Improved testing, population changes play a role

HIV, AIDS rates increase

ALLISON RUPP Star-Tribune staff writer | Posted: Monday, November 24, 2008 12:00 am

The number of new HIV and AIDS cases Early Intervention Services has added to its program this year is almost three times as many as in previous years.

Laurie Johnson, clinical director, said the federally funded program usually adds six to 10 new people every year. Since about April, Johnson has placed 24 new people in the program and there are several others waiting for confirmation test results.

"Over the past four months, we have seen a lot of absolute new cases, with clients who have told us this is their first test," Johnson said. Early Intervention Services tries to contact each person who tests positive in the state.

She said the 24 people are most likely new diagnoses, but a few of them could have tested positive in other states and not told anyone.

Dr. Mark Dowell, of Rocky Mountain Infectious Diseases in Casper, said he received a call Thursday from another Wyoming physician about a patient who just tested positive for HIV.

Dowell, who helps oversee Early Intervention Services, said he attributes the increase to greater access to testing.

"There are multiple places to get testing and because of rapid testing," said Dowell, who along with his business partner and a Cheyenne doctor, treats most of the HIV/AIDS patients in the state.

A rapid HIV test is much easier for providers to administer - it's just a finger prick - and results appear in about 15 to 20 minutes. Results from a conventional blood test can take two weeks.

Testers can take rapid HIV tests to various sites to reach people who might not see a doctor regularly, Johnson said.

Rob Johnston, HIV prevention program manager for the Wyoming Department of Health, agrees rapid testing has helped identify more people, but he has simply seen more people become infected.

In Laramie County, there was a cohort of young gay men infected this year, Johnston said. They never thought of themselves at risk.

Over the past year, Johnston's program has followed up on positive tests more thoroughly and increased efforts to contact sexual partners who might have been exposed.

Another factor is people do not talk about men in heterosexual relationships who also have sex with men, Johnston said.

"Their girlfriends, their wives have no idea," he said. "Talk about a hard group to reach out to."

Laurie Johnson said she thinks some people have just forgotten the disease exists.

"It's not a hot topic anymore," Johnson said. "People don't hear about. They don't think about it so they don't use protection."

Dowell said not many people are acquiring the disease in Wyoming. They are leaving the state, engaging in risk factors and then returning, he said.

"It's not like a new reservoir of HIV infection living in the state," Dowell said.

Some of those who do acquire it in the state become infected by someone who moved to the state, he said.

Other reasons for the increase in cases include growing transient and overall populations, Dowell said.

Even though some of the cases come from outside Wyoming, health officials said HIV/AIDS is definitely "here in Wyoming."

As of Dec. 31, 2007, 166 people were living in Wyoming with HIV/AIDS, according to the state health department's HIV/AIDS surveillance report.

Johnson and Dowell track numbers separately from the state but are in the process of coordinating better with the state, they said.

Between Jan. 1 and June 30, there were only eight new cases of HIV or AIDS reported, according to the surveillance survey.

Cheryl Corbin, HIV surveillance coordinator for the state, said this year's numbers will be a "little higher" than 2007, when there were 14 new HIV cases and three new AIDS cases with no prior diagnosis of HIV.

"But not that much bigger unless I get real busy in these last four or five weeks," Corbin said. "Our numbers are so low anyway, if we go from 10 to 20, it's 'Oh, no, we doubled.'"

Dowell said the state's numbers lag behind what he experiences. He usually finds out about a new positive immediately while the state has to wait for the diagnosing physician to fill out appropriate paperwork.

It could be weeks or months before the new HIV case finds itself in the state's data, Dowell said.

"It's not really about the absolute numbers but about the concepts," Dowell said. "The concept is this: There is increased awareness about HIV and much more access to testing. We should be proud we have more availability of testing."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.

Wyoming numbers

Year New reported HIV cases New reported AIDS cases with no prior HIV diagnosis

2007 14 3

2006 6 4

2005 10 2

2004 9 9

2003 7 3

2002 13 5

Source: HIV/AIDS in Wyoming Surveillance Report, December 2007.

Quotable

"This is going to scare people. I just think about how my family and friends are reacting to this."

-Anna Kinder, director of the Wyoming AIDS Education and Training Center