World AIDS Day

Today is the 25th World AIDS Day — an opportunity to support patients, commemorate lives lost and unite in the fight against the spread of Human Immunodeficiency Virus.

Testing is the one of the best means, outside abstinence and safe behavior, for preventing the spread of the virus, which can, over time, progress into AIDS, or acquired immunodeficiency syndrome, the most advanced stage of the HIV infection, said Wing Takakuwa, a registered nurse with the Hawaii Island HIV/AIDS Foundation. The foundation is a 501(c)(3) that in addition to testing provides HIV-positive people with a variety of services, including case management and referrals for care as well as advocacy, education and prevention.

Out of its Hilo and Kona offices, the foundation offers services including walk-in anonymous, free, rapid HIV testing with results in just 15 minutes — a far cry from just about two years ago when results took a week or two to come back. The offices are open Monday through Friday from 9 a.m. to 4 p.m.

The test is relatively simple: Come to the foundation’s office, go through the necessary paperwork and screening process and then the test is conducted. It involves a quick finger prick, just a drop of blood and then a 15-minute wait to receive a result.

A preliminary positive result requires a second test involving a blood draw that is sent away for laboratory confirmation, said Hawaii Department of Health’s STD/AIDS Prevention Branch Chief Peter Whiticar. If confirmed positive, the information is submitted to the department for statistical use, and only permitted employees within the branch have access to the information.

“It’s epidemiological data that helps us better understand what is happening,” he said, explaining the data, without names, is also sent to the Centers for Disease Control and Prevention. “It helps to make sure that we have the appropriate services available for the population.”

Whiticar and HIHAF Executive Director Tina Clothier said all people between the ages of 15 and 65, no matter their risk, should undergo routine HIV screening.

“The key message is: People out there who don’t know their status need to … get tested,” he said.

There are a variety of sites that offer free testing, including HIHAF and the Department of Health. A full list of testing sites, in addition to private doctors, can be found at hawaii.gov/health/healthy-lifestyles/std-aids/index.html.

Who should be
tested and when?

Anyone and everyone, said Whiticar, especially if you expose yourself to risky behaviors like having multiple partners, injecting drugs or having male-to-male sex. Those with riskier behaviors are advised to take part in regular testing.

Clothier also noted young gay males and the elderly should be tested.

“It needs to occur on an ongoing basis, because each time you are having sex, you are putting yourself at risk,” Whiticar said.

Testing should normally be done two to three months after exposure for the most effective rapid test results, Whiticar said, however, testing can be done as soon as the day after possible exposure.

“The test doesn’t identify the virus in the blood, it identifies the body’s response to the virus being in the blood, or the creation of antibodies,” he said. “It can be identified earlier if somebody has been recently exposed or think they are at great risk.”

Waiting until symptoms arise is often too late, Whiticar said, noting that the infection can take eight to 10 years for symptoms to show.

Symptoms of HIV can be similar to the flu.

“If you have symptoms that means you likely have AIDS,” he said. “You do not want to wait for symptoms.”

Once diagnosed, the state works with doctors and organizations like HIHAF to help people navigate the system and receive support and medical care.

Though not curable, treatment can slow HIV’s progression to AIDS and reduce the chances of transmission. Treatment involves antiretroviral therapy, which consists of a daily regimen of three or more anti-HIV medications.

“The earlier you can be treated, the better,” Whiticar said, noting treatment is also a means for preventing the virus’ spread. “This means they still have HIV, but they will not go on to develop AIDS and be able to live a relatively normal and long life.”

The unknowns

Approximately 20 to 25 percent of those infected with HIV do not know their status, according to the CDC.

Getting those people tested, and, if they are HIV-positive, getting them the care needed, are some of the biggest challenges faced by the state branch, which is tasked with providing statewide leadership for prevention, treatment, care and surveillance of infections transmitted primarily through sex or injecting drugs.

It offers a variety of programs, including free testing and insurance assistance, and grant funding to community organizations, like Hawaii Island HIV/AIDS Foundation.

“We know that there are people in Hawaii that have HIV and are not getting the care of a physician,” he said, noting that anyone concerned they may have the virus, or have been previously diagnosed, should contact an organization like HIHAF for assistance navigating the system and receiving the necessary care.

For more information about HIV/AIDS visit the Centers for Disease Control and Prevention website at cdc.gov or the state Department of Health’s website at hawaii.gov/health/healthy-lifestyles/std-aids/hiv-aids/index.html.

For more information on HIHAF and its programs, or to contribute, visit hihaf.org or call 331-8177 in Kona or 982-8800 in Hilo.

HIHAF in Kailua-Kona is located within the Pines Plaza off Nani Kailua Drive.