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Ken S. Ho, MD, MPH

Over the years, treatment for people who are HIV positive has gotten better. Though there is still no cure for HIV, people can better control how the infection affects their bodies by using drugs that suppress the virus. But even with advances in medications, HIV prevention is still a high priority for public health advocates and health care providers.

In 2016, the Pennsylvania Department of Health documented 127 new HIV cases, and an estimated 2,910 people lived with HIV in Allegheny County. Allegheny County has the second-highest number of new HIV cases and people living with HIV in Pennsylvania. Centers for Disease Control and Prevention (CDC) 2016 data show that Blacks/African Americans accounted for 44 percent of HIV diagnoses, though they comprise only 12 percent of the population of the United States.

One organization dedicated to HIV/AIDS care and prevention in Allegheny County is AIDS Free Pittsburgh. The AIDS Free Pittsburgh initiative began on December 1, 2015, as a partnership between UPMC and Allegheny Health Network. AIDS Free Pittsburgh does not provide services. It raises awareness about HIV/AIDS and collaborates with the many partners in the region that provide services to people with HIV/AIDS or to high-risk negative communities.

According to Sue Steele, project coordinator with the Jewish Healthcare Foundation, the fiscal agent for AIDS Free Pittsburgh, the organization’s mission is to have no AIDS diagnoses in Allegheny County and to reduce the rate of new HIV infections by 75 percent by 2020. Ms. Steele says AIDS Free Pittsburgh hopes to accomplish this mission through three goals:

1. Normalizing HIV testing—make HIV/AIDS screening routine in medical settings

AIDS Free Pittsburgh states that, in 2015-16, only 39 percent of adults in Allegheny County reported having ever been tested for HIV. Early HIV detection and treatment dramatically reduce the transmission of new cases. (Readers can visit http://aidsfreepittsburgh.org/hiv_testing.php to find a list of free HIV testing locations.)

2. Increasing access to PrEP—establish ways to prevent HIV transmission, including education about PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis)

PrEP is a daily pill that can help lower chances of getting infected with HIV or stop the infection from spreading. CDC reports that taking PrEP as prescribed reduces the risk of getting HIV from sex by more than 90 percent.

“Truvada, also known as PrEP, was approved by the Food and Drug Administration in 2012 and is quite effective,” says Ken S. Ho, MD, MPH, assistant professor of medicine at the University of Pittsburgh. (Dr. Ho also conducts studies about PrEP and other HIV-prevention tools. Information about two such studies can be found elsewhere on the page.) “People at high risk who should at least have PrEP offered to them are men who have sex with men and transgender women, heterosexual men and women and injection-drug users. We need to do better with targeting people who are at high risk.”

However, a disparity exists in who benefits from PrEP. CDC data suggests that PrEP is not reaching most Americans who could benefit, especially people of color. Forty-four percent of people who could potentially benefit from PrEP for HIV prevention are African American, but only 1 percent of those were actually prescribed PrEP in 2015.

“A lot of people are on PrEP, but they’re mostly white men with insurance,” says Dr. Ho. “But we look at where new HIV infections are coming from—youths and men of color who have sex with men. These are not the groups who are usually on PrEP. So now we’re looking at how best to target the groups at high risk for HIV and make PrEP available to them.”

PEP (post-exposure prophylaxis) is 28 days of HIV medication that can be taken to protect against infection. People have to start taking the medicine within 72 hours (about three days) after a suspected or known exposure to HIV. (Readers can visit http://www.preppgh.com to find an online directory of local PrEP and PEP providers.)

3. Improving linkage to care—helping people who are diagnosed with HIV get quick access to high-quality health care

AIDS Free Pittsburgh can be a first step for people who are HIV positive or at high risk for HIV exposure. The organization and its partners meet regularly to coordinate services and find the best way to find help for people living with HIV. The Ryan White HIV/AIDS program provides a comprehensive system of care that includes primary medical care and essential support services for people living with HIV who are uninsured or underinsured. Most of all, Ms. Steele wants people to know that there are safe places for people to go.

“There’s no reason why anyone who is HIV positive shouldn’t get treatment at a place where they feel comfortable,” she says. “If people are trying to prevent or treat HIV, there are services, regardless of the situation. AIDS Free Pittsburgh can help break down barriers to care or treatment for any individual.”

 

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