New HIV/AIDS initiative pending clarification

Mary Botello has helped more than a dozen people with AIDS die comfortably and with dignity.

The Comfort House administrator began volunteering at the McAllen hospice in 1999 and has been working with the terminally ill since then.

Botello, who said her specialty was caring for AIDS patients, remembers the 1980s as a different time.

“Back then we didn’t think we would ever see anyone in the Valley with the disease,” she remembers almost incredulously. “We thought it wouldn’t affect us.”

Almost three decades later, there are nearly 1,600 known cases within the Rio Grande Valley and Corpus Christi area, and the transmission of the disease continues aggressively, said Valley Aids Council Executive Director Bob Smith.

The virus is so widespread that the White House released a national HIV/AIDS initiative July 13.

The new strategy -- which targets Latinos as one of four groups most likely to be affected by the spread of the virus -- seeks to reduce the number of new infections, give infected people faster access to care, and reduce HIV-health related disparities within the next five years.

It is still unclear how it will affect residents in the Rio Grande Valley.

Valley Aids Council -- the nonprofit organization charged with raising awareness and providing care to people living with the virus in the Rio Grande Valley and Corpus Christi area -- is excited about the initiative, but the information is so new that there are no immediate implications, Smith said.

“It’s kind of like health care reform,” he said. “It’s there; there are some ideas in place, but we don’t know how it will affect us.”

One of the main reasons for the uncertainty is that the steps needed to reach the objective are still being outlined by several federal agencies including, Health and Human Services, the Justice Department, the Labor Department, and the Department of Housing and Urban Development.

The agencies were tasked by President Obama to come up with a plan by mid-December to implement the new national effort.

PREVENTION

One of the main goals of the new strategy is to reduce the number of new infections, which are currently about 56,300 annually, by 25 percent.

At the onset of the epidemic, the average number of new cases stood at about 130,000 per year. It dropped to nearly 55,000 in the mid-1990s, and since then reduction has had little or no progress, according to a report issued by the White House.

In the Valley, council is growing at a rate of about 20 percent a year, Smith said. He explained that at that rate, the council can expect to see about 320 new patients by the end of the year, bringing the total number of patients closer to 2,000.

However, Smith explained, that doesn’t necessarily mean that those new patients are newly infected cases.

“Some are relocating to the Valley and may have already received services somewhere else,” he said.

ACCESS TO CARE

The initiative also aims to facilitate faster access to care for newly-diagnosed patients.

 Currently only 65 percent of people who are diagnosed with the disease obtain care within the first three months. The federal government hopes to increase that number to 85 percent.

Botello knows first-hand what happens to infected people who don’t get the adequate medical attention they need after working with nearly 20 people who died from complications of the disease. 

She said the worst cases involved brain infections and dementia.

In the Valley, the council has provided care for more than 20 years. It was established in 1987 by several organizations to raise awareness and promote prevention, Smith said. It began to grow in the early 1990s, and hired a doctor in 1994.

When Smith arrived in 1997, there were only three locations and 35 employees. Today the organization runs five different locations and employs 80 people.

The clinic offers primary care, testing, counseling, lab work, food pantry, outreach, transportation and educational services to patients.

“The (HIV/AIDS) care has gone through some weathering over the years, but people are still standing,” Smith said.

CLOSING THE GAP

The 60-page report released by the White House states that the transmission of HIV has long been concentrated in groups that have been marginalized or underserved. It goes on to identify Latinos, African Americans, substance abusers, and gay and bisexual men as the four groups that are most likely to be affected by the spread of the disease.

According to the Centers for Disease Control and Prevention, the diagnosis rate for Blacks was eight times the rate for Whites in 2006. African Americans had the highest diagnosis numbers that same year, followed by Latinos.

Those numbers are not reflected in the council’s patients, where 87 percent are Hispanic, 12 percent are Anglo, and only 1 percent is African American. The reason, Smith said, is that the council’s numbers reflect the make-up of our community, where Hispanics are prevalent.

According to a CDC report released earlier this month at the International AIDS conference in Vienna, poverty may be one of the main factors for the disparities. The results of the report suggest that people in low-income neighborhoods are more likely to be infected because they live among more people who are infected.

The initiative hopes to battle this by making testing resources more readily available to these four groups and by striving to increase the percentage of infected people who know their condition from 79 percent to 90 percent.

According to the report, of the more than 1.1 million Americans living with the virus, one in five people are unaware of their status, placing them at greater risk of spreading the virus to others.

“I believe there are many people in the Rio Grande Valley walking around with the virus, and they don’t even know it,” Botello said.

Many organizations are fighting this front by offering free testing. They offer the service at three of their five locations in Brownsville, Harlingen and McAllen free of cost.

The report also said gay and bisexual men make up more than half of new infections. According to Smith, a combined gay, bisexual, and transgender make up 41 percent of their patients.

However, Botello warns, not all patients are gay.

She remembers the stigma and discrimination people in the area faced even from their own families, and admitted making the mistake of assuming that one of her male patients had contracted the virus from another man, only to later find out he had actually gotten it from his first and only female sexual partner.

The report also identifies a disparity when it comes to HIV-related deaths. Blacks and Hispanics are more likely to die earlier from AIDS than Whites.

The virus has already claimed the lives of nearly 600,000 Americans, and the Rio Grande Valley is no exception.

Nearly 20 percent of the 400 patients who have sought help at the Comfort House have died from the virus.

FUTURE

Although the new strategy does not call for more spending, many federal agencies and organizations are helping foot the bill.

The council was awarded a 5-year grant two weeks ago by the Health and Human Services Department. They will receive $130,000 per year for substance abuse treatment. 

The U.S. Department of Housing and Urban Development recently awarded the State of Texas nearly $7.8 million to help provide rental assistance and support services to individuals with HIV/AIDS and their families. The grants are distributed to states and cities based on the numbers of AIDS cases reported to the CDC, and in this case, Houston took all of the funding.

Botello will continue to care for all who pass through the hospice and will keep pushing prevention efforts in the United States and Mexico.

“We need to not forget how serious this disease can be, and how easy it is to become infected,” she said.

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Naxiely Lopez covers PSJA and general assignments for The Monitor. She can be reached at 683-4434.