By Denise Nelson-Prieto
Earlier this year, The New York Times reported that of the 25 metropolitan areas with the highest HIV rates among gay and bisexual men, El Paso ranked third after Jackson, Mississippi, and Columbia, South Carolina.
The article, titled “America’s Hidden HIV Epidemic” cited a study conducted by Emory University in Atlanta, which used data from the U.S. Centers for Disease Control and Prevention and AIDSVu.org from 2012-2013.
Specifically, the study looked at MSM, or “men who have sex with men.” Why use that term? It’s not uncommon to find men who identify as straight – including married ones – who’ve in fact had sex with men. Modern studies include this factor when looking at rates of HIV, the virus that causes AIDS.
“We haven’t had a study like that done in the past with the number of sexually active men who have sex with men,” said David Peralta-Torres, HIV education and prevention specialist at the city’s Department of Public Health. “They usually use a denominator like the general population, so you get a different, very tiny number. But in this [Emory University study], we had a pretty significant number.”
Despite the study’s startling findings, Peralta-Torres said that HIV rates have steadily decreased among the city’s gay men.
“I do see the data saying that at least within the county, there’s been a decrease in the past six or seven years,” he said.
While gay and bisexual men are a large focus in HIV studies, that doesn’t mean women and straight men shouldn’t take the same preventative measures.
“Early on, the epidemic [affected] a lot of gay men, and even throughout the years with more women being diagnosed, it’s still seen as a so-called gay disease,” Peralta-Torres said. “We don’t tend to look at HIV on a global scale. In developing countries, HIV is primarily a disease children are born with.”
In fact, the 2014 City of El Paso HIV surveillance data reported that women made up nearly 20 percent of the 4,405 people diagnosed with HIV in the county. AIDSVu.org, an interactive online map that looks at HIV rates in the U.S., reported that in the same year, 297 of every 100,000 people in the county were living with diagnosed HIV.
As the United Nations and the World Health Organization aim to end AIDS as a public health threat by 2030, advocates across the globe are using World AIDS Day on Dec. 1 to support that goal with educational outreach.
In El Paso, the M Factor – the arm of the city’s Department of Public Health that focuses on gay and bisexual men – is one of several groups working to promote HIV awareness and education.
“Now the issue is identifying those who are HIV-positive and unaware, and to start treatment immediately,” Peralta-Torres said. “Our goal is to reduce the number of new infections among gay and bisexual men by promoting safer sex practices and HIV testing.”
The center offers free HIVß, syphilis and hepatitis C testing, as well as free condoms at organizations throughout the city. The effort is also an attempt to quell other STDs, like chlamydia and syphilis, which have made a resurgence in the last several years, Peralta-Torres said.
M Factor helps link those who’ve been diagnosed with HIV with proper care. For those who don’t have insurance, the La Fe Care Center and Project Champs will help with services.
The El Paso health department’s Choosing Life: Empowerment! Action! Results! program, or CLEAR, offers free one-on-one counseling services to heterosexual youth and adults who are HIV positive.
The program has an HIV support group for men and women who’ve been recently diagnosed or who’ve been living with the illness for years. The group is discreet and confidential and meets every second and fourth Monday.
Floyd Johnson, president of local HIV advocacy nonprofit Border AIDS Partnership, stressed the importance of access to PrEP, or pre-exposure prophylaxis. The antiviral drug helps prevent HIV in susceptible patients. It’s in the form of a pill under the brand name Truvada.
“Our greatest tool is education. And also right now with PrEP, it’s so important to have access to that,” Johnson said.
The problem is PrEP’s exorbitant cost. Without insurance, Truvada costs about $1,300 a month. Gilead, the drug’s manufacturer, offers a payment assistance plan.
Border AIDS Partnership’s signature event, “Spotlight,” has raised $2 million since 2008.
“We’re one of the few organizations that is staying proactive and we want to continue that trend,” Johnson said. “It’s important to have funding for education on HIV and treatment.”
The group has awarded funds to organizations like University Medical Center’s Teen Advisory Board and the Opportunity Center for the Homeless.
No longer a death sentence
Research has shown that HIV and AIDS patients taking antiretroviral drugs like Triumeq can show decreased viral loads to the point where the virus becomes undetectable, and in some cases, “untransmittable.”
“It brought me from full-blown AIDS when I first got diagnosed, to being undetectable,” said Gabriel, a 45-year-old local who asked to be identified only by his first name. He was diagnosed with HIV four years ago.
Although antiretroviral drugs have been a game changer for those living with HIV– enabling them to live long, relatively healthy lives – some epidemiologists worry about how long the medications’ effectiveness will last. Chicago Tribune recently reported that HIV drug resistance went up from 11 percent in 2001 to 29 percent in 2017. The main reason is inconsistency with taking the medications, allowing the virus to mutate and develop drug resistance. Experts say researchers should focus more on developing a vaccine.
In the meantime, many people living with HIV like Gabriel remain resilient and hopeful.
“I decided, after living in fear – because I grew up when the crisis began – f**k this,” Gabriel said. “I’m not going to live in fear anymore.”