At­lanta's HIV/ AIDS cri­sis

What's the CDC's plan?

GA Voice - - Front Page - By PA­TRICK SAUN­DERS psaun­ders@the­gavoice.com

In June 2014, a team of HIV/AIDS ac­tivists from New York teamed up with At­lanta ac­tivists to call out the Cen­ters for Disease Con­trol and Preven­tion on their strate­gies and sense of ur­gency re­gard­ing the fight against HIV/AIDS. They also met with the CDC’s HIV preven­tion per­son­nel to dis­cuss their con­cerns and present them with The At­lanta Prin­ci­ples, a se­ries of pro­posed ac­tions they be­lieved the CDC should take.

Nearly two years since then, ac­tivists are get­ting more frus­trated as new and more alarm­ing in­for­ma­tion on HIV/AIDS in At­lanta and across the state con­tin­ues to sur­face ev­ery few months. A new re­port au­thored by re­searchers at Emory Univer­sity’s Rollins School for Pub­lic Health re­veals that men who have sex with men (MSM) ac­count for ap­prox­i­mately two-thirds of all new HIV di­ag­noses each year, and the high­est rates of in­fec­tion are in the South.

Re­sults in­di­cated:

There were six states where more than 15 per­cent of MSM were liv­ing with di­ag­nosed HIV in­fec­tion in 2012, all of which were in the US South

Of the 25 metropoli­tan sta­tis­ti­cal ar­eas (MSAs) with the high­est lev­els of MSM liv­ing with an HIV di­ag­no­sis, 21 were lo­cated in South­ern states

Es­ti­mates showed in 2012, at least one in four MSM were di­ag­nosed with HIV in the fol­low­ing MSAs: Jack­son, MS; Columbia, SC; El Paso, TX; Au­gusta, GA; Ba­ton Rouge, LA

The At­lanta/Sandy Springs/Roswell, Ge­or­gia MSA was 13th out of 25 MSAs listed, with a rate of 16.43 di­ag­nosed HIV-pos­i­tive per 100 MSM. Ac­cord­ing to a re­cent CDC study, the risk of di­ag­no­sis for Ge­or­gia res­i­dents (MSM or not, male or fe­male) is one in 51. And one Emory Univer­sity AIDS re­searcher com­pared down­town At­lanta to third-world African coun­tries when it comes to HIV/AIDS in­fec­tions.

PrEP, trans­gen­der is­sues among con­cerns

At­lanta HIV/AIDS ac­tivist Adolph St. Ar­ro­mand was part of the group that pre­sented The At­lanta Prin­ci­ples to the CDC in 2014. The group rec­om­mended a more ag­gres­sive push to sup­port PrEP, more fund­ing to go to the hard­est hit com­mu­ni­ties and bet­ter data col­lec­tion on trans­gen­der in­di­vid­u­als, specif­i­cally sep­a­rat­ing that group from MSM to bet­ter ad­dress their spe­cific needs.

While he notes that the CDC has been push­ing PrEP more, he says they have not done enough to train more providers around the uti­liza­tion of PrEP.

“They have done some pub­lic cam­paigns around the end users but not ne­c­es­sar­ily pub­lic cam­paigns to physi­cians and med­i­cal groups around PrEP,” St. Ar­ro­mand told Ge­or­gia Voice.

The CDC did re­lease a study in Fe­bru­ary show­ing that ex­panded HIV test­ing/ treat­ment and the use of daily PrEP could pre­vent an es­ti­mated 185,000 new HIV in­fec­tions in the U.S. by 2020—a 70 per­cent re­duc­tion in new in­fec­tions.

St. Ar­ro­mand says how­ever that “noth­ing has been done” on the trans­gen­der is­sue, but adds, “From what I un­der­stand it goes higher than the CDC, so we’re still in a place where trans­gen­der peo­ple are still be­ing mis­gen­dered. It sounds like it has to come down from HHS [U.S. De­part­ment of Health and Hu­man Ser­vices].”

Over­all he gives the CDC a grade of C- on their HIV/AIDS ef­forts, say­ing the At­lanta rates are all the more em­bar­rass­ing con­sid­er­ing that’s where the CDC is lo­cated.

“There are too many tal­ented ex­perts that live within a 25-mile ra­dius that can come down here and kind of help to break some of the chains and bar­ri­ers that we have,” St. Ar­ro­mand said. “But that’s not hap­pen­ing at all from the CDC.”

The CDC was not able to pro­vide a re­sponse to St. Ar­ro­mand’s com­ments by press time, but did is­sue a press re­lease last week about the Emory Univer­sity find­ings, with Dr. Jonathan Mer­min, di­rec­tor of the CDC’s Na­tional Cen­ter for HIV/AIDS, Vi­ral Hep­ati­tis, STD, and TB Preven­tion say­ing, “By pin­point­ing where HIV strikes the hard­est, we have a key piece of the puz­zle high­light­ing the largest dis­par­i­ties within states and the South. We hope these data em­power lo­cal pub­lic health of­fi­cials, com­mu­nity-based or­ga­ni­za­tions and ev­ery­one fight­ing HIV to bring re­sources to the gay and bi­sex­ual men who need them the most.”

Call for DPH over­haul

One en­cour­ag­ing point that ac­tivists cite is the for­ma­tion in De­cem­ber 2014 of the Ful­ton County Task Force on HIV/AIDS, es­pe­cially con­sid­er­ing the num­ber of new in­fec­tions in At­lanta. But St. Ar­ro­mand says that the other 19 coun­ties in the At­lanta/ Sandy Springs/Roswell MSA haven’t been as ag­gres­sive in their ap­proach to end AIDS.

And crit­i­cism from At­lanta HIV/AIDS ac­tivists isn’t solely di­rected at the CDC.

“The other prob­lem that we have is the Ge­or­gia De­part­ment of Pub­lic Health (DPH),” St. Ar­ro­mand says. “We need to get rid of all the ad­min­is­tra­tors and start all over at the De­part­ment of Pub­lic Health and HIV Preven­tion. They are fail­ing the state of Ge­or­gia around STDs, they are fail­ing the state of Ge­or­gia around HIV. There is no lead­er­ship com­ing out of that place at all what­so­ever.”

A DPH spokesper­son re­sponded to St. Ar­ro­mand’s com­ments by say­ing, “The Ge­or­gia De­part­ment of Pub­lic Health is work­ing dili­gently to ad­dress HIV/AIDS in Ge­or­gia, with par­tic­u­lar em­pha­sis on At­lanta and the MSM pop­u­la­tion. Ge­or­gia is the only state in the na­tion to em­ploy two MSM Co­or­di­na­tors who, with the HIV pro­gram, have de­vel­oped a strat­egy aimed at re­duc­ing the rates of HIV among this tar­get pop­u­la­tion. This strat­egy in­cludes, but is not lim­ited to, treat­ment as preven­tion—HIV pos­i­tive in­di­vid­u­als who fol­low an ef­fec­tive treat­ment reg­i­men are 96 per­cent less likely to spread HIV to oth­ers— con­tin­ued work to im­prove the ef­fec­tive­ness of be­hav­ioral risk re­duc­tion out­reach and ed­u­ca­tion, and stigma-free HIV/AIDS and STD coun­sel­ing via telemedicine.”

“We need to get rid of all the ad­min­is­tra­tors and start all over at the De­part­ment of Pub­lic Health and HIV Preven­tion. They are fail­ing the state of Ge­or­gia around STDs; they are fail­ing the state of Ge­or­gia around HIV. There is no lead­er­ship com­ing out of that place at all what­so­ever.” — HIV/AIDS ac­tivist Adolph St. Ar­ro­mand

(File photo)

A team of HIV/AIDS ac­tivists, in­clud­ing Adolph St. Ar­ro­mand and AID At­lanta’s Craig Washington, pre­sented rec­om­men­da­tions to the CDC in June 2014.

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