Thirty years ago, a HIV-positive diagnosis was a death sentence, and gay men and IV-drug users were most likely to get infected.
Today, the demographics of infection have changed a lot, and advancements in drug treatment that make HIV a "chronic disease" have created a new set of problems.
WUSF’s Florida Matters is sharing stories from the Health New Florida series HIV in Florida: The Rising Tide of Infection.
University of South Florida physician Diane Straub is medical director at the Ybor Youth Clinic, which serves at-risk youth in the Tampa area.
She told Health News Florida Editor Mary Shedden about how young people infected now with HIV are facing different challenges and a different reality than Floridians infected decades ago.
What are some of the misconceptions that still exist around HIV infection and transmission?
Straub: “I think people believe that you have to be an IV drug user or gay to get it, a, and while those certainly are the highest numbers, those are certainly not the only ones who get it.
“I think it’s interesting how little relevance people see related to it anymore. I was telling somebody recently that I work with kids that are HIV positive, and they were like, ‘Really? Are there very many of those anymore? I didn’t think HIV was a big deal anymore.’ And I was just astounded by that response. So clearly, I think in terms of education, it’s become less relevant because people think there is less of it, and it’s become less relevant because it’s not scary anymore.”
The rates of new infection increased about 12 percent over the past year. Do you have any sense of why that may be, and what does that say to you, as someone who has been watching?
Straub: “I think it says that we are not investing in prevention. In other states, there’s a lot more effort going into preventing HIV. A lot of states are talking about ‘Let’s make it zero.’ …For instance, New York was the number one state before us and their governor has put a lot of effort and money into it. So there have been needle exchange programs, quite a few different programs that have really attacked HIV transmission rates. And it works. And we have not had that same commitment here in Florida to decrease the rates of HIV infection.”
In 2014, 428,000 were tested for HIV through county public health departments. That’s significantly more than ever before. And 5,377 Floridians were diagnosed with new infections, the highest number in the country. Why are the numbers up and continue to increase?
Straub: “The biggest driver right now with new HIV infections is young men who have sex with men. This generation of YMSM did not see all of their friends die from AIDS. They think of HIV as a chronic disease. I’ve given an HIV diagnosis and actually had a kid say, ‘Oh well, I knew I was going to get it eventually. At least I don’t have to worry about it anymore.
So there also are a lot of barriers when you get a positive HIV test. You have to disclose to your family, whoch often means disclosing your (sexual) identity. And there is a lot of homophobia, which makes it very difficult to do. There are a lot of barriers of getting into the medical system. Once you get into the medical system, you have to actually get the medication and they are very expensive. And then adhering to the medication can be very difficult. So it’s a long process from HIV diagnosis to getting virally suppressed.
And when you’re not virally suppressed, and you are still having sex, you’re spreading it to others. So a lot of the emphasis in recent years has been to not just testing, but also to getting them treated. Because that is where we are going to prevent transmission.
Mary Shedden is a reporter for WUSF in Tampa. WUSF is part of Health News Florida, which receives support from the Corporation for Public Broadcasting.
