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Facing the future
County organizations work together in new ways to help locals living with HIV and AIDS
BY AMY ASMAN

Date: 04/23/2008

Hanging on the deep purple walls of the Pacific Pride Foundation's recreation room in Santa Maria are a dozen white, plaster of Paris masks. The tranquil, almost dream-like faces make up an installation visitors would likely find on display at a local cafe or winery. But these pieces of art have a much more profound and somber meaning than simple decoration.


Getting the word out:
The programs at Pacific Pride Foundation are run by a small but dedicated group of a dozen or so staff members and volunteers, including (from left to right) Director of Education and Prevention Buck Derrington, certified HIV tester Curtis Treehaw, and Volunteer Coordinator Jocelyn Smalley.
PHOTO BY AMY ASMAN
"Those are death masks," said Buck Derrington, the organization's director of HIV and AIDS Education and Prevention. "Each one of those masks represents a man, woman,www.everlongines.com or child living in Santa Barbara County who has either been infected or affected by HIV and AIDS."

The masks were made by Pacific Pride Foundation clients and volunteers in 2006 to mark the 25th anniversary of the HIV/AIDS epidemic. They serve a dual purpose: honoring people affected locally by the disease, as well as the roughly 30 million AIDS-related deaths that have occurred worldwide since the early 1980s.

Prevention and treatment for both HIV and AIDS has come a long way since the epidemic first began. Thanks to improvements in medication and educational materials, people infected with HIV are living longer and more fulfilling lives, and minimizing transmission of the virus.

Still, it's nowhere near being eradicated. According to the World Health Organization and the Centers for Disease Control, there are approximately 2.2 million new HIV infections in the world each year, 60,000 of which occur in the United States.

Also, the face of HIV and AIDS is changing throughout the world, with women and children almost equaling men for numbers of infections. What was once given the knee-jerk label of a "gay disease" is affecting men and women of all ages, ethnicities, and sexual preferences.

There are, however, some emerging trends. Today, in the United States, women account for more than one quarter of all new HIV/AIDS diagnoses. In 2004, the most recent year for which complete data is available, the CDC found that HIV infection was the leading cause of death for black women ages 25 to 34 years old one of the leading causes of death for black women ages 35 to 54 years old and the fourth leading cause of death for Latino women ages 35 to 44 years old.

Overall, HIV was the fifth leading cause of death among all women ages 35 to 44 years old, and the sixth leading cause of death among all women ages 25 to 34 years old. The only diseases that caused more deaths among women were cancer and heart disease.

These trends are reflected in Santa Barbara County.

"Fifty percent of our new HIV cases are women," said Pacific Pride Foundation Executive Director David Selberg, adding that many women discover their positive HIV status only when they become pregnant.

And, according to the Santa Barbara County Public Health Department, nearly 50 percent of the new HIV-positive diagnoses are coming out of the Latino community. Most of these new cases, Selberg said, are affecting not only individuals, but entire families.

Overall, as of December 2007, there are approximately 330 recorded cases of people living with AIDS in the county, and 75 recorded cases of people living with HIV. That number, however, doesn't account for people who either aren't aware of their status or don't seek treatment.

"We're confident about our data on AIDS diagnoses in 2007," said Dan Reid, HIV/AIDS program administrator for the Santa Barbara County Public Health Department. "Our HIV data is definitely not as good and somewhat suspect."

In order to combat the spread of HIV and AIDS among people of all ages and ethnicities, organizations across the world are hard at work bringing resources to people in need.

In Santa Barbara County, there are three county-run medical testing sites and several outreach sites, including the Pacific Pride Foundation, Allan Hancock College, Planned Parenthood, and Santa Barbara Neighborhoods.

These organizations work jointly with local governments to increase regular HIV testing and overall HIV/AIDS awareness, as well as access to affordable treatment and other resources.

The Pacific Pride Foundation, which provides the majority of prevention and educational materials in North County, offers multiple programs to people with HIV and AIDS, as well as the lesbian, gay, bisexual, and transgender communities. These programs include education and prevention materials, free HIV testing, counseling, a food pantry, access to support groups and activities, community referrals for treatment, and other resources.

"We have two major goals at the Pacific Pride Foundation: to keep HIV-positive people from transmitting the virus to negative people, and to monitor and treat people living with HIV and AIDS," Derrington said.

The Pacific Pride Foundation receives the majority of its funding through Santa Barbara County, as doled out by the Board of Supervisors. In March, the Department of Public Health was authorized to establish a three-year contract between the county and the Pacific Pride Foundation to the tune of approximately $508,000 to implement the Early HIV Intervention Project.


Masked pain:
These plaster of Paris "death masks" hang on the walls in one of Pacific Pride Foundation's meeting rooms in Santa Maria. The pieces are a local memorial to the millions of people worldwide who have either been affected by or infected with HIV or AIDS.
PHOTO BY STEVE E. MILLER
Through the project, Pacific Pride Foundation provides free, anonymous HIV testing once a week to North County residents. The organization is also the only North County location legally authorized to conduct weekly clean syringe exchanges.

That program and the Pacific Pride Foundation have been blasted by several critics in the county who feel that it's simply enabling drug users.

When asked what he thought about the criticism, Derrington said, "The purpose of the exchange is to prevent the spread of blood-borne pathogens, such as HIV and hepatitis. It's not designed to be an enabling device, it's designed to be a harm-prevention program."

The exchange is conducted on a one-to-one ratio one clean syringe is given out for each dirty syringe received. However, unlike many other counties implementing similar programs, Pacific Pride Foundation has a 113-percent return rate, meaning that the organization receives more syringes than it gives out.

"So we're actually reducing the footprint of needles in the county," Derrington said, adding that, in comparison, San Francisco has return rate of 60 percent.

Executive Director Selberg agreed: "Drug use is everywhere, including Santa Barbara County. What's interesting is that our community isn't very aware of it. We literally exchange tens of thousands of needles a year."

During HIV testing sessions and the syringe exchanges, Pacific Pride Foundation staff members record personal information about the individuals participating, including any high-risk behavior. They then discuss alternative behavior options and provide resources, such as educational materials and referrals for medical care.

"If someone is ready to get clean, we're more than willing to drive him to down to detox or walk him over to Narcotics Anonymous," Derrington said.

Still, while drug use is a major factor in HIV transmission in the county for both men and women, the leading cause of infection for both groups is unsafe sex.

The majority of women who contract HIV, both in Santa Barbara County and the rest of the nation, do so through unprotected, heterosexual sex. In most cases, the woman doesn't know the HIV status of her partner. This trend is especially apparent in minority populations.

According to the CDC, black and Latino women account for roughly 81 percent of the women living with HIV in 2005 who acquired it through high-risk heterosexual contact.

Some factors impacting this trend include a lack of HIV knowledge, lower perception of risk, drug and alcohol use, and relationship dynamics. Poverty also plays a large role. Socioeconomic problems, including limited access to high-quality health care, and high levels of substance use, can increase HIV risk factors.

And language is a major barrier in HIV prevention and education.

"For so many years, all HIV and AIDS prevention materials and programs have been in English," Derrington said. "We're trying to change that."

One way Pacific Pride Foundation staffers reach their non-English-speaking clients is through "chicos novellas"--roughly translated as "little comic books"--which help define HIV and illustrate key factors to HIV prevention.

Even with all of the preventative tools available today, Pacific Pride Foundation doesn't always reach everyone in time.

"There's a mentality out there that if you don't feel sick then you're not sick," said Carol Gerletti, one of Pacific Pride Foundation's nurse case managers.

Gerletti said that many people don't even find out they're HIV positive until the virus has progressed into full-blown AIDS.

"[At that point], we just pray that their immune systems recover--and a lot of times they don't," she said.

Still, many people don't seek treatment even if they know their status because they're afraid of being ostracized. For example, Gerletti said she's had clients who, after revealing their status to their families, were asked to leave or given their own cups, plates, and utensils with which to eat.

"There was no more touching, and no more hugs," she said. "One client of mine wasn't even allowed to see his nieces anymore. And he'd been babysitting them since they were toddlers."

"It's very sad and it's not uncommon, even in today's culture of awareness and treatment," she said.

Fear of being ostracized, she said, is especially prevalent in areas that are considered socially and politically conservative, such as Northern Santa Barbara County.

Derrington agreed, stating that "places with 'hidden' populations" usually have a higher risk of transmitting and contracting HIV, and are more subject to violence and stigma.

"Hidden" populations, he explained, are people on the margins of society, such as homeless people, members of the LGBT community, potential drug users, and immigrants. Such populations are especially vulnerable in rural places where there aren't a lot of public meeting places or support systems.

That's why, Derrington explained, places like the Pacific Pride Foundation are so important: "They offer coping mechanisms and allow people living with HIV to forge meaningful relationships with other people experiencing the same challenges."

 

INFO BOX: HIV/AIDS resources in Santa Barbara County

For more information about free HIV testing and HIV/AIDS prevention and education, contact Pacific Pride Foundation at 349-9947 (North County) or 963-3636 (South County), or visit www.pacificpridefoundation.org.

Contact the Santa Barbara County Public Health Department at 346-8410, Ext. 5120 (North County) or 681-5120 (South County), or visit www.sbcphd.org/dcp/hiv_aids.html.

SIDEBAR: Living with HIV

Santa Maria native Curtis Treehaw moved to San Francisco's Castro District in 1978. As a gay 17-year-old, Treehaw said he couldn't wait to get out of the Central Coast area and into city life. For six years, Treehaw "partied and did everything" imaginable during a time rife with drug use and sexual experimentation.

But Treehaw's wild partying and carefree lifestyle came to an abrupt halt in 1984 when he tested positive for HIV (or Human Immunodeficiency Virus, a retrovirus that can lead to AIDS).

"I'm not sure when I was infected. I never had any health problems," Treehaw said.

In 1981, the Centers for Disease Control and Prevention reported the first official instance of AIDS (Acquired Immune Deficiency Syndrome) in its Morbidity and Mortality Weekly Report. The newsletter reported the appearance of a rare form of pneumonia in five gay men living in Los Angeles.

Following the release of the CDC article, similar cases--along with other opportunistic diseases commonly found in immunosuppressed patients--were discovered among otherwise healthy men in cities throughout the country.

In June of 1982, a report documenting several cases of immunodeficiency among gay men in southern California suggested that infection might be caused by a sexually transmitted disease. As a result, the syndrome was initially termed GRID, or Gay-Related Immune Deficiency.

It was an extremely frightening time for Treehaw, who watched almost all of his longtime friends become infected with HIV and eventually die from AIDS-related illnesses.

While the virus didn't seem to be affecting him physically, it had a devastating effect on the world around him.

"It got to the point where you'd walk down Castro Street and see someone you knew, and if you didn't see him for a couple of weeks, you just assumed he died," he said.

"I really didn't think I'd see 1990," he explained. "[Being infected with HIV at that time] was like waiting for the other shoe to drop, but it never dropped."

Despite the early terminology, health officials soon realized that nearly half of the people identified with the syndrome were not gay men. According to the CDC, opportunistic infections were also reported among hemophiliacs, heterosexual intravenous drug users, and Haitian immigrants. The CDC renamed the disease AIDS in August of 1982.

Treehaw made it out of the '80s alive--unlike so many of his friends and tens of thousands of other AIDS victims. He then spent more than a decade in considerably good health.

But in 2005, Treehaw's T cells--specifically CD4 cells, which help the immune system fight against infection--hit an all-time low of 200 cells per cubic mm, signifying the onset of AIDS. By comparison, a healthy, HIV-negative adult usually has anywhere from 500 to 1,500 cells per cubic mm.

Following his diagnosis, Treehaw had to go on disability and started taking one of several potent "drug cocktails" concocted to combat the virus. Burdened by medical bills and the increased cost of living, Treehaw moved back to Santa Maria in 2006.

"I didn't have to worry about money, and I was so happy to be living closer to my family," he said. "But it was quite a transition."

In order to help him cope with the virus and his changing lifestyle, Treehaw got involved with the Pacific Pride Foundation. He started by answering phones and doing other administrative tasks, but soon decided to become a certified HIV tester.

"I felt it was time to give back in a positive way," he said.

Treehaw said he sometimes uses his own experience with HIV and AIDS as a way to connect with his clients, and help people overcome their fears and misconceptions of the virus.

"[HIV] isn't a death sentence anymore. You can lead productive lives and have meaningful relationships," he said. "I never thought I'd hit 40. Shoot, I never though I'd reach 30--and now I've got gray hair."

-Amy Asman


Staff Writer Amy Asman can be reached at aasman@santamariasun.com.

 


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