Saturday, June 4, 2016

NC HIV Advocacy Day - June 7, 2016

Tuesday, June 7, 2016 is HIV Advocacy Day in North Carolina.  Unknown numbers will convene in Raleigh to advocate for issues surrounding HIV.  This is a day that has been sponsored by NC AIDS Action Network (NCAAN).  This year, an issue they are raising with lawmakers is the ability, really inability,  for those individuals living with HIV and receiving funds from the AIDS Drug Assistance Program (ADAP) to pay for health insurance premiums bought through the Affordable Care Act's Marketplace with funds received from ADAP.

North Carolina is one of the few states that does not allow ADAP funds to be used for premiums.  Funding for ADAP comes from both state and federal funds as well as rebates from the Pharmaceutical Industry.  The program helps individuals with low incomes to purchase HIV medications.  The ultimate goal is not only to treat as many people with HIV as possible, but to keep them treated as continuous treatment contributes to viral suppression.  Viral suppression helps individuals live longer and healthier lives.  It also makes transmission of HIV more difficult.

Allowing premiums to be purchased with ADAP funds would save North Carolina millions of dollars and improve quality of health.  This is because individuals not only need medications, but need access to healthcare as well.  A guidance was proposed by the US Health Resources & Services Administration in September, 2015 that would require states to use ADAP funding to pay for premiums in order to receive rebates from the pharmaceutical industry.  In states that don't allow funding to be used for premiums, such as North Carolina, money received from rebates would be lost.  This would add up to millions of dollars not being available to those people participating in ADAP in North Carolina.  This would negatively impact the health of these individuals and may contribute to transmission rates of HIV as viral loads go up.  If you are interested in this issue or participating on June 7, visit NCAAN's website, www.ncaan.org, or visit http://statevoices.salsalabs.com/o/72/p/salsa/event/common/public/?event_KEY=649  to register.


REFERENCES

Keeton, K;  Storrow, L.  (2016)   Ken Keeton and Lee Storrow: Better access to HIV medications would save lives.  Greensboro News and Record.  Retrieved from http://www.greensboro.com/opinion/columns/ken-keeton-and-lee-storrow-better-access-to-hiv-medications/article_30abe3dc-4ba7-55a9-b491-c214cb5b5955.html

NCAAN.  (2015)  Lack of Premium Assistance in North Carolina threatens ADAP budget. A Sustainable Future For The NC AIDS Drug Assistance Program.  Retrieved from http://www.ncaan.org/uploads/7/5/8/9/7589793/adap_funding_handout.pdf

HIV/AIDS






 

Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immune Deficiency Syndrome (AIDS).  HIV attacks an individual's immune system, specifically CD4 cells, a type of White Blood Cell.  There is a process of differentiation and responses that occur with CD4 cells, but what is important to know is that CD4 cells "kick into gear", so to speak, when someone is exposed to an infectious agent, HIV included.  HIV destroys CD4 cells, and therefore, destroys a person's immune system.  There are treatments for HIV, but there is no cure.  Sometimes HIV and AIDS are thought to be synonymous, but there is a difference.  HIV is the virus.  Someone can be said to be HIV+ if they are infected with the virus.  AIDS is the end stage of the HIV Infection.  Not everyone who is HIV+ has AIDS.  The stage at which someone is diagnosed with AIDS is when they are HIV+,  their CD4 count drops below 200, CD4 cells make up less than 14% of a person's white blood cell count and an individual has developed an opportunistic infection which is an infection that takes advantage of a weakened immune system (UCSF, n.d.).

There are over 1.2 million people in the United States living with HIV.  1 in 8 of these individuals are unaware they are HIV+.  Youth between 13 and 24 make up 25% of new HIV infections.  Men who have sex with men (MSM), African Americans and Hispanics are other groups who are at higher risk of being infected.  Across the globe, 36.9 million people are living with HIV/AIDS.  2.6 million of these people are children (AIDS.gov, n.d.).

Historically, there have been misconceptions about how HIV is transmitted.  HIV is found in bodily fluidds such as blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids and breast milk (AIDS.gov, n.d.).  The ways that HIV is transmitted is primarily through unprotected anal, vaginal and oral sex with someone who is HIV+ and sharing needles/syringes with someone who is HIV+.  It is less common, but it is also possible for a mother to pass HIV to a child, either during pregnancy, childbirth or breastfeeding.  There is also the risk of healthcare workers being stuck with a needle contaminated with HIV+ blood.  Again, this is less common, especially if the health care worker is practicing Universal Precautions.  HIV does not live outside the human body and therefore is not spread by air, water, insects, saliva, tears, sweat, hugging or water fountains (AIDS.gov, n.d.)

The only way to know if someone has been infected with HIV is to be tested.  There are symptoms an individual may experience soon after being infected.  It is usually described as flu like symptoms; fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes and mouth ulcers (AIDS.gov, n.d.).  They can last up to several weeks.  As time progresses, an individual may either not have symptoms or only have mild symptoms.  If someone progresses to AIDS, someone may experience rapid weight loss, recurring fever, extreme and unexplained fatigue, diarrhea lasting more than a week, pneumonia, memory loss or depression (AIDS.gov, n.d.). 

There are ways to protect yourself.  Having sex within a committed relationship, using condoms, not using intravenous or other drugs and using barriers during oral sex are all ways to reduce the likelihood of contracting or transmitting HIV.  For individuals who are in a relationship with someone who is HIV+, using condoms and taking Pre Exposure Prophylaxis (PrEP) can reduce the chances of transmission (WebMD, 2016).

Although there is no cure, there are treatments for HIV.  Different drugs affect HIV in different ways.  Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) inhibits HIV's ability to copy itself.  Nucleoside Reverse Transcriptase Inhibitors (NRTIs) alters what HIV uses to copy itself.  Protease Inhibitors (PIs) disable a protein HIV uses to make copies.  Fusion inhibitors block a protien HIV uses to incorporate its genetic material into a CD4 cell (Mayo Clinic, 2015).  It is important that individuals who are HIV+ start treatment.  It is important that once on treatment, the treatment is continued with no breaks.  While on treatment, the amount of HIV in the body can be lowered to the point where it is hard to detect the virus.  Having the HIV in the body at this level lowers the chance of transmission.

It is possible to live a long time with HIV and there are treatments.  If you are HIV+, it is important to be treated.  If you are HIV-, it is important that you stay HIV-.  It is not possible to look at someone and tell that they are HIV+.  It is possible to be around someone who is HIV+ and not know.  Whether you realize that you know someone with HIV or AIDS or not, it is important to remember that even if you are not INFECTED with HIV, you are still AFFECTED by HIV.


REFERENCES

AIDS.gov.  (n.d.)   HIV Basics.  AIDS.gov.  Retrieved from https://www.aids.gov/hiv-aids-basics/index.html

Avert. (2015)  What are HIV and AIDS?  Avert.  Retrieved from http://www.avert.org/about-hiv-aids/what-hiv-aids
Mayo Clinic. (n.d.)  HIV/AIDS Treatments and Drugs.  Mayo Clinic.  Retrieved from http://www.mayoclinic.org/diseases-conditions/hiv-aids/basics/treatment/con-20013732

UCSF Medical Center.  (n.d.)  AIDS Diagnosis.  University of California San Fransisco.  Retrieved from https://www.ucsfhealth.org/conditions/aids/diagnosis.html

WebMD.  (2015)  Understanding AIDS/HIV Prevention.  WebMD.  Retrieved from http://www.webmd.com/hiv-aids/guide/understanding-aids-hiv-prevention

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