David Sweat is chief of the Shelby County Health Department’s Office of Epidemiology and Infectious Diseases.
As part of the Positive While POZitive project by The New Tri-State Defender, Sweat laid out the numbers of those living with HIV/AIDS In Shelby County.
According to the health department, there were 6,481 people in Shelby County living with HIV/AIDS in 2016.
“We test more than 40,000 people each year,” Sweat said.
The county rate of people living with HIV is 690, which is three times higher than the state’s rate, and twice as high as the national rate.
Of those 6,481 people, 4,484 were men. Forty-two percent of those were men who’d had sex with other men. Sweat said black males ages 15 to 30 are a challenging population for the health department to reach.
That’s not only true in Shelby County, but across America as well.
“Don’t care who you are or how old you are – men are not good at accessing healthcare,” Sweat said. “They look fine, they look healthy, they don’t feel bad.”
Being black and poor doesn’t help, either, Sweat said.
“In areas of high poverty, you tend to see more HIV rates and sexually transmitted disease – especially in the Southern part of county,” Sweat said.
According to aidsvu.org, a site that keeps data on persons living with HIV based on where they call home, Frayser is an HIV hotspot. Data show that approximately 1,119 in Frayser were people were living with diagnosed HIV.
“It’s more about behavior more than where you reside,” Sweat said.
Friends For Life counselor Mildred Richard said HIV isn’t really talked about in areas like that. Sex education is often limited, and still taboo conversations in families.
“For each individual, especially those who know they’re at risk, that can be a scary moment,” Sweat said.
The number of people contracting the virus has decreased, thanks to prevention efforts by the health department.
Since 2012, Sweat said, there has been a 31 percent decline in infections, and it’s been steadily dropping over the past five years.
“About five years ago, 70 percent of cases were male, 30 percent female,” Sweat said. “Now it’s about 80 percent male, 20 percent female. So we’ve seen a decline in transmission, particularly to women.”
Sweat hopes for even more of a decrease in Shelby County.
“Part of what’s contributing to the decline in infections is Shelby County applied for Ryan White Part A Funding – and we got it,” Sweat said.
The Ryan White HIV/AIDS Program is a federal initiative that helps HIV patients pay for treatment they might not otherwise be able to afford. It was named after Ryan White, an Indiana teenager who was diagnosed with AIDS after a blood transfusion in 1984.
Income-based, the program could cover most, if not the entire cost of medicine and doctor visits needed.
“When someone gets infected, we focus on linkage and retention to care,” Sweat said. “Our goal is to get patients to zero,” he said, referring to a 2017 report from the Centers for Disease Control and Prevention that equated having an undetectable viral load with being unable to transmit the virus.
Other HIV treatment and prevention efforts included PrEPcq (pre-exposurecqcq prophylaxis).
PrEP is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day.
“It’s a drug someone who’s HIV negative can take that in case you encounter the virus, your body is ‘super charged’ to ward it off,” Sweat said.
The regimen is similar to regimens for people who are HIV positive. But the PrEP regimen doesn’t make a person immune to the virus.
“That’s the strategy – people who are high risk – we get them on PReP; those who are infected, we get them to zero,” Sweat said. “Those are the things that help drive down the amount of new cases.”
Although the Shelby County Health Department doesn’t offer treatment, Sweat said the department’s partnerships with local organizations such as Friends For Life, Shelby County Schools and St. Jude Children’s Research Hospital who help lead patients to medical care or provide it.
The department, staffed with disease-intervention specialists, is charged with helping people explore treatment options to lead a healthy and happy life.
Sweat said the focus of his department is a simple one for people who are living with HIV/AIDS:
“What does that mean for you now, and where do we go from here,” Sweat said. “Getting people in care, maintaining the care, keeping them virally suppressed – those things have been big efforts.”
The CDC recommends everyone get tested once a year or every six months if you’re at high risk. The Shelby County Health Department offers free testing at the Packer Clinic at 814 Jefferson Avenue in Memphis.