Addiction, homelessness and prostitution provide fertile breeding ground for HIV
EL CENTRO — The impact of drug abuse, homelessness and unprotected sex continues to be felt in many ways here in the Valley. Among those ways is in the spread of Human Immunodeficiency Virus, the virus responsible for AIDS, speakers told participants in a recent HIV workshop.
Recent reports out of Massachusetts point to a marked rise in HIV cases among the homeless populations in northeast region of the state. Closer to home, HIV continues to be a threat locally, with Clinicas de Salud del Pueblo reporting two new cases this year.
“Having multiple sex partners, sharing needles, and having unprotected sex contributes to the risk of HIV transmission … the most common form of transmission is unprotected anal sex. And not many people are aware of that,” Dr. Karla F. Torres, with ViiV Healthcare, said in a presentation at the workshop.
The Centers for Disease Control reported almost 40,000 people were HIV positive in 2016. The report also stated that among all ethnic groups, African Americans, followed by Hispanics, were the most common groups to contract the virus.
HIV not only harms your body, but it also causes an effect with your mental health. According to the U.S. Department of Health and Human Services, “People with HIV … have higher rates of mental health conditions than the general public. People with HIV may experience depression, anxiety, post-traumatic stress disorder, suicidal thoughts and insomnia.”
Persons living with HIV have to be even more diligent than most about taking care of themselves and avoiding infections or other STDs. This includes keeping up with their medication.
“Sticking to your HIV treatment provides many benefits,” said Eulalia Hermosillo, case manager for Clinicas De Salud del Pueblo. “Among them, it allows HIV medications to reduce the amount of HIV in your body. If you skip your medications, even once in a while, you are giving HIV the chance to multiply rapidly.”
This reduces the risk of contracting AIDS or transmitting the virus to others.
“If you take HIV medicine as prescribed and get and keep an undetectable viral load, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.” And by keeping up with your medicine you also prevent resistance to the disease, “Drug resistance develops when the virus changes form (mutates) and no longer responds to certain HIV medication. This limits the options for successful HIV treatment. Drug-resistant strains of HIV can be transmitted to others, too,” Hermosillo said.
“Undetectable” is an important term that people often misuse when being HIV positive. A Huffington Post article by Tyler Curry reported that those who have an undetectable viral load tend to continue to participate in unsafe sexual practices.
“Undetectable” does not mean “cured.” An undetectable viral load means that so few copies of the virus are present in the blood that today’s monitoring tests are unable to detect them. Even with an undetectable viral load, however, an HIV-positive person still has the virus,” Hermosillo said. “When a patient is virally suppressed (undetectable) they are considered/ classified as undetectable.” Matters get even worse when HIV-positive patients become homeless. Homeless people often lose access to social services. Living on the streets, people tend to lose personal belongings like IDs, and without these documents, they become more limited in resources due to the fact they are not able to legally identify themselves.
“When you do not have a permanent address, it is hard to case manage people” said Rosa Diaz, CEO of Imperial Valley LGBTQ. “Therefore, those who become homeless lose access to medication and follow-up information.”
Reports from different healthcare providers indicate that many LGBTQ members who become homeless turn to sex work in an effort to make an income.
In a recent program, the BBC showed how unemployment and homelessness have been significant contributors in the increase of HIV. Those who turn to sex work are at a huge risk of contracting HIV. In the sex work industry, people pay more for unprotected sex, which puts those in need of money at a higher risk of infection.
The high rate of unemployment in the Imperial Valley has a similar impact. “Working with HIV-infected men who were looking for a means of survival, getting someone to pay for sex is easy and quick money, but in doing that, they put others at risk of becoming infected with HIV, some being married men,” Diaz said.
“People do turn to sex work sometimes for survival and other times for their next lunch,” Diaz added. “If they are addicts, they will have sex for drugs. What happens here is that they do not think about using protection because they focus on immediate need due to hunger or drug use.”
While drug use is inherently unsafe, certain practices can make it worse. “When there is no clean needle exchange program people will use and pass the same needle around,” Diaz said. “It is an inconvenience for people to have to go buy new clean needles, sometimes hard without a prescription, which causes people to just share one needle.”