DENNIS ODA / DODA@STARBULLETIN.COM Nari Okui, left, and Noweo Kai knelt yesterday next to the "quilt of flowers" that was made on the Great Lawn at Kapiolani Community College. The quilt of flowers added a local touch to the AIDS Memorial Quilt, a symbol for those who have died of the disease. The flowers were donated by local florists.

Group stresses access to care

Events in Hawaii are part of a global effort to keep fighting the persistent viral killer

World AIDS Day will be observed in Hawaii tomorrow with mixed reports about prevention and treatment of HIV/AIDS here and elsewhere.

"Hawaii is better off than most places," said Tom Sheeran, who has been HIV positive since 1983 and is a leading HIV/AIDS advocate. "At the same time, where the epidemic is bad, it's awful, in inner cities and impoverished communities."

Sheeran is informal co-chairman of events planned to commemorate World AIDS Day, which began in 1988 to increase awareness of and fight prejudice against the disease.

Significant progress has been made in prevention and treatment of HIV/AIDS in Hawaii, with needle exchanges, rapid tests and effective drugs, officials say.

But funding remains a problem, Sheeran said, pointing out that medications are keeping people alive longer with HIV, but people still get infected. "We have a growing population that needs care, but funding is flat."

Federal funding has shifted from blanket services to only medical care, he said. "Housing, food and everything else are getting squeezed out, instead of addressing needs."

Access to care also remains a problem, he said, "depending on who you are and where you live. It's particularly bad on the neighbor islands and on rural Oahu."

He said leadership is needed to overcome the stigma that keeps many people from being tested for HIV/AIDS, and emphasis this World AIDS Day is on youth leadership.

Overall, Hawaii "is doing a pretty good job" in addressing HIV/AIDS, said Peter Whiticar, chief of the state Health Department's STD/AIDS Prevention Branch.

"Some really wise legislators in this state 15 or 20 years ago jumped on the epidemic in a major way," he said. "They made a substantial investment, getting needle exchange going and sufficient prevention early on.

"But it doesn't mean we should take it easy," he said, pointing out the epidemic is changing to minority and potentially homeless populations that have difficulty accessing services. He said the state "is really trying to get a grip on that."

Nancy Kern, HIV/STD prevention coordinator, said attention given to HIV/AIDS in the early years of the epidemic has waned since the 1990s.

"Fortunately, the treatment and medications have really improved, and people, at least in Hawaii and most of the United States, have access to those. They have allowed people who are HIV positive to live lives of quality and much longer than the estimate in the early days of the epidemic."

But she also stressed that discrimination and stigmas continue in the daily lives of HIV-positive people. "What we're trying to do with World AIDS Day is have more awareness of HIV/AIDS and the need for compassion for people who are HIV positive."

"World AIDS Day is always a good day for remembrance," said Melanie Moore, Life Foundation spokeswoman. "We reflect on those we lost to AIDS and keep the fight going."

Life Foundation, the state's oldest and largest AIDS organization, has taken the lead in offering rapid HIV tests with results in about 20 minutes. About 150 tests per month are being done -- 50 to 100 more than in the past because of the shorter wait, Moore said.

"Life Foundation is doing a really good job," Whiticar said, explaining a staffing shortage has delayed implementation of rapid tests in state health clinics.