A New Strategy In Fighting HIV

Tuesday’s announcement of a new national policy of addressing HIV and AIDS has inspired optimism among many Baltimore health care workers.

The White House report, available here, announced several goals, including lowering the rate of new cases of HIV by 25 percent in the next five years, reducing the HIV transmission rate by 30 percent, and increasing the number of people who know their HIV status to 90 percent. The Baltimore-Towson area has a high rate of diagnosis of new HIV cases, and the fifth-highest report rate of AIDS cases in 2007.

The national report points out that “the urgency associated with combating the epidemic appears to be declining as people with HIV live longer and more productive lives” and that there need to be greater targeted efforts toward high risk populations, including men who have sex with men and black women. According to the report, roughly three-fourths of HIV/AIDS cases in the United States are among men, the majority of whom are gay and bisexual men. The HIV diagnosis rate for black women is more than 19 times the rate for white women

John Cmar, a Sinai Hospital internal medicine physician with a subspecialty in infectious diseases, says the 60-page report is a “call to arms” in that it asks government agencies, hospitals and non-profits to work together in lowering the number of new cases and making sure there are specific outreach efforts to key groups.

“The previous strategy for addressing HIV have been targeted toward the general population and targeted everyone, as opposed to saying that there are high-risk populations and we need to focus more intensively on those groups,” he says. “Also, the report addresses prior efforts, which have often been bulwarked on a single thing, such as finding a vaccine. Moving forward, we have to do a whole bunch of different things at the same time in order to reduce both the number of new cases and increasing the number of those with knowledge of the HIV status.”

For health care educators like Robbin Alexander, Sinai outreach worker for HIV/AIDS, there’s a balancing act between acknowledging that certain groups are at higher risk alongside making sure that everyone understands how HIV can be transmitted.

“Yes, there are certain populations impacted more than others, but we must certainly not overlook any one population, because all people can practice risky behaviors,” she says. “Let's not look the other direction anymore, and believe it is not happening, because it is here, and both the state and individual communities have the power to help ourselves and the people we care about.”

In addition to Sinai’s community outreach efforts, many physicians like Dr. Cmar work with HIV-positive patients to make sure they are receiving the proper medical care, a key recommendation in the White House report. Sinai also has an outpatient infectious disease program and rapid HIV testing available to patients treated in Sinai ER-7. Patients who are admitted to the hospital for another reason, but are diagnosed with HIV during their stay, are immediately plugged into the care services available at Sinai.

On Monday, several teams will be canvassing Baltimore to offer free rapid HIV tests. Participants are tested with a cotton swab on the inside of their check and receive results in 20 minutes. Sinai will be hosting a health fair and free HIV testing on Friday, July 30 in the Zamoiski Auditorium from 1 p.m. to 5 p.m. .