STATE OF THE HIV/AIDS EPIDEMIC IN CHARLESTON 12/1/2015 A Crisis Among Lowcountry Youth The Charleston region is facing a serious issue of rising HIV rates, particularly among those under the age of 30. Prepared by Lowcountry AIDS Services aids-services.com
State of the HIV/AIDS Epidemic in Charleston A C R I S I S A M O N G L O W C O U N T R Y Y O U T H Lowcountry AIDS Services (LAS) is nonprofit organization serving men, women and children living with HIV/AIDS in Berkeley, Charleston and Dorchester counties. LAS provides case management, access to medical care, housing assistance, financial assistance, nutritional assistance and legal assistance along with an array of other supportive services to hundreds in the Charleston area. LAS also works to prevent this epidemic through education, media campaigns, community outreach and free, daily HIV/STD testing. For more information, visit aids-services.com. A H I V C R I S I S A M O N G O U R Y O U T H The Charleston region is facing a serious issue of rising HIV rates, particularly among those under the age of 30. Lowcountry AIDS Services is reporting a higher rate of new HIV infections in 2015 over the previous four years. And what s most alarming is that the majority of these new infections are in teenagers and young adults. In 2014, the largest number of HIV/AIDS cases in South Carolina were in those ages 13 to 29 (46%). It s important our community let that number sink in: almost half of the HIV/AIDS cases last year were in people under the age of 30. ₁ So far this year, the numbers don t seem to be improving. To date, Lowcountry AIDS Services has administered almost 1,500 HIV tests in the tri-county area. Of those, 37 have tested positive and the majority are young African-American men. Additional testing is being done daily and more positive tests are being recorded. In the last five years, Lowcountry AIDS Services is reporting its highest number of positive HIV tests: 37 in 2015 compared to 20 positive tests in 2014. Page 1
Charleston residents should be alarmed by this statistic. Young people are engaging in behavior that puts them at a higher risk for contracting HIV. In 2013, more than 47% of high school students in South Carolina reported having had sexual intercourse. Of those who are sexually active, 40.9% did not use a condom during their last sexual intercourse. ₂ There are a number of reasons for the rising rates of HIV infection among youth in the Charleston region as well as around the United States. Some of it is related to socioeconomic disparities and higher rates of poverty, particularly among African-American youth. Sex education is largely absent from South Carolina schools, which leaves young people learning about sex from their friends, the Internet and the media. In addition, because AIDS doesn t seem as scary as it once did, it s just not something young people think about. They don t fear it and don t think it will happen to them. It s also important to note the large number of sexually transmitted diseases among South Carolina s youth. Of the chlamydia cases reported in 2014 in South Carolina, 87% were among those 29 and younger. Of the reported gonorrhea cases, 80% were among those 29 and younger. ₁ What does the high number of STDs have to do with HIV? According to the Centers for Disease Control, people who have STDs like chlamydia and gonorrhea are more likely to get HIV than people who do not have STDs. The same risky behaviors that put someone at risk for a STD also can put someone at a greater risk of contracting HIV. Plus, having a sore or break in the skin from a STD may allow HIV to more easily enter the body. ₃ ₁ South Carolina s STD/HIV/AIDS Data Surveillance Report December 31, 2014 www.scdhec.gov/health/docs/stdhiv/data/sr2014.pdf ₂ S.C. Department of Environmental Control www.scdhec.gov ₃ Centers for Disease Control and Prevention www.cdc.gov/std/hiv/stdfact-std-hiv.htm H I V I N T H E L O W C O U N T R Y: A H I S T O R Y For almost 25 years, Lowcountry AIDS Services has been in the trenches of the HIV epidemic. When the agency first started, AIDS was making headlines. The statistics were staggering, and those infected faced an almost immediate death sentence. It s been more than three decades since public health officials began tracking HIV cases in the United States. Since then, health researchers have been working to find a cure for AIDS and public health organizations like Lowcountry AIDS Services work to help those living with HIV/AIDS while also educating the public about the disease and preventive methods. ₁ Page 2
While no cure exists, the medical advances and introduction of antiretroviral therapy in the mid-1990s have made HIV a manageable illness. With proper treatment and medication, HIV patients can live out full and meaningful lives without the worry of an early grave hanging over their heads. In many ways, HIV/AIDS research has been a victim of its own success. In the 1980s and early 1990s, AIDS was the health-related cause of choice. Celebrities rallied around AIDS awareness, sporting red ribbons at awards shows and attending fundraisers. Thanks to those efforts, medical advancements were made and people were living longer and beginning to battle back HIV s progression to AIDS and early death. As the headlines faded and the red ribbons fell away, awareness about HIV/AIDS also took a backseat. The public heard less about AIDS so they cared less. Not because they were unsympathetic but rather apathetic because AIDS didn t seem like a big deal. And now in 2015, people often say, People still get AIDS? Yes, people still get HIV and AIDS. Every year about 50,000 people in the United States are newly infected with HIV a number that has remained steady for many years. Despite education and prevention efforts, the infection rates aren t dropping. ₂ In fact, the epidemic that was so widely publicized 30 years ago is still very much an epidemic today. And this epidemic isn t something that s occurring in third-world countries or only in major U.S. cities like New York and Los Angeles. This epidemic is taking hold right here in South Carolina and the Charleston region. According to the S.C. Department of Health and Environmental Control, as of December 2014, 16,222 people were reported living with HIV/AIDS in South Carolina. It s estimated there are another 18% more who are unaware of their HIV diagnosis. New data shows South Carolina had an 8.3% increase of newly diagnosed HIV/AIDS cases in 2013 and 2014 compared to the previous years. The Charleston/North Charleston metro area ranks 31st among all U.S. metro areas for the highest rate of new HIV infections. Those numbers are trickling down into the Charleston region as well. In 2013, the Centers for Disease Control and Prevention identified Charleston as an emerging community, defined as a metropolitan area for which there has been at least 500, but fewer than 1,000, AIDS cases reported to and confirmed by the CDC during the most recent five calendar years for which such data is available. ₃ According to the CDC, the Charleston/North Charleston metropolitan area ranks 31st among all U.S. metropolitan areas for the highest rate of new HIV infections in 2013. ₃ But when you look at the number of AIDS cases in 2013 in U.S. metro areas, Charleston drops to a ranking of 19th. That speaks volumes about the lack of medical access in our community. A person living with HIV Page 3
who doesn t have access to quality care or who isn t able to afford medication is more likely to develop AIDS. ₄ Enrolling individuals in health insurance plans or securing medical treatment provided by initiatives like the Ryan White Program are just the first step toward helping those who test positive for HIV. Housing, jobs, stability, mental health, support networks all of these are contributing factors to healthful outcomes for Lowcountry AIDS Services clients and all areas that agency focuses upon for each client. ₁ The AIDS Institute www.theaidsinstitute.org/education/aids-101/where-did-hiv-come-0 ₂ Centers for Disease Control and Prevention www.cdc.gov/nchhstp/newsroom/docs/factsheets/todaysepidemic-508.pdf ₃ HIV Surveillance Report www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport-vol20-no3.pdf (An area will remain an emerging community unless it fails to meet both of the following requirements for three consecutive fiscal years: (a) a cumulative total of at least 500 but fewer than 1,000 cases of AIDS reported to and confirmed by the director of CDC during the most recent period of five calendar years for which such data are available, and (b) a cumulative total of 750 or more persons living with HIV infection ever classified as AIDS reported to and confirmed by the director of CDC as of December 31of the most recent year for which such data are available.) ₄ South Carolina s STD/HIV/AIDS Data Surveillance Report December 31, 2014 www.scdhec.gov/health/docs/stdhiv/data/sr2014.pdf M O V I N G F O R W A R D I N 2 0 16 Looking at these sobering statistics, it is clear the work being done at Lowcountry AIDS Services is critical to combating this epidemic. Here s what Lowcountry AIDS Services is doing in the coming year to increase its prevention and education services: Lowcountry AIDS Services will continue to offer free HIV testing from 8:30 a.m. to 3:30 p.m. Monday through Thursday at its location in North Charleston. Testing is confidential and results are delivered in about 20 minutes. Lowcountry AIDS Services also does on-site testing in the community, including at local colleges. Provide critical case management services to those living with HIV. By helping people get proper medical care and adhere to their treatment and medication schedules, clients can become contributing members of our community. Connecting those who are newly diagnosed with HIV to care as well as working to reconnect those who have fallen out of care and still need medical treatment and help. Community outreach and education are key components of Lowcountry AIDS Services mission. It is imperative our community understands the severity of this disease. It can impact anyone of any race, sex, age or sexual orientation. Page 4
State of the HIV/AIDS Epidemic in Charleston Breaking down the stigma associated with HIV/AIDS is critical to preventing the spread of the disease. The Centers for Disease Control and Prevention estimates that one in eight people living with HIV does not know they are infected, which means they are potentially spreading the disease to others. Often people are too ashamed to get a HIV test. They would rather not know than face the stigma of this illness. Lowcountry AIDS Services is working tirelessly to sign up clients for health care coverage through the Affordable Care Act. In 2015, the agency enrolled 55 clients in a health care plan, and the goal is to enroll more than 70 clients in 2016. Helping clients continue to reduce their viral loads through access to health care, services and sustainable living situations, which helps lead to reduced transmission rates in our community. Expanded outreach to the most affected subsects of our community that have the highest HIV infection rates, including men who have sex with men (MSMs), African Americans and Latinos. Lowcountry AIDS Services will continue to work with community partners like the Medical University of South Carolina, Roper St. Francis, the S.C. Department of Health and Environmental Control and Lowcountry Infectious Diseases & Infusion Center to not only treat individuals living with HIV but also create new educational and preventive initiatives. W H AT C A N T H E C H A R L E S T O N C O M M U N I T Y D O? It s easy to read information and statistics like this and think there s no way to make an impact. Nothing could be further from the truth. In fact, there are many ways businesses, individuals and organizations can play a role in reducing HIV infection rates in our community, protecting our youth, ending the apathy surrounding AIDS and eliminating the stigma associated with the disease. Invite Lowcountry AIDS Services to your work, organization, school, church or civic group for a presentation on HIV education and prevention. Request safe sex packets from Lowcountry AIDS Services. The agency has educational materials and condoms available for free. Encourage local school districts to teach comprehensive sex education. It is important to teach abstinence as the foul-proof way to avoid STDs and unwanted pregnancies. Yet statistics tells us teenagers are choosing to have sex anyway so arming them with all the information abstinence and sex safe behaviors is critical. Get a HIV test. More than half of all Americans have never had a HIV test. ₁ The first step toward reducing HIV infection rates is stopping the spread of the illness that means people need to know if they are infected so they can not only get proper treatment but also take precautions so they don t spread the disease to others. Arm yourself with the facts. HIV can t be spread through toilet seats and drinking glasses. HIV/AIDS doesn t discriminate on the basis of race or socioeconomic status. While some groups may indeed face a higher risk, anyone who has unprotected sex or uses intravenous drugs is at risk. Page 5
Support the work of Lowcountry AIDS Services. Whether it s volunteering, financial donations or simply talking about the agency s work, you can be an advocate for change. ₁ Centers for Disease Control Fact Sheet: HIV Testing in the United States www.cdc.gov/nchhstp/newsroom/docs/factsheets/hiv-testing-us-508.pdf TA B L E S / C H A R T S Positive HIV tests 2011-2015 (data includes only those tests administered by LAS) Page 6
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Source: South Carolina s STD/HIV/AIDS Data Surveillance Report December 31, 2014 www.scdhec.gov/health/docs/stdhiv/data/sr2014.pdf Page 8
HIV Surveillance Report www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillancereport-vol20-no3.pdf (An area will remain an emerging community unless it fails to meet both of the following requirements for three consecutive fiscal years: (a) a cumulative total of at least 500 but fewer than 1,000 cases of AIDS reported to and confirmed by the director of CDC during the most recent period of five calendar years for which such data are available, and (b) a cumulative total of 750 or more persons living with HIV infection ever classified as AIDS reported to and confirmed by the director of CDC as of December 31of the most recent year for which such data are available.) Page 9
L O W C O U N T R Y A I D S S E R V I C E S For more information on this report, to schedule a presentation/testing event, host an event or simply learn more about ways the community can help fight HIV/AIDS, please contact: Lowcountry AIDS Services 843-747-2273 information@aids-services.com 3547 Meeting Street Road Charleston, SC 29405 Additional contacts: Media requests: Holly A. Fisher 843-991-1689 or holly@hafcreative.com Development/Volunteering: Jason Kirk 843-747-2273 or jkirk@aids-services.com This report was prepared by Lowcountry AIDS Services using the most current statistics and information available to date. Page 10