by Mylika Scatliffe
AFRO Women’s Health Writer
June 27 is National HIV Testing Day (NHTD). The annual event has been organized since 1995 by the United States Department of Health and Human Service to encourage people to regularly test for HIV, know their status, and seek care and treatment.
The 2023 theme for NHTD is “Take the Test & Take the Next Step,” focusing attention on testing for HIV, knowing your status, and knowing the options for staying healthy.
The AFRO recently spoke with Dr. Allison Agwu, an infectious diseases expert specializing in HIV/AIDS in both children and adults at Johns Hopkins Hospital, and Dr. David Griffith, the medical director of the Hopkins HIV Service County Program. Working in tandem, they emphasize HIV testing as routine health care. Agwu and Griffith spoke with the AFRO about the importance of testing and knowing your status.
“We need to normalize HIV testing so it’s as common as checking your blood pressure,” said Griffith.
Acquiring HIV in 2023 does not mean what it did 40 years ago. When HIV was first discovered in the early 1980s, it was considered an infection specific to gay, White men that would lead to an eventual prolonged and painful death.
“The good thing about HIV treatment today is that we have excellent medications. If someone starts on medication and they take it every day, they will have a near normal life expectancy,” said Griffith.
Hazel Greene is 37-years old. She lives in Baltimore, Md., owns her own cleaning company, and has been living with HIV all her life. Greene was born HIV positive in 1986, when the virus was passed to her by her mother during childbirth.
Greene’s mother was an injection drug user who struggled with addiction. She spoke with the AFRO on the condition that we use a pseudonym.
“I’m not ashamed of my status, but it’s also not for the world. My family and friends closest to me know my status and that’s who matters,” said Greene.
The AFRO asked Greene what she wanted everyone to know about living with HIV.
“It’s not a death sentence. I’ve been on this Earth almost 37 years and I live just as normal a life as anyone else,” she responded. Greene acknowledged it gets hard some days. Some days she gets depressed. Sometimes she doesn’t want to have to look at her medicine. “But then I say to myself when I take this pill every day that I’m living a day longer. I repeat that every day, every time I take the pill,” Greene said referring to the daily medication that keeps her viral load so low that it remains undetected in her system, which means she won’t pass the virus to anyone else.
“Get tested,” encourages Greene. “Know your status.”
Testing is the key.
HIV is no longer considered only a gay, White man’s disease. The largest demographic of individuals in Baltimore City living with HIV are Black men who engage in male-to-male sexual contact. The National HIV/AIDS Strategy(NHAS) identifies the following priority populations disproportionately impacted by HIV:
• Gay, bisexual, and other men who have sex with men, particularly Black, Latino, and American Indian/Alaska Native men
• Black women
• Transgender women
• Young people aged 13-24 years
• People who inject drugs
Agwu spoke about the disease in the Black community.
“I would be remiss if I didn’t mention that Black women far outpace all other races of women in terms of diagnoses (for HIV),” said Agwu. “Many women are finding once a pregnancy is confirmed that they are HIV positive, when they never got tested before,” continued Agwu.
The National HIV/AIDS Strategy(NHAS) Federal Implementation Plan has set a target for ending the HIV epidemic in the United States by 2030, including a 75 percent reduction in new HIV infections by 2025, and a 90 percent reduction by 2025. As outlined confirmed by hiv.gov, the Strategy focuses on four goals to achieve this vision; preventing new HIV infections, improving HIV health related outcomes of people with HIV, reducing HIV related disparities and health inequities, and achieving integrated , coordinated efforts that address the HIV epidemic among all partners and stakeholders.
Agwu is a strongly advocates for knowing your status as well as any other personal vital health statistic. “Dr. Griffith mentioned various methods where people have to specifically request testing like during a clinic or emergency room visit; I think we should be providing it like any other vital sign – blood pressure, blood sugar, and what have you,” Agwu said.
HIV testing is often mentioned as an afterthought during routine health visits. “A lot of times its presented as ‘Oh we’ll check your cholesterol and then oh well if you want an HIV test you can have one, but HIV is prevalent enough in Baltimore and throughout Maryland that we should just be testing,” said Agwu.
Forty years after HIV/AIDS was discovered, there are still barriers to getting testing and treatment for HIV barriers. Smartphones are mini computers that practically everyone carries these days and can be used at any time to locate a nearby testing location in minutes, or even seconds. But all barriers are not tangible.
The Black Aids Institute (BAI) is an organization dedicated to educating Black Americans about HIV/AIDS treatment and care. Its mission is to stop the AIDS epidemic in Black communities by engaging and mobilizing Black institutions and individuals to confront HIV.
“We’re exploring new programs and niches to grab people and have captive audiences, build their capacity to have conversations about HIV that are broad and applicable to build community health literacy regarding HIV,” said Deja Abdul-Haqq, communications director at the Institute.
“Is there stigma associated with getting tested? Yes, I think it’s the number one barrier. There is stigma associated with testing because there are fears. Fears because we’re not educated about what HIV is and what it isn’t, what the transmission modes are, what PrEP is and how it works, how to get engaged in care and keep your viral loads low if you are HIV positive,” said Abdul-Haqq. Education arms communities with knowledge which will reduce fear and stigma, two of the greatest barriers to testing, according to Abdul-Haqq.
As confirmed by the Centers for Disease Control and Prevention, HIV is passed from one person to another through anal or vaginal sex, sharing needles, syringes, and other means to inject drugs. There is little to no risk of acquiring HIV from oral sex (except if there are open sores on the mouth or genitals), blood donation, consuming food handled by someone with HIV, closed mouth kissing, touching, toilet seats, or through saliva.
“The federal plan is basically saying we have seven years to do what it took the last 40 to get right. We have to expedite the process with communication in rural areas like those in Mississippi or areas where sex isn’t talked about because in seven years there won’t be focus on us,” said Abdul-Haqq.
Recognizing the reservations Black people may have about the scientific world as it relates to medicine, Abdul-Haqq still emphasizes the need to take advantage of the opportunity to amplify science.
“I know the scientific world has done the Black community dirty a couple times. We understand that, but the difference between the period that happened during the Tuskegee experiment and when Henrietta Lacks was robbed of her DNA is we didn’t have as many Black people that were engaged on levels of science that impact those types of environments. Now we have epidemiologists, physicians, nurse practitioners, doctors involved in research that can help dispel the myths and misinformation at the barbershop and Sunday dinner table,” Abdul-Haqq continued.
The rate of HIV in Baltimore, in Jackson, Ms. where Abdul-Haqq is located, and nationwide is highest among men having sex with men. “Men who have sex with men often engage in behavior that is the riskiest for transmitting HIV – unprotected anal intercourse. “I think it’s really important to note that there isn’t a biological reason that Black men or gay men have such a high risk, rather it’s more a risk of behavior. Let’s remember that anal receptive sex is not exclusive to men,” said Agwu.
When considering testing and how to keep yourself healthy, we should remember it’s about behaviors we engage in, not necessarily any specific orientation, and we don’t want to get hung up in what we call people and questioning orientation. “There may be men having sex with men, but do not consider themselves gay. And the receptive partner in anal intercourse is sometimes a woman,” Agwu continued.
Maintaining your health when considering HIV is not limited to testing and knowing your status. Each individual knows their level of risk for the activities in which they engage. Pre-exposure prophylaxis, or PrEP, is medicine that reduces your chances of getting HIV from sex or injection drug use. It is highly effective at preventing HIV when taken as prescribed, as confirmed by the CDC.
Greene has one single piece of advice for anyone. “I encourage everyone to get tested. Know your status.”
Read about the fight against HIV from Word in Black, here
Click here for CDC HIV surveillance reports