreasing since 2012 by over 51%; but he also said black and Latino men (having) sex with men (MSMs) and transgender women have had increasingly high infection rates.
“African Americans and Latinos comprise less than 20% of San Francisco but have a combined infection rate of more than 20%. On the other hand, while the majority of the city is white, their HIV- infection rate is at a low 39-40%,” Barajas reported.
“One major challenge we have is meeting the needs of the people reaching out to us. Regardless of the residency status, one should be insured as the cost of PrEP is a relatively high $1,600/30 day bottle retail rate, which most health insurance cover.”
Vieto who works with HIV-positive persons revealed that more than half of the people they talked with had no clue that PrEP is available, “so we are doing a lot of education as to what PrEP is and what it is not.”
“A lot of misconceptions on PrEP that we hope to break down include that it is not for them as they don’t see themselves needing the protection, that it is only for white people who have money and that they cannot afford the medication,” Vieto explained.
“Truvada, the brand name for PrEP is mainly a pill and taken alone will not work in checking your infection. When you are HIV positive, you should take Truvada with other medications as part of the course of medication. Also, Truvada may help one to be safe from HIV, but it does not cure the sexually transmitted disease.” It may slow the disease’s progress and prolong life in combination with drugs that treat HIV infection.
Program coordinator Wilder shared that more than 85% of those who goes to them are not from San Francisco and came to San Francisco to be comfortable being gay.
“The flipside, however, is that they see more and better opportunities in the streets and a lot of sexual activity including having sex with people who are HIV positive,” laments Wilder.
“As to accessing PrEP (which is rather expensive), it is also hard to expect those who worry about where to get their next meal to think about getting where to get money for their next PrEP pill. Also the stigma is not getting better for the black and brown population.”
API Wellness Filipino American program supervisor Nate Cedilla, in a subsequent phone interview, said that one major success in reducing HIV stigma was their men’s project, The Connection, a program with 20-30 volunteers started and largely run by Filipinos. It has been going on for years.
“The Connection is a community space that fosters trust, care and friendship among API men who have sex with other men. In the program, API men have the opportunity to truly express who they are and how they feel. We build community by taking our guys out on weekend trips, hosting parties and doing workshops around healthy relationships and their ideal sex life,” describes Cedilla.
Cedilla’s API HIV Prevention Program supervisor Prasertsith said that many Filipinos serve as volunteers to attend to Asian clients, and some of them are even doctors of wellness centers.
“We have Filipino language resources and we have the cultural knowledge there to serve so there is comfort there, there is a familial feeling,” Prasertsith elaborates. “Since there is a relatively a big number of Filipinos in the Bay Area, we get people from Union City and Daly City coming to our API offices to get resources and help.”
“Filipinos are getting tested for HIV and are accessing PrEP, but it was a slow process that got better as time went on. When PrEP came out in 2012, API folks, especially Filipinos, were not accessing it. Problems include insurance and family. A lot of them are scared to get insurance due to documentation issues,” Prasertsith explained.
“Others are in their parents’ insurance but are afraid to use that to access PrEP, since it is going to show up on the benefits records. They are still scared that their parents will know about their PrEP use, and since many of the Filipinos are Catholics, they are not sure if their queerness will intersect well with their religion,” he added.
API Wellness is an LGBTQ and people of color community health center that transforms lives by advancing health, wellness and equality. It believes that everyone deserves to be healthy and needs access to the highest quality health care.
For more information visit www.apiwellness.org.