AIDS problem persists for New Haven

While most HIV/AIDS organizations work to aid people in developing countries, some organizations are fighting the disease in the Elm City, which still has its own AIDS problem.

The AIDS Project New Haven, the Mayor’s Task Force and Hispanos Unidos, are all aiming to prevent the spread of AIDS in New Haven and provide health and educational services to residents suffering from the disease. Nick Boshnack, the director of client services for AIDS Project New Haven, said that the media attention on AIDS in developing countries often overshadows the local impact of the disease. His organization provides local patients with HIV testing, mental health counseling, substance abuse recovery assistance and nutritional counseling.

“Even though some people feel it is not an issue in developed countries anymore, they still benefit from the prevention and education services we provide,” Boshnack said.

Merceditas Villanueva, an infectious disease specialist and director of the AIDS program at Yale-New Haven hospital, said that of approximately 1.5 million Americans reported to be living with the disease, 10,574 are in Connecticut and 1,536 live in New Haven. New Haven has the second-highest prevalence and rate of AIDS infections in the state, after Hartford.

Gerald Friedland, a doctor at Yale-New Haven Hospital, said New Haven is one of 15 U.S. cities where AIDS is the leading cause of death for both men and women.

“For a small state, we have a large number of cases,” Villanueva said. “It predominantly affects people of colour, so it’s an issue of racial disparity, and that’s typical of inner cities.”

Villanueva said that in New Haven 65 percent of reported AIDS cases are in the African American population, 25 percent in the Hispanic population and 24 percent in the Caucasian population, with 1 percent being described as “other.” By comparison, the 2010 census found that New Haven’s population was 44 percent White, 37 percent African-American and just 9 percent Hispanic.

Such racial disparity sparked the development of ethnicity-based AIDS programs, such as Hispanos Unidos, which has offices in New Haven and Meridan, Conn., and provides services in English and Spanish. Hispanics are the organization’s primary target population, but it also helps African Americans, Caucasians and Asians by providing mental health therapy, medication adherence services, outpatient substance abuse counseling and summer camps for children whose families are affect by AIDS.

“There are so many barriers for patients to the services, such as the language barrier, transportation and housing,” said William Castillo, Hispanos Unidos’ interim executive director.

New Haven’s response to these challenges is the Mayor’s Task Force on AIDS, which serves as an advisory body to the Mayor of the City of New Haven and strives “to foster a broad-based community response to the HIV epidemic by encouraging partnership building and by raising AIDS/HIV awareness at the local, state and federal levels,” according to its mission statement. The task force brings together different groups and platform to influence local AIDS policy.

Leif Mitchell, assistant director of the Community Research Core at Yale’s Center for Interdisciplinary Research on AIDS (CIRA), represents CIRA on the task force.

“CIRA is focused on research, but the Mayor’s Task Force is a local voice advocating local AIDS policy that works directly with the mayor and Board of Aldermen,” Mitchell said, adding that it deals with funding issues and sponsors local events.

Such an event is the vigil to commemorate World AIDS Day, which will be held at noon on Thursday at the United Church on the Green.

Mitchell said that AIDS does not receive attention proportional to the the rate of new HIV/AIDS diagnoses, which is approximately 56,000 people each year in the U.S. In New Haven, around 25 individuals were diagnosed with HIV/AIDS in 2009, the last year there is data for.

“Historically, injection drug users were most prone to infection, but over the past few years, this has declined,” Villanueva said, attributing the decline to the growth of needle-exchange programs, the absence of shooting galleries and the greater availability of unused needles.

She said the highest incidence of new cases is in MSM (men who have sex with men), although heterosexual spread is also a major factor. Approximately 65 percent of those infected in New Haven are males and 35 percent, females.

One important role of the New Haven AIDS organizations will be to encourage earlier diagnosis and treatment of the disease, Villanueva said.

“As a physician, I see too many cases that present too late,” she said. “People need to enter the healthcare system earlier.”

Villanueva added that in developing nations, the lack of accessible medication is the main barrier to effective treatment of the disease, whereas in the United States, the stigma associated with AIDS and the race and poverty disparities of patients often prevent people from seeking treatment. With medications developed over the past two decades, people infected with HIV can live almost normal lifespans, she said.

The Yale clinic is the largest AIDS clinic in the state and is the only one in the city to provide intensive patient care, including liver and kidney transplants.

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