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The Many Faces of HIV

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April 10, 2002

with Linda Michal

In the early 1980s when AIDS was first identified as a disease and epidemic, the look of the infected people was well identified in the media. People with AIDS didn’t live long and there was significant fear in the general population about the disease, how it was spread and how to avoid it. Many people, especially in the U.S., felt that it was a gay man’s disease and not something they had to be concerned about.

Information finally spread that HIV/AIDS is not a disease that only gay men get and prevention efforts spread to the general population.

Today, with the advent of aggressive antiviral treatments, people infected with HIV/AIDS are living longer, don’t look like the early photographs of people with AIDS and the awareness of the disease, its impact and the importance of prevention are fading. Fading for those of us who are not impacted by the disease process, but not for the individuals, their families and friends who are continuing to face the challenges of the disease.

While the medications help prevent the HIV virus from multiplying as quickly and destroying the immune system, the medications can cost thousands of dollars a month and have many side effects. One man we found was taking 86 pills a day. However, the populations at risk don’t know or fully understand those facts.

According to Center for Disease Control Statistics presented by Jeff Lee, RN, STD, HIV/AIDS Program Coordinator from Panhandle Health District, in the United States there are:

·    Approximately 900,000 people currently living with HIV (1/3 are not aware they are infected)

·    450,000 people have died from AIDS

·    40,000 new infections each year (1 every 12 minutes)

·    50% of all new cases are 13-25 years old

·    Young women (ages 14-25) are the fastest growing population being infected with HIV.

    Many people believe this is a disease that only infects people who live in the city. However, it is definitely a disease that knows no boundaries. While the numbers are not as large, the infection is present in many of our rural localities.

In Montana in 2000, there were 23 new people who tested positive for HIV and 20 newly reported cases of AIDS, according to Margaret Souza, STD, HIV/AIDS Public Health Specialist. In the Idaho Panhandle in 2001, Mr. Lee reports that there were 5 newly reported HIV cases - over 75% of them were in heterosexual individuals.

    “Because of our rural nature statistics take longer to catch up with the rest of the country” said Souza “and far more woman than in the past are being reported. There have been 66 women (in Montana) infected; 13 from IV drug use, 39 from heterosexual contact, 10 undisclosed, and four transfusions. The transfusion cases were early cases."

    HIV is now a preventable disease. Early in the epidemic, people didn’t really know how the disease was spread. Now we do and we can each take responsible steps to protect ourselves from this problem. We can control the risky behaviors that we engage in, yet we may not always be sure of the behaviors of our partners. One of the prevalent factors is in the newly identified female cases is that they have had sexual partners that have either been, or are, IV drug users or men who have sex with men. Often, especially in rural areas, men will not identify themselves as gay and yet be engaging in sex with other men. They may be bisexual or still attempting to live the heterosexual lifestyle.

    Panhandle Health District (PHD) and the North Idaho AIDS Coalition (NIAC) are agencies that are actively pursuing prevention of HIV infection. Both organizations offer testing for HI. PHD offers confidential testing at each of its offices in Kootenai, Bonner and Boundary counties. In addition to doing the test, they offer client-centered counseling and risk reduction information to individuals. Services are charged on a sliding fee schedule. In Idaho, anyone 14 or older may come in for confidential services, including information and testing by calling the office for an appointment. “Eighty percent of all sexually transmitted diseases (STD’s) occur in the 14-25 year old age range and there is a five- to ten-fold increased risk of HIV transmission with another STD present,” says Lee.

    NIAC is a non-profit organization serving the five northern counties. They are primarily funded by grants and private donations.

    The Center for Disease Control realized that to combat this epidemic a partnership with public health and community- based organizations was needed. NIAC is one of those community- based organizations. Their focus is prevention, care and advocacy for people affected by or infected with HIV/AIDS. NIAC director, Keith Wolters, MS, is passionate about the work that he does and the mission of the organization. He is willing to be creative in the approaches needed to reach out to the people most at risk. He is very positive about the working relationship with PHD and the coordination of efforts they maintain.

    “ Some people are not willing to go to the health district for testing and counseling and will come to a community office instead,” Wolters says. 

    A major focus of the work that NIAC is involved with is community building. “If you can create a sense of community amongst a population, you can improve your outcomes,” says Keith. “If someone is feeling isolated and depressed, the risky behaviors they might engage in are not their first concern. If you have an IV drug user who is addicted and needing a fix, they don’t care if it takes sex or a dirty needle to get one," he continued. "The community building helps to establish community norms about healthy behaviors and choices to avoid risky behaviors within a group of people that can provide continue support."     "While the ideal would be to have people not engage in any risky behavior, any risk reduction is better than none,” says Dani Mahoney, BSW. Dani is the NIAC employee whose focus is risk reduction and education with populations at risk, including youth, IV drug users and women.

    Terry Davis, Positive Power Coordinator with the Spokane AIDS Network, is partnering with NIAC to do empowerment groups for people infected with the virus. Again, community building is a focus. As Terry says, "If people don’t have food, access to medical care or social support, they are not apt to be taking care of themselves and making healthy choices."  The object of the group includes how to disclose having HIV, negotiating safer sex, and dealing with isolation, depression and medications. Tarena Coleman, LSW working with NIAC provides case management services on an individual basis and also helps people with those issues.

    Access to medical care in our area is challenging for people. Keith reports that there is a new grant to fund an HIV/AIDS clinic with the Community Health Association of Spokane (CHAS) clinic in Spokane for eastern Washington and North Idaho people infected with the virus. If you or someone you know needs help because they are infected with the virus, contact NIAC. In addition to direct services and risk education, NIAC also provides community education. They are able to speak to your organization about HIV/AIDS general education, risk reduction and or care related issues.

    “A donation to NIAC is a social investment,” says Wolters. He is proud of the fiscal management of the organization and is looking to expand local fundraising efforts in order to support the continued need for services. NIAC is available to help anyone in the five northern counties of Idaho.

    HIV/AIDS is a disease of many faces. You can prevent this infection if you don’t already have it, you can get treatment and support if you do have it and you can be a compassionate and responsible neighbor to those you know who may be impacted in any way by this infection. To get information, contact any of the following numbers for confidential information and services.

Panhandle Health District

·    Kootenai County  208-667-3481

·    Bonner County 208-263-5159

·    Boundary County 208-267-5558

NIAC   208-665-1448

Sanders County Health Dept.406-827-4397

Mont. STD, HIV/AIDS Info Line 800-233-6668 toll free

Centers for Disease Control and Prevention

Montana Dept. of Health & Human Services  click link and then choose Health & Human Services

Idaho Aids resource


    Linda Michal is a nurse practitioner and writer. Ernie Hawks is her teachable partner.

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Author info

Ernie Hawks Ernie Hawks is a former theater director who has branched into the creative fields of writing and photography. He lives in a cabin in Athol with his lovely wife Linda, and feeds the birds in his spare time.

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