WORLD AIDS DAY
Anonymous HIV tests mask infection trends
Hawaii health officials say new cases cannot be precisely quantified
>> Events planned around the state
>> Food charity executive wins isle AIDS Day honor
HAWAII will observe World AIDS Day Thursday with events to remind residents that the disease continues to afflict new patients, and those who have it are surviving longer.
When the HIV-AIDS epidemic first began, patients died in 10 to 15 years, but many Hawaii residents now have lived with the disease 20 or more years, said Nancy Kern, STD/AIDS prevention coordinator at the state Department of Health.
She said HIV-positive patients in Hawaii have fairly good access to drugs, which "has really changed the nature of the disease."
But there is a danger in people thinking drugs are a panacea, she said.
Peter Whiticar, STD/AIDS Prevention Branch chief, said residents would see people they knew dying from the disease in the past, but that does not happen much now because of the medications.
"I have even heard people say, 'It's not so bad, you can take medications and get on with your life.'"
But that is not the case, he emphasized, pointing out drugs to treat HIV are expensive and somewhat toxic -- with a lot of side effects.
HIV/AIDS in Hawaii
» An estimated 2,300 to 3,200 Hawaii residents are HIV positive.
» A total of 2,808 AIDS cases were reported in Hawaii from 1983 to June 30, 2005, including 137 new cases from July 2004 to June.
» Of the new AIDS cases, 91 percent are among men.
» Asians and Pacific Islanders comprised 27 percent of new AIDS cases in the past fiscal year.
» Only 7 percent of reported AIDS cases were among injection drug users, partly because of the state's 15-year-old needle exchange program.
» An estimated 1,500 people have died of AIDS in Hawaii.
Source: State Department of Health
"The medicine is advertised in magazines with young men riding bikes and climbing mountains," Whiticar said. "It's wonderful people can do this, but these are not sports medications."
Gov. Linda Lingle and Mayor Mufi Hannemann have signed proclamations declaring Thursday World AIDS Day in Hawaii. They are encouraging residents to learn more about prevention and treatment of HIV, the virus that causes AIDS (acquired immunodeficiency syndrome).
The observance was initiated by the World Health Organization in 1988 "to share a message of hope, understanding and compassion about AIDS."
"No Shame" was chosen as the theme of Hawaii's observance to remove one of the major obstacles in fighting the disease.
Although HIV-AIDS was identified 23 years ago, it is still associated with shame and stigma, similar to the Hansen's disease epidemic in the late 19th century, Kern said.
Whiticar said the epidemic is getting worse in Africa and many other areas, with an estimated 42 million people living with HIV/AIDS globally.
Closer to Hawaii, Papua New Guinea "appears to have an epidemic that is really catching fire," he said.
In the meantime, the United States is not winning the battle against HIV-AIDS, with about 40,000 new infections each year, Whiticar said.
He said it is difficult to know exactly how many new cases of HIV are occurring here because Hawaii's unnamed test code system for reporting cases does not provide accurate data.
Hawaii is one of 13 states that do not have named HIV reporting, and all are taking steps to change that, Whiticar said.
There is some concern about tests reported by name, but they will be confidential and guarded under "a whole range of stringent security requirements," Whiticar emphasized.
Named tests will provide a better idea of how many people tested for HIV are positive, but people with HIV who are not being tested remain a problem, he said.
He said the Health Department is working closely with the Life Foundation and many other community-based agencies to make counseling and testing services more available in hopes of reaching people who might not go in for testing.
Sometimes people who test HIV positive do not return for the results, and since it is an anonymous test now, there is no way to get in touch with them, Whiticar said.
"One thing holding us up in Hawaii is we still don't have access to the HIV rapid test," also pending approval of new administrative rules, he said.
The rapid test, intended to be a field test rather than done in a laboratory, will be helpful, Whiticar said. Preliminary results are available within 20 minutes after the rapid test.
Injection drug users with HIV on the mainland have fueled an epidemic among female partners, but that has not happened here because of Hawaii's needle exchange program, Kern said.
About 400,000 needles are exchanged annually in Hawaii, a public health strategy that has helped to decrease HIV transmission, she said.
Few perinatal infections are occurring here, she said. "Perinatal transmission across the country has dropped incredibly in the past several years with development of drugs that can be given to women who are pregnant or even during delivery."
Another important health tool to prevent HIV transmission is a condom, Kern said.
Using a condom can decrease chances of transmission among men having sex with other men (the majority of HIV cases), although it does not prevent other sexually transmitted diseases, she noted.
Whiticar said syphilis, chlamydia and gonorrhea are increasing or are at high levels throughout Hawaii, as well as nationally, which are "indicators of risk behavior."
He said no major changes have been seen in the HIV/AIDS epidemic in Hawaii. However, native Hawaiians remain a concern.
"We're finding native Hawaiians with higher rates of sexually transmitted diseases and some indications when they're coming in for medical care that they've had HIV for a longer period of time," Whiticar said.
Events planned around the state
» Health and HIV/AIDS organizations will set up tables outside Bank of Hawaii on Bishop Street and on Fort Street Mall starting at 11 a.m. Thursday. Information will be distributed on HIV prevention and care services.
» A candlelight service will be held at 5:30 p.m. Thursday at the Cathedral of Our Lady of Peace at 1184 Bishop St., with speakers and presentation of the state's Second Annual Suzanne Richmond-Crum Award. AIDS Memorial Quilt panels will be on public display at the cathedral from 2 p.m. until the end of the 5:30 p.m. ceremony.
» Public schools are participating in a poster contest supporting the "No Shame" theme of World AIDS Day in Hawaii and "Stop AIDS -- Keep the Promise," the national theme. The winning work will be displayed in the Cathedral of Our Lady of Peace gallery from 10 a.m. to 5:30 p.m. Thursday.
» The Emmy award-winning PBS television documentary "Simple Courage" will be shown Thursday from 7:30 to 8:30 p.m. at the club Next Door, 43 N. Hotel St. The 60-minute documentary shows similarities between the management of the Hansen's disease epidemic in the late 19th century and the current AIDS situation in Hawaii. Stephanie Castillo, writer, director and producer, will be available to answer questions.
» The Hawaii Island HIV/AIDS Foundation and University of Hawaii-Hilo students will set up displays and demonstrations Thursday. HIV/AIDS counseling and testing will be provided. The foundation will host a memorial celebration at the Japanese Tea House, Liliuokalani Garden Park in Hilo, from 5 to 7 p.m. Similar events will be held at Hulihe'e Palace in Kona.
» The AIDS Quilt will be displayed Saturday at Gaylord's and Monday to Dec. 9 at the Learning Resources Center/Library at Kauai Community College.
» World AIDS Day information tables will be placed on the North Shore and west side of the island Thursday as well as at Malama Pono and the Department of Health. HIV testing will be available at the last two sites.
» Call 242-4900 to see what the Maui AIDS Foundation is planning.
For more information on World AIDS Day, call Nancy Kern at the STD/AIDS Prevention Branch, state Department of Health, 733-9281.