July 24, 2002 – Public health officials in the Virgin Islands say they are working to meet the national challenge of cutting the number of new cases of HIV infection in half by the year 2005. The challenge is daunting, given that the territory has the fourth-highest incidence of HIV/AIDS per capita among the states and territories, according to federal statistics.
A release issued Wednesday by Government House stated that "nearly 1 percent of the population of the Virgin Islands is infected with the HIV virus." As a first step to reducing that incidence, Health Commissioner Mavis Matthew held an "HIV summit" this week to make her doctors, nurses and counselors aware of all the resources available to meet the needs of their patients.
At the gathering, Sunday through Tuesday at the Westin St. John Resort, the health-care professionals got an update on programs providing funds under the federal Ryan White Care Act. Matthew said she found that service-providers whose programs were funded under the act felt limited to providing only those services in the areas with which they were familiar. The result, she said, was often the lack of comprehensive treatment for HIV patients.
According to the national Centers for Disease Control, 506 persons in the Virgin Islands have been diagnosed with AIDS, and of those, 49 percent are still living. Meanwhile, 213 persons have tested positive for HIV, and of those, 93 percent remain alive.
Nationwide, in addition to reducing the new HIV infection rate by half over the next three years, the CDC's strategic plan calls for raising awareness of their status to 95 percent of HIV-positive persons and getting appropriate services to them. Research has shown that a problem in seeking to stem the spread of the infection is that, especially among African-American men, many of those who are tested don't go back to get their results. (See "Many tested for HIV don't return for results".)
The statistics above suggest that there may be widespread lack of awareness among HIV-infected individuals in the territory. If nearly 1 percent of the V.I. population is infected with the HIV virus, this would be about 1,000 persons.
According to one of the presenters on St. John, prevention instructor Pat Odoms, specialists working in different programs need to be able to tap into each other's resources if their particular program doesn't offer a service needed by one of their patients. "The summit was held to see if the funded programs could be organized to make a better effort to provide comprehensive services to people infected with HIV and AIDS," she said.
The Government House release said another presenter, Renee Hartford, who heads a counseling service, discussed the situation of men in homosexual relationships and emphasized prevention and risk re-education for people of color.
Matthew said she hoped that setting up a network would help the various providers to fill in the health-care gaps;
"This conference responded to a challenge that was issued to us by the federal government," she said. "We have now received the three Ryan White titles here in the U.S. Virgin Islands — federal funding for Title II, Title III and Title IV."
Matthew added, "We're charged to collaborate among the various programs — not only those that provide services for AIDS/HIV medication and testing, but also to work with the CDC-related services for prevention as well as surveillance." The summit's objective, she said, was "to bring all the health-care providers in the territory that work primarily within the Department of Health to respond to this challenge."
Some six Ryan White Title II programs are operating in the territory; patients' options depend on whether they visit a clinic, an outpatient center or a hospital. The programs are exclusively for Virgin Islands residents and can be extended to persons with HIV who are incarcerated. Title II does not pay for medicines, but there are other programs that do.
Title III provides mental health, nutrition and oral health assistance to persons with HIV and also offers counseling and testing and provides funds for public education. Persons with HIV can apply for transportation services to get to and from their medical appointments. There is no residential requirement for services provided under this program.
Title IV services, available only at the Frederiksted Clinic, are for women and children, including pre-natal counseling and testing. Those needing these services can apply for transportation vouchers so they can get to their medical appointments and for help with day care for their children. Adult male members of clients' families can get one-time counseling and testing but are not eligible for extended services.
In addition, Title V provides funds to train counselors and other professionals interacting with people seeking HIV testing and providing services to those who are HIV positive. Recently, trainers funded under Title V conducted a program for members of the V.I. faith-based community to help them counsel churchgoers who are confronted with HIV in their families.
And another program, VICARE, provides psychological services, counseling for youth, promotion of prevention strategies and a focus for substance abusers. Those in prison can receive their HIV assessments through VICARE.
And new to the mix is the breast and cervical cancer program, which offers free mammograms and pap smears for HIV-positive women who meet income guidelines. Screenings are available under this program through Sept. 30. Administrators say they will provide 75 screenings for women in each district.
Matthew said she especially wanted her HIV specialists to know about the breast and cervical cancer program, because it represents a resource that until now went unnoticed.
Within the next two weeks the Health Department is to put together a reference guide to the locally available HIV prevention and treatment programs.
According to the Government House release, while the number of AIDS cases is declining nationwide, the number of people surviving with HIV infection is on the rise, "largely due to treatment with a combination of drugs known as cocktails."
To help get information about preventing the spread of HIV out to African Americans and other minority populations, the federal Office of Minority Health has set an HIV Clearing House web site.
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