Health Care Council |
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What Ever Happened to AIDS? Twenty years after the beginning of the AIDS epidemic, the "disease du jour" is another 4-letter word - SARS. Spread by airborne and other methods, it is a much more frightening disease with no effective vaccine or cure and a high mortality rate. Similarly, HIV today remains a frightening disease and still has NO vaccine or cure. And like SARS, we need to educate people about how both diseases are spread and change behaviors in order to stop these epidemics. We certainly have made significant impact on the mortality rate of HIV/AIDS. Thanks to our scientists, we now have treatments to slow the progress of the virus. As with many new medications, the cost is high and the side effects are many and diverse. Resistant strains of HIV are becoming more in evidence and are increasingly difficult to conquer. The numbers of people living with HIV in Orange County continues to climb as new infections increase steadily, and the so-called "face of AIDS" now consists largely of people of color, women and the poor. Although AIDS has always been a reportable disease, regulations requiring that HIV infection be reportable took effect in July 2002. HIV information is collected using a non-names based system in California, requiring more data analysis and added efforts to process HIV case reports. The data on HIV surveillance have not been released and analyzed yet, but there is every indication that the rate of HIV infection has not slowed down. The CDC relies on a national estimate of 40,000 new cases of HIV every year in the United States. This means that there are more than 100 new HIV infections each and every day. Systems of care that are already stretched to the breaking point are in danger of collapsing as more and more people living with HIV present themselves for care at some point in the future. The implications for our health care system are enormous. The federal Ryan White CARE Act provides grant funds that allow local communities to piece together a continuum of HIV care and services. These are federal discretionary funds of last resort and are used to coordinate services from local HIV providers like AIDS Services Foundation, The Center Orange County, Laguna Shanti, Laguna Beach Community Clinic, Delhi Center, Mercy House and New Millennium. Together, these agencies provide food, housing, transportation and critical case-management and mental health services. A mix of private and public funds allows for improved access to services and provides an enhanced safety net for needy clients. For the past 17 years, AIDS Walk Orange County has contributed millions of dollars to supplement this system of care and has provided assistance to thousands of people. HIV care for the uninsured is provided through the Orange County Health Care Agency at the Sexually Transmitted Disease Clinic and at Laguna Beach Community Clinic. Specialty medical care is provided at UCI Medical Center. This decentralized network has been maintained over the years, even though it presents a large transportation burden and raises a number of access issues that sometimes serve as a barrier to care for HIV patients. Public transportation to various access points for HIV care across the County is impractical and time consuming. Currently, clients have to travel around the County, many times taking several buses, to get their care and basic survival services. Patients with children face particularly difficult challenges. A one-stop shopping HIV clinic that contains all services is needed. AIDS Services Foundation has applied for a planning grant to explore such a project. We are hopeful that the collaboration and commitment of the HIV community will once again result in an improved system of care. More than ever, we must educate the infected and help promote behavior changes that will stop the spread of HIV. Prevention for positives is being merged into the care of clients. Bringing the HIV infected into care is an obvious way to slow the spread of this epidemic. Providing information about medication adherence, keeping the viral load down, and using proven prevention methods play a vital role. Condom use and education are proven methods for reducing the spread of HIV. Likewise, a program for providing clean injection equipment has been scientifically shown to decrease the spread of HIV and Hepatitis C. I know I am preaching to the choir, but thank you to all the Health Care Council members for all you do that makes such a difference in the lives of the less fortunate in Orange County.
COPYRIGHT © 2000-02 Health Care Council of Orange County
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