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Half of heterosexual men with HIV received a diagnosis 5 years or more after getting the virus – later than any other group.
Why Should You Get Tested For Hiv
7 in 10 high-risk people who were not tested for HIV in the past year saw a health care provider during that time. More than 75% of them were not offered a test.
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Fifty-nine percent of heterosexuals at high risk for HIV, 42% of people who inject drugs, and 29% of gay and bisexual men were not tested for HIV last year.
*People at increased risk for HIV include: 1) sexually active gay and bisexual men, 2) people who inject drugs, and 3) heterosexuals who have sex with someone who is exposed to or has HIV.
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When the lab results came back and Gillum learned he was HIV positive, he was shocked. But he is not the only one who was – or is – in the dark about their status.
HIV may not make national headlines like it did in the 80s and 90s. But it should. Too many Americans today have never been tested for it, so they don’t know if they carry the virus.
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Of all the 1.2 million Americans living with HIV, the CDC estimates that about 15 percent are unaware of their HIV-positive status.
According to a November 2017 report by the Centers for Disease Control, half of Americans newly diagnosed with HIV had been living with the virus for at least three years without realizing it. (A quarter had been infected for more than seven years.)
Indeed, of all 1.2 million Americans living with HIV, the CDC estimates that 15 percent are unaware of their HIV-positive status. And people who don’t know they have HIV are thought to be responsible for 40% of new HIV transmissions.
The Centers for Disease Control recommends that all people between the ages of 13 and 64 be tested for HIV at least once as part of their routine health care. For those with specific risk factors, the CDC recommends annual testing.
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Just as troubling as the lack of HIV testing and awareness of one’s condition is this: too many of those who have been tested and found out they have HIV are not taking the drugs that today can effectively suppress it. So while HIV testing is important, so is what comes after it.
For example, newly diagnosed people need support to process their mental and emotional state. And they may also need help connecting to HIV treatment (or to address barriers like transportation or lack of health insurance that they need to connect to treatment).
Gillum puts it this way: “If I had just found out I had HIV, it wouldn’t have been enough. When you focus only on the [results] of the test, you forget that people have a whole life outside of the HIV test.”
When he was diagnosed in 1987, it took him seven years to accept his status. During that time, he lived with intense denial, fear and shame.
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He did not seek treatment for HIV during those years (and was initially reluctant to seek treatment for the substance abuse problems he was also experiencing). Nor did he reveal that he was HIV positive to anyone except his aunt and mother.
“For me, I had to deal with my self-esteem first,” says Gillum, explaining that he grew up in a church environment where there was stigma around sexuality and substance abuse. “First I had to get clean [of pot, cocaine and alcohol] and then I had to start healing emotionally and mentally to deal with my condition.”
In 1994, Gillum finally came out publicly. Some of the first people he told were those in his church.
“[I’ve] watched people die in the church and the church would say they died of cancer or they died of pneumonia, but they never said the person died of complications from HIV and AIDS,” he says. “So I wanted to understand that HIV affects people in the church … and that we don’t talk about it … It was important for me to start [activism] where my life started.”
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Hennepin County Medical Center’s Positive Care Center offers HIV testing, HIV counseling, and linkage to HIV care and treatment.
That same year, Gillum began doing professional HIV outreach for the Minneapolis Urban League. Since then, he has been an HIV outreach worker for several hospitals and clinics and is currently a community health specialist at Hennepin County’s Red Door.
“Information can change behavior,” Gillum, now 51, says of his work. “And the more you know, the better choices you can make.”
To that end, Gillum says he tries to meet clients where they are and asks questions that help guide him.
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“Where do you feel most comfortable receiving treatment?” he might ask. “What are the best business hours for you to see a provider? Do you need assistance such as bus tokens to get to your medical appointment? Do you need me to make your appointment so you don’t have to call from a household where you may not be able to maintain your privacy?”
In addition to taking a patient-centered approach, Gillum emphasizes to clients that things are drastically different than when he tested positive in 1987.
Now, with advances in biomedical technology, people can receive treatment so that their virus levels are so low as to be undetectable. And once they are undetectable, they cannot transmit the virus. So, with proper treatment, an HIV-positive person can be safe in a sexual relationship with someone who is not HIV-positive. And they can have children without passing on HIV.
HIV testing is covered by most health insurance plans and provided by most primary care providers. Three affiliated health providers in Hennepin County offer HIV testing, HIV counseling, and linkage to HIV care and treatment. These services are offered at low cost or free to people who are uninsured or underinsured. According to the CDC, about 1.1 million people in the United States are living with HIV, and about 56,300 people are infected each year. In addition, 20% of the population does not know that they are infected. Early detection and treatment of HIV is important because it reduces patient mortality and prevents future HIV transmission. The earlier you are diagnosed with HIV, the sooner you can start treatment.
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Most people infected with HIV receive health care services in the years before they are diagnosed, but unfortunately are never tested for HIV. In fact, over 33% of HIV-positive people are diagnosed in the later stages of the disease, when it is too late for them to benefit from early treatment. Antiretroviral therapy (ART) is very effective if started early before symptoms appear. The earlier you start treatment, the less likely you are to get sick from opportunistic infections, HIV-related cancers, and AIDS.
HIV screening is very effective in prevention efforts. Those who are unaware of their HIV status are three times more likely to transmit the virus compared to those who are aware of their HIV status. The 20% of the population who do not know their HIV status are responsible for 50 to 70% of new HIV infections – that’s why knowing your HIV status is essential. Studies indicate that people who are aware of their HIV infection are less likely to engage in high-risk behaviors.
Once people start HIV treatment, their viral load drops to undetectable levels. The risk of someone passing on HIV when the viral load is undetectable is close to zero. In addition, ART helps reduce the viral load to
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