Sunday was World AIDS Day, a day for raising awareness and funding for HIV prevention and treatment that was started by the United Nations in 1988. For the Oregon Health Authority (OHA), it’s also an opportunity to take stock of how HIV prevention and treatment efforts across the state are working, and look ahead to future goals.
To coincide with World AIDS Day, this week OHA released its annual progress report for End HIV, a federally funded state initiative, launched in 2016, with the goal of ending new HIV transmissions. That report identifies where OHA has found success in HIV education, prevention, and treatment across the state, and where the agency plans to do more.
One of the goals of End HIV is to have all Oregonians get regularly tested for HIV. As of 2017, only 39 percent of Oregonians had ever been tested for HIV—but the state ramped up its testing efforts in 2019.
That includes offering “integrated testing,” or testing people for HIV at the same time they are tested for other sexually transmitted infections (STIs) like syphilis, gonorrhea, and chlamydia, because these STIs can increase the risk of spreading or contracting HIV. In 2019, OHA began providing funding specifically for integrated testing in the seven Oregon counties with the highest HIV rates in the state.
OHA also began working with a Multnomah County health provider this year to perform dried blood spot testing for HIV, which the report describes as “an even lower-barrier way to test, as it doesn’t require a blood draw and can be used for self-testing by a person at home.” OHA plans to bring dried blood spot testing to other Oregon counties in 2020.
In addition to testing, OHA also took new steps to prevent HIV infections in the last year. Through a new public health effort, OHA trained 300 medical providers in screening for HIV and prescribing pre-exposure prophylaxis (PrEP), a daily pill that can help prevent the spread of HIV. Fifty-five percent of those doctors are located outside of metropolitan centers—an important metric, the report notes, as resources for people with HIV are often hard to find in rural areas. That’s why it’s also significant that six more Oregon counties began operating syringe exchange programs, which help prevent the spread of HIV and other diseases among intravenous drug users, in 2019. That brings the total number of Oregon counties with syringe programs to 17 out of 36.
Harney County, which has a population of just 10,000 people, is among those counties. Harney County’s syringe exchange is small: It operates for 90 minutes per week, and has served six clients since opening in mid-2019. But the OHA report notes that small programs like this can have a big impact on public health.
“Most clients are secondary exchangers (people who exchange syringes on behalf of others in their community), which means the effect of the program is amplified beyond those directly served,” the report says. “In addition, the health department maintains a sharps drop box outside the office for 24-hour safe and confidential syringe disposal.”
OHA operates PrEP navigation services in every county, to help people at risk of contracting HIV get PrEP perscriptions. In the first half of 2019 alone, those services reached about 4,300 people, though only 95 of those people ended up taking PrEP.
As detailed in the Oregonian last month, living with HIV can be particularly challenging for people who are homeless, and being homeless likely increases a person’s risk of contracting HIV. OHA started working with medical providers this year to find “low-barrier housing assistance” for people with HIV, and will spend $10 million to fund and develop housing options for people with HIV over the next five years.
You can learn more about what OHA is doing to test for, prevent, and treat HIV by reading the full report. And if you want to do something to help people living with HIV locally, consider donating to or volunteering for the Cascade AIDS Project, one of the community organizations OHA works with on End HIV programs.