HIV Infection

Background

HIV and AIDS are affecting every segment of society, and the number of individuals infected with HIV continues to grow. The face of AIDS in America is changing. It's a younger face than it used to be. It's more likely a face of color than it used to be. And more and more people with HIV and AIDS are from areas outside of major cities. Nationally, between 1985 and 1994, the proportion of people with AIDS who reported heterosexual contact with a person at risk of or with documented HIV infection increased from 1.9% to 10%. In West Virginia through June 1996, statistics indicate that 11% of all AIDS case reports are among females and 27% of all HIV reports are female.

The West Virginia Bureau for Public Health AIDS Program has been charged with determining the impact of the disease on the state and providing public education. As these efforts require a statewide commitment, the AIDS Program works with 12 community-based organizations, 8 community planning groups, a statewide AIDS taskforce, 16 AIDS Prevention Centers, and an HIV Care consortium. In addition, the AIDS Program conducts AIDS/HIV education and surveillance activities. With a grant of over $1.4 million from CDC in 1996 to conduct prevention activities, the AIDS Program will continue to address the objectives.

The Objectives

OBJECTIVE 18.1 Confine annual incidence of diagnosed AIDS cases to no more than 115 cases.

UPDATE From April 1984 through June 1996, 668 West Virginians were diagnosed with AIDS. The annual incidence of reported cases ranged from a low of 6 cases reported in 1984, the first year of data collection, to a high of 117 in 1995 (see Figure 1). The AIDS case definition was expanded beginning in 1993 to include those HIV-infected individuals with a CD4 lymphocyte count of less than 200/mm³ or a CD4 lymphocyte percent of total lymphocytes of less than 14, or who have been diagnosed with pulmonary tuberculosis, invasive cervical cancer, or recurrent pneumonia. At 117 cases in 1995, West Virginia's incidence rate was above the year 2000 target of 115. At the present rate of increase, the state's year 2000 incidence is projected to be 167.

NOTE: It is important to note that the HIV virus has a long incubation period. An individual can carry the virus for ten or more years before developing AIDS.

OBJECTIVE 18.2 Confine the prevalence of HIV infection to no more than 8 per 100,000 population.

UPDATE The HIV incidence rate (positive HIV test results per 100,000 population per year) has ranged from a low of 3.9 in 1989, the first year for which data are available, to a high of 6.2 in 1992 (see Figure 2). The 1995 rate of 4.3 represents an apparent leveling off of newly diagnosed HIV infections each year. To date, the HIV incidence rate in West Virginia remains below the year 2000 target objective of 8.0. At the present rate, the state's year 2000 incidence rate of HIV infection is projected to be 3.7.

OBJECTIVE 18.3 Increase to at least 95% the proportion of middle and secondary schools that have included HIV instruction in their curricula as part of comprehensive school health education.

UPDATE WV Code 18-2-9 requires all county boards of education to provide health education, which includes instruction on AIDS and other sexually transmitted diseases, in any of grades 6 through 12 as is deemed locally appropriate. All county boards of education are required to develop policies on implementing this education. To assist the county boards, the Department of Education has distributed a model HIV/AIDS curricula that integrates HIV/AIDS instruction into comprehensive health education for grades K through 12.

Results from the 1996 School Health Education Profile administered by the Department of Education in 212 randomly selected schools with enrollment in grades 6-12 indicated that 98% of the teachers surveyed delivered instruction to increase student knowledge and 99% delivered instruction to improve student attitudes regarding HIV prevention.

Meeting the Objectives

The Director of the Division of Surveillance and Disease Control, in which the WV AIDS Program is located, will be the contact person for policies and strategies in addressing Objectives 18.1 through 18.3.

In order to meet the objectives and confine the annual incidence of diagnosed AIDS cases and the prevalence of HIV infection by the year 2000, the following strategies will be continued. To reach all segments of the population, the health promotion channels to the community that are listed in the box on the previous page (and discussed in detail in the Introduction) will be used.

• Maintain a statewide system for detecting, reporting, and analyzing HIV infection and AIDS cases.

• Use HIV/AIDS data to develop educational strategies for at-risk individuals.

• Implement the Safe Choices program in agencies that serve high-risk youth such as runaways, school dropouts, Job Corps students, and residents of shelters.

• Assist AIDS service groups in developing and implementing HIV/AIDS prevention programs that specifically target minorities, IV drug users, men who have sex with men, women, at-risk youth, and all other individuals who participate in unsafe behaviors.

• Collaborate with gay bars, women's shelters, drug treatment centers, sexually transmitted disease clinics, and youth agencies in distributing condoms and literature and in promoting HIV testing.

• Incorporate messages supporting preventive behaviors such as abstinence and condom use into prevention programs, literature, public service

• Enlist the support of HIV-positive individuals and their families in conducting HIV/AIDS educational presentations.

• Assist community-based HIV/AIDS organizations in conducting culturally sensitive AIDS presentations, conferences, special programs, and street outreach.

• Generate support for AIDS education in the school system by informing the general public about the growing risks of HIV infection in young people.

• Provide free confidential and anonymous HIV antibody testing, partner notification, and counseling for at-risk individuals.

• Monitor trends in HIV testing to determine if HIV educational programs are effective.

HIV Infection - Meeting the Objectives

Lead Entity:
West Virginia AIDS Program
Division of Surveillance & Disease Control

Plan Coordinator:
Loretta Haddy, MA, MS, Director
Division of Surveillance & Disease Control
WV Bureau for Public Health
(304) 558-5358/FAX (304) 558-6335

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