When the Centers for Disease Control and Prevention in 2017 identified San Antonio as having the largest of 16 HIV clusters in Texas, local health officials developed strategies to stop the spread of infection.
Within six months of signing on to an international initiative to get more HIV-infected people diagnosed and undergoing treatment, there has been significant local progress toward outlined goals.
San Antonio Metro Health officials in late May released a six-month update that shows that 86 percent of people living with HIV in Bexar County were aware of their status, 72 percent of people with an HIV diagnosis were connected to a medical home to receive care, and 85 percent of those diagnosed had an undetectable viral load.
An initiative the City joined in December aims to get 90 percent of people who are HIV-positive cognizant of their status, 90 percent connected to a medical home, and 90 percent on antiretroviral therapy by 2020.
In Bexar County, the number of people newly diagnosed with HIV has increased by more than 50 percent in the last decade, according to Metro Health.
Dr. Junda Woo, Metro Health's medical director, told the Rivard Report that in addition to people not being tested as regularly as they should, health officials found that those diagnosed with HIV took a long time to get care, which increases the likelihood that the virus will affect their immune system.
“We found that the time between someone receiving a diagnosis and getting care was 32 days – way too long by anybody’s estimate,” Woo said. In response, health officials set a goal to bring the number of days between receiving a diagnosis and finding a medical home to seven days, and achieved a baseline number of just under seven days, she said.
Effective HIV treatment reduces the viral load in body fluids, lessening the likelihood of transmission. If a patient’s viral load is undetectable for six months, the person is considered infected but not infectious, said Dr. Barbara Taylor, associate professor of infectious diseases at UT Health San Antonio.
Taylor provides medical care to people living with HIV at the Family-Focused AIDS Clinical Treatment Services (FFACTS) clinic through University Health System, the largest HIV care provider in the region. She said people often are hesitant to find a medical home immediately after diagnosis because they are concerned about the cost of treatment.
The FFACTS clinic treats more than 3,000 people living with HIV. While the drugs are expensive, there is a lot of support from the government and pharmaceutical companies, Taylor said, adding that she has never had to deny medication to a patient who needed it.
Anita Kurian, assistant director of communicable diseases at Metro Health, said in an HIV/AIDS forum in November 2017 that 6,343 people in Bexar County were diagnosed with HIV, with 85 percent being male. In 2015, almost 5,800 people in Bexar County had been diagnosed.
Carlos Carmona was diagnosed with HIV in the summer of 1990, and is now an advocate working to connect people with HIV diagnoses to resources throughout San Antonio. He told the Rivard Report that the most important step in eradicating HIV completely is informing the public about the disease, how to treat it, and whom it affects.
“We have to let people know that HIV doesn’t just happen to gay men and it's not a death sentence,” Carmona said. “Information is key to helping people get tested and receive the treatment necessary to become virally suppressed.”
On Friday, the Health Collaborative, a community health advocacy nonprofit, hosted San Antonio’s first HIV Long-Term Survivors Day, recognizing survivors, advocates, and caregivers for their contributions to the HIV/AIDS community.
“There is a generation of people living with HIV who watched most of their friends who were diagnosed die,” Taylor said. “These people, through their activism, led the way for advances in medication and treatment since the '90s.”
Most current HIV patients are treated with a once-daily pill to suppress their viral load, a far cry from the toxic treatments of years past, where the handfuls of pills people were required to take often caused additional medical issues such as kidney failure.
“From a provider standpoint and biomedical research standpoint, I can tell people that if they get into treatment they will live a normal lifespan,” Taylor said.“Our goal is to get people into treatment long before they have any symptoms of HIV.”