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World AIDS Day in the Age of Anti-Retroviral Therapy (ART)
• December 2021 •
From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse
World AIDS Day in the Age of Anti-Retroviral Therapy (ART)
L.A. CADA reminds you that the theme for World AIDS Day on December 1st, 2021 is “Ending the HIV Epidemic: Equitable Access, Everyone’s Voice.” And there are more voices than ever before. In 2021, we honor the first voices that were silenced before treatment became available. We recognize the long-time survivors who have continuously fought for increasing awareness and treatment. This World AIDS Day, we also thank all the scientists, doctors, nurses, and healthcare workers on the frontlines of prevention and treatment delivery. And just as important, we welcome the new voices of youth, advocates, and HIV patients who join us in working for equitable access to HIV education, care, and support.
Since anti-retroviral therapy was introduced in 1996, AIDS-related morbidity and mortality has declined significantly. The good news is that people living with HIV are now expected to live nearly as long as people without HIV. The bad news is that despite the advances, many people living with HIV report poor well-being and health-related quality of life.
Multimorbidity (such as HIV and behavioral health disorders), as well as poverty, stigma, and discrimination continue to be major issues for people living with HIV. This is true even for those who have achieved viral suppression – and in particular for marginalized populations. Multimorbidity often leads to depression, social isolation, and barriers in accessing health and support services. Worse yet, many of these issues are not currently addressed in HIV monitoring, strategies, or guidelines.
In 2021, the work of those of us in HIV care includes holistic case management. Here at L.A. CADA, we believe addressing important support issues like mental health and substance use disorder treatment, stigma reduction, quality of life, stable housing, and food security, can significantly improve HIV outcomes. Case management also increases vital adherence to antiretroviral medications and viral suppression like PrEP and PEP. Other evidence-based practices we use are Harm Reduction (not discharging patients who relapse), Housing First (giving patients a stable place from which to access all other services); and Trauma-Informed Care that attends to the cumulative trauma most people with HIV have experienced throughout their lives.
This World AIDS Day, if you know some living with HIV, listen to their voice And use your voice to help those who need help with HIV and substance use to find L.A. CADA at (562) 906-2675.
Hear: Darlene’s Story
Client's Corner
Joe T.
“I’m Joe and I’ve been through every HIV program in L.A. it seems like. They all tell you the same things and it runs together. It’s like they’re competing with each other for me as a client. But I already knew I should live different. Still and then, the parties were calling my name, you know? Using, drinking, and clubbing helped me get out of myself and forget real life for a while. Today, I understand I was running from trauma. I was a foster kid until I was 18. I don’t want to talk about it – just that it’s not a life anyone wants, being passed from family to family. I finally found a recovery program for people with HIV. The counselors told me about trauma and how healing is possible. They had it too. So, I thought if they can recover, maybe I can, too, you know? It was a long road and I’m still on it, working my program. But today I have more than 18 months clean and sober. For other people, I would tell them that being clean is not all recovery can do. It really changes how good you feel about just being you!”
SPOTLIGHT – THE EVIDENCE IS IN:
HIV Prevention Medications
In 2021, there are medications that can prevent HIV. Patients at high risk can take advantage of newer anti-viral medicines prescribed by healthcare providers. They’re called pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). These are tools in the prevention toolkit that we could have only dreamed about in 1981 when the CDC first reported on a new disease called AIDS.
PrEP is an on-going prevention method for people who are HIV-negative and at high risk for being exposed to HIV through sexual contact or injection drug use. By taking this medication and seeing a healthcare professional every three months for HIV testing, we keep the virus from establishing an infection.
PEP refers to antiretroviral drugs for people who are HIV-negative after a single high-risk exposure to stop HIV infection. This kind of exposure typically occurs through sex or sharing syringes (or other injection equipment) with someone who has or might have HIV. Exposure to HIV is a medical emergency – HIV establishes infection very quickly, often within 24 to 36 hours after exposure. Health care providers should evaluate persons at risk within 72 hours after a potential exposure. PEP must be started as soon as possible to be effective and continued for 4 weeks.
Watch a short video: PrEP and PEP
STAY IN THE LOOP
