The experts gathered Thursday afternoon at IU Bloomington Hospital Community Health’s clinic at 333 E. Miller Drive to discuss the state of HIV care in Indiana.
“Two decades ago, an HIV diagnosis was a death sentence,” said Linda Grove-Paul, vice president of Recovery and Innovation at Centerstone. The development of the HIV cocktail, an antiretroviral therapy, in 1995 enabled patients to live with an HIV diagnosis, she said.
During the past 20 years people have worked diligently to improve HIV care across the nation, and now it is our responsibility to sustain that movement, Grove-Paul said.
From 2002 to 2014, new HIV cases decreased from 463 to 421 and newly diagnosed AIDS cases from 194 to 94, according to the Indiana State Department of Health. Despite that improvement, there are still more than 5,000 people living with HIV in Indiana, according to the Centers for Disease Control and Prevention.
Experts at Thursday’s talk scrutinized barriers that prevent people from getting tested, acquiring the proper medical treatment and continuing their treatment programs.
The Rural Center for AIDS/STD Prevention at IU School of Public Health-Bloomington is conducting an ongoing survey, encompassing all 92 counties in Indiana, where more than half of the respondents documented physical and organizational structure barriers such as office hours, wait time and location of services as the primary barriers to testing and treatment services, said Carrie Lawrence, postdoctoral research fellow at the Rural Center for AIDS/STD Prevention. Other factors included a lack of health insurance and income.
The first step in improving HIV healthcare would be to motivate more people to get tested, said Lawrence.
“The question to ponder is how do we engage people to get tested,” she said.
Jasynda Radanovich, research associate at the Indiana Prevention Resource Center and former HIV caseworker, encouraged health workers and service providers to be more active in their communities with their testing practices.
Radanovich recalled a time when she tested a patient in the ice room of a grocery store.
“If you wanted to test our Latino population, they were working,” she said. “It was noisy, awkward and kind of weird but it just made sense, and it dawned on me that people were getting treatment, they were getting educated and tested. That’s all that mattered.”
Radanovich continued to emphasize the importance of actively engaging the community.
“You have to meet them where they’re at,” she said. “You just can’t put a sign up on your door about certain services you offer and expect people to flock to them.”
Julius Lee, who works at IPRC, said newly diagnosed patients need professional support and to illustrate this, he reflected on his diagnosis of diabetes six years ago.
“When I was diagnosed with diabetes, I can remember it was like this gong going off in the back of my head,” he said. “Everything the doctor was saying, I couldn’t hear her and so it may be the same with the person who is diagnosed positive. Heaven only knows.”
There was a consensus among the professionals present that there needs to be a human component, a tangible support system readily available for people who need it.
“Sometimes you need that person to walk hand-in-hand with you,” Lawrence said.
Another major issue is how the state allocates funding to organizations that provide treatment services. Funding goes to the most competitive applicant, so the system does not support collaboration.
“If people are going to collaborate together and pull our ideas and resources together for the greater good, you have to be able to provide funding that supports that,” Grove-Paul said.
Another, and perhaps the most vital, point is the necessity to stress the importance of promoting prevention methods, said Greg May, Centerstone grants and data manager.
“Treatment is now a very reactive approach,” he said. “It’s ‘oh, you’ve got HIV. Now we can talk about how you got this, how not to engage in high risk behavior, the importance of not sharing needles, safe sexual practices.’”
A key factor of HIV care in Indiana needs to be an emphasis on educating young people, Lee said.
“The public health infrastructure needs to focus on the youth in terms of creating programs that would be approving to parents and guardians and at the same token highlight prevention methods and techniques,” Lee said.
