Monday, March 19, 2018

Appalachia at high risk of HIV and hep C, but stigma and other factors hamper testing, monitoring and treatment

Bloodborne diseases like HIV and hepatitis C are an increasing threat to public health in Appalachia, but the stigma associated with such diseases may be hindering monitoring, testing and treatment, ultimately increasing the risk of outbreaks.

A big part of the risk comes from sharing needles while shooting opioid drugs such as heroin. In 2016 the Centers for Disease Control and Prevention found that Appalachian counties were some of the most vulnerable in the U.S for HIV and Hepatitis C. A cluster of 43 recent HIV cases has popped up in northern Kentucky, and in West Virginia the CDC "just released a report on 40 new HIV cases diagnosed in 2017 in 15 mostly rural counties," Roxy Todd reports for WKMS-FM in Murray, Ky. Health officials worry that many more could be infected and not know it.

The number of HIV cases reported (left) vs. the possible number of cases both reported and unreported (right)
(CDC map; click on the image to enlarge it.)
Tania Basta, who chairs the College of Health Sciences at Ohio University and has researched the effects of stigma in rural Appalachia, said some rural health-care providers still stigmatize their patients. "They may feel that, unfortunately, some people with HIV, they did this to themselves," she told Todd. "Testing is an issue . . . And I’m not saying that stigma is any higher in rural areas. It’s just that, because of the nature of living in small towns, where everybody kind of knows everybody, word travels quickly."

The CDC report on the HIV outbreak in West Virginia also said lack of health literacy and transportation from remote areas to treatment or syringe exchanges also contributes to the spread of the disease. "Fourteen of the 15 counties where new cases were identified were on the CDC’s 2016 list of counties at high risk of disease. Yet only three of the counties had syringe service programs, which medical evidence shows is an effective way to reduce harm from drug use. Syringe services, also known as needle exchanges, can also serve as an opportunity to test for needle-borne disease," Loh reports. They also offer opportunities to get users into treatment.

No comments: