Life Foundation
receives $404,617The isle organization is selected
to take part in the national
HIV prevention program
Hawaii's Life Foundation, the state's oldest and largest AIDS organization, has received $404,617 from the U.S. Centers for Disease Control and Prevention for the first of a five-year program to reduce new HIV infections.
The foundation was one of 142 community organizations selected from 571 applicants for the national HIV prevention program.
"It is a real vote of confidence in the Life Foundation," said Peter Whiticar, chief of the state Health Department's STD/AIDS Prevention Branch. "There is a lot of competition and political pressure for the awards."
Paul Groesbeck, the foundation's executive director, said many grants are targeted at the HIV epidemic in African-American communities.
Ki Michele, left, and Novalei Gonzales, self-described healers, led a parade earlier this year during the Walk for Life fund-raiser for the Life Foundation.
In Hawaii, he said, a lot of work is being done to identify and prevent HIV infection in high-risk groups: Pacific Islanders, gay men and people having unprotected sex.About 45 percent of the foundation's 600 clients are Caucasian, a figure once close to 90 percent, he said. About 40 percent are Pacific Islanders -- half of whom are native Hawaiians -- and 15 percent are African Americans, Hispanics, American Indians and Asians.
The major risk factor here remains among gay men, while it is intravenous drug use on the mainland, Groesbeck said. The state's needle exchange program, run by the Community Health Outreach Work project, "has done a good job keeping HIV out of the community of IV drug users," he said.
"As a result, it's kept the percentage of women relatively low (7 percent)," he said, noting the major risk factor with women tends to be having sex with men who are drug abusers.
Also, only 17 pediatric AIDS cases have ever occurred in Hawaii because of effective strategies keeping children born to HIV-positive women from becoming affected, Groesbeck said.
The needle exchange program got another boost this year with the governor signing legislation to continue a 2001 law and make sale of syringes by pharmacies permanent, Whiticar noted.
"It is real smart, practical public health intervention -- a no-cost intervention that potentially will save the state lives and money," he said.
He said the Health Department has distributed more than 50,000 brochures to pharmacies with information about the risk of blood-borne diseases, such as HIV and hepatitis, safe disposal of syringes and how to link with the needle exchange program and other public health services.
Whiticar said HIV-AIDS trends in Hawaii, "established early in the epidemic in those most at risk, tend to remain the same."
However, in the past year, he said the risk was unknown for a larger number of people, either because physicians are not getting information from them or are not including it in reports. "We have to go back to doctors, who have to talk more to patients," he said.
"Male-to-male sex looks like a decrease, but it may be in the undetermined category."
Counseling and testing -- "making sure that people are aware of their HIV status" -- are the main thrusts of CDC's Advancing HIV Prevention Initiative, launched last year, Groesbeck said. "There still is a sense that one out of three HIV-positive people aren't aware of their HIV status.
"The CDC is looking to get as many people who are at risk ... and through our work we will identify risk factors, get them tested and, if found to be positive, get them hooked up with medical and social services."
"We do a lot of work on this issue of how to talk to sexual partners about your status, how and why to divulge your status in a way that is not demeaning or embarrassing, but promotes healthy life and esteem," Groesbeck said.
One of the newest developments to assist testing and counseling is a saliva OraQuick rapid HIV test, approved July 10 by the Food and Drug Administration, that returns results in 20 minutes.
Previous tests were a blood draw with a needle, taking two weeks for results, and Orasure, using a swab to collect cells from the inner cheek, taking one week for results. OraQuick, a finger-stick sample of blood, was the first rapid test with results in 20 minutes, but preliminary positive readings must be followed up, Whiticar said.
He said the new oral rapid test is more expensive and will be used just for the highest-risk populations. "When people are counseled before a test, we will determine the level of risk and offer them a choice."
Getting immediate results will alleviate a big problem of people not returning for test results, and they cannot be found to report the results since testing is anonymous, Whiticar said.
Quick results from the new oral test will help to reduce chances of someone transmitting the infection while waiting for the results and make sure they get services, he said.
Groesbeck said the foundation is working with the Health Department and state labs to make sure the test is done right, and it is helping health care providers incorporate a prevention message in contacts with HIV-positive patients.
The CDC grant will be used to provide support and staffing assistance to HIV prevention programs across the state and in Guam, he said.
"We'll work together to try to make sure all of us in the Pacific are as well trained and as aware as possible about the best ways to continue to limit the spread of HIV."
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By the numbers
AIDS data
>> A total of 2,824 AIDS cases were reported in Hawaii from 1983 to Dec. 31, 2003, through the state Health Department's HIV/AIDS program. Of those, 1,545 or 54.7 percent were known dead.
>> Last year, 112 cases were reported -- an annual rate of 9.0 per 100,000 population. Of these, 95, or 84.8 percent, were men; 17, or 15.2 percent, were women.
>> The City and County of Honolulu had 85 cases; Maui County, 12 cases; Hawaii County, 10 cases; and Kauai County, five cases.
HIV data
>> A total of 655 HIV cases were reported to the state Health Department since HIV reporting began Aug. 27, 2001, up to Dec. 31, 2003. But the data are incomplete because of delays in the time between diagnosis of HIV infection and reports to the Health Department.
>> The largest age group of people living with AIDS at the end of 2003 are those between 40 and 49, a total of 594 people, or 46.4 percent. The second-largest group, 408 people, or 31.9 percent, was over 49.
For more information
>> The Life Foundation at 521-AIDS (2437)
>> The STD/AIDS Prevention Branch, 733-9010
Source: State Department of Health
