Continuing to Fight HIV Together
ANGELITA BROWN, MS | HIV TESTING & PREVENTION PROGRAM MANAGER
As a young African American woman living in New Orleans, I began my career working as a career counselor at several of the local colleges and universities. I found myself yearning to make an impact in the city that I affectionately called home. I was a transplant and loved the city of New Orleans, but at the same time I was very troubled by the extreme disparities I witnessed such as: high poverty rates; lack of medical care outside of, at that time, the charity system for the disenfranchised; and the failing public educational system serving more than 95% African American students. As a result, I found myself seeking employment in what was at the time one of the most controversial epidemics in the world - HIV/AIDS. I have always had great compassion for African American women who are mothers and who are extremely disenfranchised by the mere challenges of life, and at the time the added challenge of living with HIV was very intriguing and I felt drawn to this field when the faces of HIV were changing to include African American women and children. I approached this with very little knowledge of the disease and I certainly had no idea of the future impact it would have on the world. When I began, it was unimaginable that some of the outcomes of this epidemic would result in the creation of movements, policy change, changed approaches to standards of care and, unfortunately, another burden on the African American woman who had to either bare or be at risk for baring this disease.
I began my career in HIV more than 25 years ago working at the Pediatric AIDS Program, the only program at that time serving women, infants, children, adolescents and families who were either infected or affected by HIV. The early days of this epidemic were not forgiving. My colleagues and I attended funerals on a regular basis (sometimes 2-3 per month) and saw clients ranging from infants to toddlers to children to adolescents and adult women. Some of the adolescents were mothers themselves, just wanting to live long enough to see their children graduate from kindergarten. I vividly recall a young mother who was living with HIV and was only 19 herself. Although she yearned for it, unfortunately, she didn’t make it to see her baby boy graduate kindergarten. At that time as a Case Manager, my termination plan was preparing for my clients’ death and making sure that they were able to have appropriate housing, food, medical care and services for their families. Fortunately, at that time through activism and efforts of the city and state, the resource pool and services specifically for people diagnosed with HIV began expanding. With funding through the Ryan White HIV/AIDS Program, the Centers for Disease Control and Prevention (CDC) and other funding sources, the city of New Orleans was able to provide resources to People Living with HIV/AIDS (PLWHA) that many cities were still lacking.
Fortunately, as I have had to witness the evolution of HIV in our community, nowadays the deaths due to complications from AIDS have decreased tremendously. With the advent of new medications and approaches to treatment and prevention such as Pre-Exposure Prophylaxis (PrEP), new movements are arising, such as “Ending the Epidemic (EtE)” and “Undetectable=Untransmittable (U=U).” EtE began in 2013, in New York when the state brought together community folk and public health officials for an initiative to end HIV/AIDS as an epidemic. Then in 2014 New York made a groundbreaking announcement by publicizing an EtE plan built around Treatment as Prevention, PrEP and increased testing. Louisiana has recently joined the EtE movement, which is being led by the Office of Public Health’s STI, HIV Prevention program (SHIP) and other key organizations including our own, the Institute of Women & Ethnic Studies (IWES). We currently have two active members on the statewide EtE planning committee, myself and Michael Chancley. Another movement impacting today’s approach, prevention as treatment, is U=U. In 2017 the CDC confirmed that if a person living with HIV has an undetectable viral load then that person is unable to transmit the HIV virus to another person, in other words, they are noninfectious, U(undetectable)=U(untransmittable).
Yes, it is a new day in the HIV arena, and I say that cautiously because, unfortunately, the burden of the disease is still high among the African American community. According to the CDC, without medical care, HIV still leads to AIDS and early death. They state that in 2015, approximately 17,670 African Americans received a diagnosis of HIV infection. Overall, they estimate that African Americans represent more than one-third (40% or 498,400 persons) of all people living with HIV and almost half (45% in 2015) of all persons with newly diagnosed infections. African American women in 2015 made up 11% of all persons diagnosed with HIV and overwhelmingly represented 61% of all women diagnosed with HIV.1 Overall since the HIV/AIDS epidemic began, almost 675,000 people with AIDS in the U.S. alone have died, and nowadays almost 13,000 people die each year in the U.S. due to complications related to AIDS.2
With that being said it is crucial for those of us who are in the field or considering getting in the field to continue fighting HIV together with compassion as if these strives haven’t taken place. We must not get complacent if we are going to truly End the Epidemic!
1. U.S. Department of Health and Human Services, Centers for Disease Control & Prevention, HIV Among African Americans: CDC Fact Sheet. February 2017. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/cdc-hiv-aa-508.pdf
2. U.S. Department of Health and Human Services, Centers for Disease Control & Prevention, Today’s HIV/AIDS Epidemic: CDC Fact Sheet. August 2016. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/todaysepidemic-508.pdf