AIDS day puts focus on facts
Lynchburg News and Advance
Thursday, November 28, 2004As the Dec. 1 World AIDS Day nears, the news is both good and bad for Central Virginia. Human immunodeficiency virus (HIV) continues to move out of the smaller populations of intravenous drugs users and men who have sex with men, and into the larger community.
“This disease is being transmitted in the heterosexual population,” said Dr. Robert Brennan, Lynchburg specialist in infectious diseases and internal medicine.
And, he said, “we’re seeing many more patients who are older - more than age 60.”
But treatments have dramatically improved.
“The treatment we have now is so much more effective, easier to take - once a day med, and has such fewer side effects we think in (the) new era of HIV care,” said Brennan.
Data on HIV in Central Virginia is increasingly available since a $1.3 million three-year federal grant was awarded in July to Medical Associates of Central Virginia in partnership with Centra Health. The grant is for providing HIV and AIDS treatment in Central Virginia, as well as Danville, Martinsville and South Boston.
Brennan, of Medical Associates, said the grant also has made it possible to hire additional nurses to work with HIV patients in Lynchburg and Danville. Two years ago the practice opened a small office in Danville, where HIV patients had been going to Charlottesville for care.
Newer medications give better results than those available in the 1990s and earlier.
Death rates from HIV infection leading to AIDS (acquired immunodeficiency syndrome) have dropped. Without treatment, HIV progressively destroys the immune system until the person is at risk of death from overwhelming infections normally no problem for a healthy person.
If patients respond to the drugs, he said, they can expect to live for years while taking the drugs.
Costs are about $12,000 to $15,000 a year just for the prescriptions.
New patients are coming into the Lynchburg clinic at a rate of about four a month, Brennan said.
He said it’s important people realize that “HIV is a lifelong illness, a life threatening illness that can be prevented by abstinence or safe sex.”
But, once infected, there’s no cure.
Brennan said the epidemic also appears to be stronger in the Southeastern United States than in the Eastern United States, particularly in the rural areas as compared to the metro areas.
According to the Virginia Department of Health, about 15,800 people in the state have HIV.
Lynchburg has more than 180 cases.
In Central Virginia, statistics are similar to recent statewide figures.
“There are a significant percentage of women, heterosexuals, and a much older age group,” Brennan said of the demographics in Central Virginia.
“We’re talking a fair number newly diagnosed. The reason is the epidemic is now involving more heterosexual individuals, including women, than it has in the past.”
One area couple, both over age 60, was diagnosed after one developed an HIV/AIDS illness.
“One became infected 10 years ago or more and infected the partner. Unfortunately it can take 10 years or more for the illness to manifest,” said Brennan.
While fewer in number, area teens continue to be diagnosed, some as young as 14, said Brennan. Those infections are often detected when the girls agree to an HIV test as part of prenatal screening tests - a life-saving decision for the baby.
New treatments reduce the presence of the virus in the mother’s blood and are often able to protect the unborn child from getting the infection.
The baby, instead of having a 30 percent risk of infection from the mother, has less than a 3 percent risk, Brennan said.
When HIV first began to appear in the 1980s, the high-risk populations were gay, or people who had blood transfusions and children born to women infected with HIV.
Today, transmission by blood products is less than 1 percent, said Brennan, and mother-to-child cases have plummeted.
Today, the epidemic continues through sexual activity. “And people are not aware that they can be infected and asymptomatic and transmit it to their partners.”
Brennan said that he would “very much encourage” the screening for HIV as part of a normal preventive healthcare routine.
In the Hill City, World AIDS Day events include a Wednesday program in the Memorial Ball Room at Lynchburg College’s Hall Campus Center, beginning with a 6:30 p.m. reception followed by a 7 p.m. program and candle lighting ceremony.
Portions of the AIDS quilt will be on display at the Free Clinic of Central Virginia, 1016 Main St., Lynchburg, through Friday.Also at the Free Clinic will be a 6 p.m. reception and 6:30 p.m. program on HIV/AIDS on Thursday.
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