As World AIDS Day is recognized Thursday, Chattanooga health care providers who offer HIV treatment and prevention services say other public health crises -- namely COVID-19 and the opioid epidemic -- are rolling back progress in combating the disease.
The first cases of AIDS, which is the disease caused by the human immunodeficiency virus, were reported in the U.S. in 1981. HIV is no longer a death sentence, and eradication is possible. That's thanks to new drugs that suppress the virus to the point it's undetectable and ones for high-risk individuals that greatly reduce the chance of contracting the disease.
But Cory Howard, chief operating officer at Cempa Community Care -- which offers HIV testing and treatment across the Chattanooga region and areas of East Tennessee -- said the pandemic and addiction crisis combined with persistent stigma surrounding HIV have led to a spike in new cases throughout 2022.
Now that there are powerful prevention and treatment options, Howard said the hardest part is getting people tested.
"A lot of people haven't gotten tested or had access to health care or been able to get tested for HIV during the pandemic," he said, noting that there's a trend of people across all health care sectors trying to "play catch up" on getting their health care needs met.
"So we're seeing an uptick all of a sudden of people getting tested, but then also finding out their status from not having access to those resources the last two years," Howard said.
Also driving the increase in cases is a growing number of people turning to substance use, he said. Much of the uptick in new HIV infections is among people who inject drugs, which is why Howard said Cempa offers syringe exchange as a means to practice harm reduction while also leading people to testing and treatment.
World AIDS Day has been recognized each year since 1988 on Dec. 1 as a time to remember those lost to the disease and reflect on the world's ongoing response to the HIV/AIDS crisis.
As of 2020, more than 19,200 Tennesseans were known to be living with HIV, and 300 Tennesseans with HIV died in 2019, according to data from the Tennessee Department of Health.
That data includes 1,123 people living with diagnosed HIV in Hamilton County, but Hamilton County Health Department spokeswoman Joeli Poole said via email that new diagnoses dropped from 50 in 2019 to 21 in 2020 due to fewer people getting tested.
There were 45 new cases reported in Hamilton County in 2021, and 39 new cases have been detected in the county so far this year, she said.
"The pandemic did limit face-to-face interaction with medical case managers and their patients," Poole said. "Services were open and available to patients as they had the option to schedule appointments or to maintain their case active via telephone contact. Many patients have expressed that during the pandemic, they felt isolated and did not want to leave their homes."
Howard said new cases have ranged across age groups, with the African American community, Hispanic communities and men who have sex with men historically experiencing a higher incidence of new cases. Though those groups are still disproportionately affected, Howard said there's a recent trend of more white rural residents also testing positive.
Particularly in the Appalachian region, there's concern among officials at the U.S. Centers for Disease Control and Prevention about there potentially being an outbreak because of more people using opioids and not having access to health care, he said.
Cempa recently received a grant from the CDC to provide free, at-home HIV testing kits that can be delivered anywhere in the nation, which Howard said he hopes will help encourage more people to know their status. Information about how to obtain the test kits is available online at cempa.org.
Cempa also has the ability to start people on medication at no cost the same day they test positive, he said.
"There's still a lot of stigma and miseducation about HIV, just because it's not like the '80s or '90s when it was on people's TV screens every other night on the news, but it's still around, and it still impacts everyday people," Howard said. "We have great medications and treatment paths nowadays, so the biggest barrier is really just getting people to know their status and get tested."