State Sees Big Drop In HIV Diagnoses
Although much progress has been made in combatting the HIV and the AIDS virus over the past couple of decades, many infected Californians remain undiagnosed – putting them at risk for unknowingly infecting others, public health officials said this week.
At a press briefing held Wednesday by the California Department of Public Health, officials said that the number of state residents newly diagnosed with HIV each year has dropped dramatically, from 13,000 at the height of the AIDS epidemic in the late 1980s and early 1990s to 4,712 in 2013. That's even significantly lower than the 2012 data, when 5,494 cases were diagnosed, according to data from the U.S. Centers for Disease Control and Prevention.
“While this represents significant progress, at least 400 people are newly diagnosed every month,” said Gil Chavez, M.D. He added that the California still has the nation's second-highest infection rate behind Florida, where there were 4,620 cases diagnosed in 2012, the most recent year for which data is available.
The CDPH is releasing the data as discussion on the disease was highlighted this week by the revelation of actor Charlie Sheen that he has had the virus for the past four years, and apparently paid millions of dollars in money to keep his condition private. It was the most high-profile personal disclosure of the disease since former basketball player Magic Johnson announced he had the virus in 1991, when it was still often deadly.
Anti-retroviral medications that were developed in the mid-1990s have kept Johnson and Sheen all but virus-free in recent years.
“People who are newly diagnosed expect to live a normal life span,” said Karen Mark, M.D., chief of the CDPH's AIDS office.
There are obstacles to obtaining appropriate drugs, which cost about $12,000 a year and must be taken daily for the rest of a patient's life. Both cost and appropriate healthcare coverage have been issues. According to a recently released study by Avalere Health, only 16% of silver-level health plans offered in state insurance exchanges cover the primary HIV drugs with cost sharing below $100 a month. In California, coverage is even more restricted, with the majority of plans covering seven out of 10 of the leading drug regimens, with cost-sharing starting at $200 a month and rising from there.
“Ensuring individuals living with HIV have affordable access to their medications is critical both for maintaining the health of the patient but also for improving public health by limiting disease transmission,” said Caroline Pearson, an Avalere senior vice president.
Mark also noted that only half of those who have been diagnosed with HIV are currently receiving proper retroviral care, and just 45% of those who are infected are considered virally suppressed – meaning the presence of the virus cannot be detected in their blood.
Nevertheless, CDPH officials say that there are at least 15,000 Californians who are HIV-positive and have not been diagnosed with the disease and could be infecting others. That's more than 10% of the estimated 137,000 Californians who are living with being infected.
And despite Sheen and Johnson
contracting the virus through heterosexual contacts, most Californians who contract HIV/AIDS do so through male-on-male sexual contact – about two-thirds in total -- or through intravenous drug use. Eighty-seven percent of recently diagnosed HIV cases are male, with those in their 20s at the highest risk of contracting the virus.
Mark observed that those engaging in sexual or drug-using activities that put them at risk of contracting HIV consider using prophylactic devices and medications, and obtain clean needles for injections.
