Opioids epidemic endangering progress eliminating AIDS

Jun 12, 2017

This month marks the halfway point in New York State's plan to end the AIDS epidemic by the year 2020. Although local health care officials say progress has been made, a new epidemic is threatening the effort.

There are tools out there at this time that could absolutely reduce and potentially even eliminate the HIV epidemic in New York and across the United States and even the world if a commitment is made to do so. - Dr. Kevin Shiley

Introduced in 2014, the state's plan to end AIDS in New York has three key points:

  • identify people with HIV who remain undiagnosed,
  • link people with HIV to health care and
  • PREP people who engage in high-risk behaviors with medicine to keep them HIV-free.

"I think that testing for HIV is just as important as testing for any other potential illness in any patient," said Dr. Kevin Shiley, a physician advisor for Catholic Health's Infection Prevention and Control Department. "Frankly, I think what is a really wonderful thing is that a disease that was once always a death sentence has now become a chronic illness if people are tested and treated appropriately."

For example, Shiley said, everyone over the age of 13 who enters a Catholic Health acute care site, like the Emergency Room, is now offered the option of HIV testing, regardless of their personal background or why they came in for care.

And testing today is more available than ever before.

Registered Nurse Mary Goodspeed, the HIV Clinical Education Coordinator at Erie County Medical Center, said another area that has been very successful is in reducing the number of babies born with HIV.

"It's pretty significant if you look at New York State being one of the highest HIV and AIDS states in the nation, we've eliminated perinatal transmission," she said. "We haven't had a baby born positive now in almost two years - and they way we've been able to do that is just by getting Mom tested."   
 

A rapid HIV test
Credit National Public Radio

However, she said, perhaps it is the increase in testing why HIV rates overall in Erie County have increased 20 percent recently. That has not been the norm in other counties.

"But another scary part of it is that our STD rates have increased," Goodspeed said. "Our gonorrhea rates have increased 49 percent and our syphilis rates have increased 89 percent - which is pretty scary, especially since we know that HIV and STDs kinda go hand in hand."

Despite some increasing numbers, ECMC, the VA Healthcare System and Evergreen Health Services are the main local places to receive treatment for HIV.

Catholic Health, for example, refers patients who test positive for HIV to ECMC. Shiley said limited treatment options is due to the limited number of HIV and infectious disease health care professionals in WNY.

But there is an even bigger problem that could derail efforts to end AIDS.  

"People across the country and certainly in this region that are using injection opiates, including heroin, this is certainly a very high-risk behavior for the transmission of HIV infection," said Shiley. "That, to me, seems like a huge hurdle."

Goodspeed agrees - even with the availability of needle exchange and other harm-reduction programs like ESAP, which allows New Yorkers to purchase needles from a pharmacy without a doctor's prescription.
 

Credit New York State Department of Health

"I think a lot of young people, especially, feel that as long as you're my friend or, you know, I'm dating you, that it's okay to share needles," she said. "So I guess a lot more information needs to be dispersed into the community about the availability of these services."
    
Do not be surprised to see AIDS education tables at summer festivals and fairs.

Goodspeed reminded that treatment now is usually one pill a day, and with fewer side effects, compared to the HIV cocktails of the past. She said someone diagnosed with HIV today at age 25 can now live a long life.