Last year, 225 new cases of HIV infection were diagnosed in Wisconsin, according to the Wisconsin HIV/AIDS Surveillance Annual Review for 2015.
That number is lower than the average of 247 new cases reported per year in Wisconsin over the past decade. But it’s slightly higher than the 221 cases recorded in 2014, when Wisconsin recorded the ninth lowest HIV-infection rate in the nation.
The 2015 review also showed ongoing disparities in new infections among men who have sex with men and people of color. Men in the state acquired the infection at 7 times the rate of women last year, with 196 new cases reported among males, compared to 29 among females.
Sixty-two percent of the new cases were among racial and ethnic minorities, even though they make up only 17 percent of the state’s population. From 2011 to 2015, the HIV infection rate among black males has been 16 times the rate among white males. Hispanic males have acquired the disease at 6 times the rate of white males during the same period.
Among women, the infection-rate disparity was even higher: African-American females were infected at 25 times the rate of white women, and Hispanic women were infected at 8 times the rate.
The infection rate for men who have sex with other men was the highest of all groups, accounting for 80 percent of all new diagnoses last year. Half of the men who were infected through gay sex were under 30 years old.
“This report demonstrates the importance of continuing to focus on the still-fatal AIDS epidemic, and especially its disproportionate impact on some of the most vulnerable members of our communities, said Michael Gifford, CEO and president of AIDS Resource Center of Wisconsin, in a prepared statement.
“We’ve got the tools to turn the tide,” said Bill Keeton, ARCW vice president of government and public relations. “We’re already seeing it.”
One of ARCW’s most promising tools is its PrEP clinic. PrEP is an acronym for “pre-exposure prophylaxis.” People using PrEP simply take an anti-retroviral pill once daily to protect them from acquiring HIV infection.
The strategy reduces the infection rate among at-risk people who don’t use condoms or don’t know the HIV status of their partners.
If every HIV-negative person in an at-risk community was on PrEP, and every HIV-infected person in an at-risk community was on medications that suppress the amount of virus in their blood to undetectable levels, then the community could become free of the virus.
“It’s going to take a while for people to understand it and get comfortable with it,” Keeton said.
Currently ARCW has about 60 individuals enrolled in PrEP, although there are probably more who are receiving the treatment through private physicians.
On gay online hook-up sites in many cities across the country, men are listing their HIV status either as “on PrEP” or “undetectable.” Still, epidemiologists warn that using condoms and adhering to safer-sexual behavior is the only way to ensure that you will not become infected or infect others.
“With PrEP and unfettered access to health care, (we’re) definitely moving in the right direction,” Keeton said. “The trend is good.”
“We’ll start to see the impact of the PrEP programs in the surveillance report that comes out a year from now,” he predicted.
In the meanwhile, ARCW has its work cut out for it. More than 7,900 people in the state are living with the virus, and the overwhelming burden of HIV disease is among young men and people of color, according to Gifford.
ARCW is working to provide comprehensive wrap-around services, which includes everything from finding a job and a place.
The AIDS Resource Center of Wisconsin is recognizing World AIDS Day by highlighting the opening of its newest HIV medical home in Madison.
The ARCW HIV medical home provides integrated medical, dental and mental health care along with a pharmacy and critical social services to make sure people with HIV have all the tools they need to live a long, healthy life with HIV, according to a news release.
“World AIDS Day is a day set aside to remember the countless number of loved ones we have lost, to support the thousands of people living with HIV today who need access to health care and treatment and to rededicate ourselves to doing all we can as individuals and as a society to eliminate new infections from occurring,” ARCW president and CEO Michael J. Gifford stated. “The opening of new medical home in Madison and our ongoing dedication to expanding HIV prevention and testing services to all who need them everywhere in Wisconsin are just two of the ways we mark this solemn and important day.”
ARCW also is offering access to pre-exposure prophylaxis, also known as PrEP, as an integral component of its health care and prevention services. PrEP works by providing HIV-negative individuals who are at high risk for contracting HIV with the same medication used to help HIV-positive individuals successfully minimize the amount of the virus they have in their body.
PrEP has been shown to be more than 90 percent effective at preventing new HIV infections when used correctly. Combined with access to health care, regular testing and other HIV prevention strategies such as condoms, PrEP provides people with a game-changing way to stop HIV.
“Today, unlike the first World AIDS Day, we have the tools and medical science to provide patients with a long, healthy life with HIV disease and to stop new infections from occurring almost completely. What we still need now is what we needed then — the collective will from our private and public leaders to join us and seize upon the opportunity we have before us,” Gifford stated. “There is much to be excited for as we look forward to a world in which everyone with HIV has unfettered access to health care, in which new infections are truly rare, and where people with HIV no longer face the stigma that helps to drive this epidemic forward.”
HIV patients and people at-risk for HIV who would like to learn more about ARCW programs and services designed for them can visit www.arcw.org, call 800-359-9272 from anywhere in Wisconsin or contact their local ARCW office by using http://www.arcw.org/locations/.
Wisconsin’s two out members of congress, Sen. Tammy Baldwin and Rep. Mark Pocan, have introduced a bill in their respective chambers that would increase services and access to care for people with HIV/AIDS.
The HIV Clinical Services Improvement Act would make HIV clinics, including the AIDS Resource Center of Wisconsin, eligible to receive the same Medicaid reimbursement rates as what are known as Federally Qualified Health Centers. Currently, HIV clinics receive substantially lower reimbursement rates for providing the same high quality health care.
“Senator Baldwin and Representative Pocan’s leadership is truly commendable,” said ARCW president and CEO Michael Gifford, in a statement to the press. “Today in the United States, the difference between a long, healthy life or rapid disease progression and significant illness for HIV patients is having a primary care physician who is knowledgeable about treating HIV disease. This bill will make sure that more Americans with HIV have access to this care.”
At the heart of the nation’s AIDS strategy is getting everyone to know their HIV status and to get into treatment quickly if they test positive. Suppression of the virus can prevent carriers from passing it on to others.
Bill Keeton, ARCW’s vice president for government and public relations, said that viral suppression has been achieved by 86 percent of ARCW patients, along with 75 percent of HIV patients in other federally funded clinics throughout the nation. Increased funding under the bill that Baldwin and Pocan introduced will provide more patients with the specialized care and services that make such results possible.
More than one million people are living with HIV in the United States today, but only 30 percent of them are achieving viral suppression.
“This legislation will ensure that clinics across the country have the resources they need to provide health care to their existing 275,000 patients and their share of the 50,000 Americans who are newly diagnosed with HIV every year,” Keeton said. “While the number of patients turning to our clinics has increased 74 percent since 2001, federal funding … has increased only 8 percent. If we are to defeat HIV and realize an AIDS-free generation, we must make sure all HIV patients – no matter where they live – have access to care.”
The AIDS Resource Center of Wisconsin is honoring philanthropists Will Radler and Susie and Cary Silverstein and more than 25 social work case managers who work with HIV patients. The awards will be presented during the 28th annual Make A Promise gala on April 26 at the Wisconsin Center. “Our award recipients for 2014 truly embody the Make A Promise tradition,” said ARCW president and CEO Mike Gifford. “These individuals are all leaders who saw a better way forward in improving the lives of people with HIV and acted on it.” For more, go to arcw.org.
Milwaukee philanthropist Bill Radler, developer of the world’s best-selling rose, announced a $1 million donation to the AIDS Resource Center of Wisconsin during a press conference this morning. The largest gift ever received by ARCW from an individual, the donation was announced to coincide with National Philanthropy Day, held each year on Nov. 15.
Radler’s donation, to be spread out over the next three years, will help to fund ARCW’s mental health services. “Over the years, I have come to realize how precious and important mental health is,” Radler said. “The brain needs the body to be healthy. How can you achieve health if you are not mentally well?”
Radler has been an ARCW donor since 1992.
Mental health is a critical component of HIV/AIDS care, but one that needs more attention, said Kevin Roeder, ARCW director of behavioral health and wellness. Roeder estimated that Radler’s gift would allow ARCW to provide clients with 60 hours of psychiatric care per week, meaning counseling for 300 to 600 patients.
Half of Americans who are living with HIV have a diagnosable mental illness, including depression, Roeder said. And half of those, he added, have an alcohol and/or substance abuse problem.
Patients’ mental health problems often prevent them from achieving the strict adherence to their medication regimen that’s required to keep their viral loads undetectable. Maintaining a level of virus that’s beneath detectability does not mean that patients are cured, but it means less damage to their immune systems and much less likelihood of them spreading the virus to others.
Roeder said if patients miss as few as two days of pills in one month, they can develop resistance to the medication they skipped.
“Will’s generosity will allow ARCW to hire a full-time psychiatrist for our patients,” said ARCW president and CEO Mike Gifford. “Will’s gift is breaking down barriers to care and ensuring our patients have the best chance for long-term survival with HIV.”
Radler said he hopes his gift will inspire others to contribute to the ongoing HIV/AIDS epidemic, which in Milwaukee disproportionately affects young gay and bisexual men of color.
“This crisis is not over,” Radler said. “Don’t turn away from it, return to it. Invest in it. There’s never been a better time, because success can be achieved on so many levels now.”
More than $1.9 billion in grants have been awarded to cities, states and local community-based organizations for fiscal year 2013, the U.S. Department of Health and Human Services announced on Oct. 30.
The funding, according to a news release, will help to provide people living with HIV/AIDS continued access to health care services and medications. The awards were funded through the Ryan White HIV/AIDS Program.
“The Ryan White HIV/AIDS Program plays an important role in the fight against HIV/AIDS,” stated Secretary Kathleen Sebelius. “These grants will help make a real difference in the lives of Americans coping with HIV/AIDS, especially those in underserved urban and rural communities.”
The Health Resources and Services Administration, an agency within HHS, oversees the Ryan White HIV/AIDS Program, which provides funding for health services for people who lack sufficient health care coverage or financial resources to pay for treatment.
“The Ryan White HIV/AIDS Program helps more than half a million individuals each year obtain clinical care, treatment and support services,” said HRSA administrator Mary K. Wakefield. “The key to its success is the cities, states and community groups who know their populations and decide how best to allocate the funding they receive.”
A total of $594 million was awarded to 53 cities to provide core medical and support services for individuals living with HIV/AIDS under Part A of the Ryan White HIV/AIDS Program. These grants are awarded to eligible metropolitan areas with the highest number of people living with HIV/AIDS and to areas experiencing increases in HIV/AIDS cases and emerging care needs.
About $1.16 billion was awarded for FY 2013 to 59 states and territories under Part B of the Ryan White HIV/AIDS Program. Part B grants include grants that can be used for home and community-based services, AIDS Drug Assistance Program assistance and other direct services.
Wisconsin received $8,662,447.
For FY 2013, about $178 million was awarded across the country to 357 local community-based organizations to provide core medical and support services to individuals living with HIV/AIDS under Part C of the Ryan White HIV/AIDS Program. Currently 351 Part C grantees are providing ongoing services. Part C grant recipients provide comprehensive primary health care in outpatient settings to people living with HIV disease.
In Wisconsin, awards included:
• $469,713, Milwaukee Health Services.
• $531,980, University of Wisconsin System.
• $485,624 AIDS Resource Center of Wisconsin.
• $392,884 16th Street Community Health Center.
The U.S. Department of Health and Human Services has awarded a three-year, $1.2 million grant to the AIDS Resource Center of Wisconsin and Community Advocates to expand alcohol and substance abuse services, along with HIV and Hepatitis C prevention efforts, targeting African-American women in Milwaukee.
Although African Americans represent 27 percent of Milwaukee County’s population, they accounted for half of the county’s new HIV infections reported last year. Their risk for contracting the virus is 25 times greater than that of white women.
According to studies, substance abuse plays a major role in fueling new HIV infections, and African-American women are at increased risk for substance abuse. In Milwaukee County, more than 7,500 African American women need substance abuse treatment, according to a press statement issued by ARCW.
The three-year, federally funded collaboration between ARCW and Community Advocates is projected to reach 9,900 women and to conduct 600 HIV and 800 HCV tests while providing alcohol/substance abuse treatment and counseling for 492 women. Services offered under the grant award will begin during spring 2014.
“Through this strategic partnership with Community Advocates, we will be able to help African-American women in Milwaukee access the medical and mental health services they need to overcome addiction and stay safe from HIV,” said ARCW president and CEO Mike Gifford.
“We know behind the data and statistics are real women and families impacted by this issue, said Joe Volk, CEO of Community Advocates. “The need for this type of collaboration is apparent in the community, and we are committed and glad to be working with partners like ARCW who are equally committed to addressing this issue.”
According to the National Survey on Drug Use and Health, Milwaukee ranks seventh in the nation for urban areas in past-month binge drinking and first in the percentage of people with past-year alcohol abuse or dependence. Alcohol abuse by women of childbearing ages is 68 percent in Milwaukee compared with 50 percent nationally.
Health care costs for drug-related hospitalizations in Wisconsin totaled $287 million in 2010, an increase of 126 percent from the $127 million in 2002.
Young gay and bisexual African-American men continue to be hardest hit by the HIV/AIDS epidemic in Wisconsin, according to the most recent data from the Wisconsin Department of Health Services.
During 2012, 241 new cases of HIV infection were diagnosed in the state, with 70 percent occurring among gay and bisexual men. About 48 percent of the new infections were in Milwaukee.
Forty-two percent of diagnoses in Wisconsin occurred among blacks, 40 percent among whites and 14 percent among Hispanics. Asians and multi-racial individuals each accounted for 2 percent.
In Wisconsin, an estimated one in four African-American gay and bisexual men are infected with the virus that causes AIDS. That compares with 3 percent of white – and 7 percent of Hispanic – gay and bisexual Wisconsinites who are infected, according to the latest report.
The rate of new infections among men under 29 was nearly double that of men over 30, and age disparity was particularly pronounced for African-American men. The median age at diagnosis was 26 for black males, compared to 32 for white and Hispanic males. The median age of African-American females at diagnosis was 38, compared with 42 for whites.
While the rate of HIV infections in Wisconsin declined by nearly 60 percent from 2003 to 2012 among heterosexuals and injection drug users, the rate among gay and bisexual men in the state stood at nearly the same level in 2012 as it did in 2003.
“HIV continues to disproportionately impact young people, people of color, gay men and low-income individuals,” said Mike Gifford, president and CEO of AIDS Resource Center of Wisconsin. “We must direct HIV prevention resources to help these communities, especially young people under the age of 25 who now make up 24 percent of new HIV infections in our state.”
Current prevention efforts in Milwaukee are focused largely on expanding testing and getting people into treatment and care as quickly as possible, ARCW spokesman Bill Keeton said.
Fighting HIV is an uphill battle in Milwaukee, which is “one of the STD capitals of the United States,” Keeton said. Public health officials have identified a strong link between the occurrence of HIV and other sexually transmitted diseases.
“Historically, half of the HIV cases in Wisconsin have been in Milwaukee, while we have only about one-fourth of the state’s total population,” he said.
ARCW provides primary medical care along with a full spectrum of support services to many of the 6,549 people living with HIV/AIDS in Wisconsin.
The U.S. Centers for Disease Control and Prevention estimates that nearly 20 percent of people with HIV, the virus that causes AIDS, are unaware of being infected. ARCW spokesman Bill Keeton said those people are responsible for the majority of new infections, because people who know their HIV status are more likely to curb risky behavior that can infect others and to take medications that lower the level of virus in their bodies, which in turn reduces their ability to transmit the disease.