State to begin HIV rapid testing

Chittenden County has 43 percent of Vt. HIV cases

By Kim Howard
Observer staff

Vermonters soon will have more access to rapid testing for HIV, the virus that causes AIDS. Local experts say the option may increase the number of people who get tested, accelerating medical attention for carriers and decreasing the likelihood of their infecting others.

The State of Vermont Department of Health plans to begin a rapid HIV testing program before the end of the year, according to Rob Lunn, director of the state Department of Health HIV/AIDS/Sexually Transmitted Diseases program. Current tests offered through state-sponsored sites require a two-week wait for results; the rapid test, an oral swab, yields results in 20 minutes.

Lunn said staff training is scheduled this week. He expects at least one state-sponsored site in Burlington will begin rapid testing before the year’s end, with expansion to more sites in 2007.

The wider availability of the testing – 25 years after AIDS was first documented in the United States – may help increase the number of people who seek testing, some local officials think.

Vermont CARES, a Burlington-based provider of services to HIV-positive individuals, has been the only agency in the state offering rapid testing. The organization first offered the service on World AIDS Day (Dec. 1) a year ago. Prior to rapid testing, Vermont CARES had only one or two HIV-positive diagnoses each year, according to Kelly Brigham, program director. Since last December, the agency has seen six HIV-positive diagnoses. The state, during the same time period in more than 40 locations, has had only one positive diagnosis, according to Matthew Pettengill, the state’s HIV/AIDS Surveillance Coordinator.

“I think a lot of people didn’t want to wait two weeks,” Brigham said. “Word is getting out – (the rapid test is) oral, no blood involved, free, completely anonymous. The goal is to reduce any barriers to people getting tested.”

As of the end of September, 438 Vermonters were known to be living with HIV or AIDS, according to the state’s HIV/AIDS surveillance program. The Centers for Disease Control and Prevention estimates another 25 percent, or 110 Vermonters, are HIV-positive but do not know it. Forty-three percent of Vermonters living with HIV/AIDS reside in Chittenden County.

Brigham, who has worked at Vermont CARES for five years, said she’s observed more people moving to Vermont already HIV-positive than people being diagnosed in-state.

That is the case with Jan Lund, 43, who was diagnosed HIV-positive in Connecticut 20 years ago. A former resident of Williston and Burlington, Lund now lives in Kirby, Vt., and volunteers for Vermont CARES. Serving on the agency’s speakers’ bureau at schools and in homeless shelters, Lund said she believes there still are misconceptions about HIV/AIDS in Vermont.

“There’s a lot of preconceptions about whether somebody is HIV positive just by the way they look,” Lund said. “…There’s still a lot of confusion as to the different ways you can catch HIV.”

In Vermont, 82 percent of people living with HIV/AIDS are men, according to state data; 18 percent are women. Among men, sex with men is the most common cited way of exposure (58 percent); among women, heterosexual contact was the most frequent (44 percent). For both genders, intravenous drug use accounted for 12 percent of transmissions.

Brigham said another misconception is that people are not dying from AIDS.

Of the approximately 125 clients Vermont CARES serves each year – and the agency is just one of several Vermont AIDS services organizations – between 10 and 20 clients die each year, Brigham said.

Still, many people, like Lund, live with a positive diagnosis for years. Services therefore need to reflect that reality. Brigham said many clients struggle with low incomes as well. Housing is a top concern among a number of clients, Brigham said, especially in Chittenden County where affordable housing options are lacking.

Lund said her limited financial resources have not hindered the quality of her medical care, but have affected the ease of access to care. When she lived in Chittenden County, she had to take two or three buses to get to her doctor’s appointments, she said.

“Being on HIV medications, that’s a struggle because you get tired really easy,” Lund said.

Vermont has one of the lowest incidence rates of HIV and AIDS in the country; as of 2004, Vermont ranked 48th in the nation with 3.2 AIDS cases per 100,000 people.

Lund said it is hard to know why Vermont’s HIV/AIDS incidence rate is so low. Even with other sexually transmitted diseases, state director Lunn said, Vermont’s rates are lower than surrounding rural states like New Hampshire and Maine.

“I don’t think we can say why Vermont is different, we just are,” he said.

According to United Nations data, about 39.5 million people are living with HIV globally. Nearly 10 percent of those were new infections in the last year. An estimated 2.9 million people died of AIDS around the world in 2006.

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