Program Director, New Orleans Regional AIDS Planning Council
In one session [entitled "Why Are There Still Such Large Gaps in Coverage in the Test and Treat Era?," Mark Nelson, M.D., of Chelsea and Westminster Hospital in the UK] talked about the "steep fall clinics" in London. In London, they don't have any government-sponsored PrEP [pre-exposure prophylaxis] whatsoever. If you want PrEP, you have to go online, pay for it out of your own pocket -- that's on the side when it comes to their prevention efforts.
What they have been doing in these specific clinics is getting many more people in for new, first-time testing and, for those most at risk, doing more frequent repeated testing. The frequency of testing, plus testing everybody, was really showing that their rate of new transmissions was plummeting -- simply from a prevention-with-positives approach, getting them on antiretroviral therapy ASAP, testing the bejesus out of people -- that was an eye-opener for me.
In New Orleans, [seeing no reduction in new HIV cases in recent years, despite improvement in viral suppression rates and other measures], I've really been stumped, and I've very much been attributing it to stigma. It was Jorge from Apoyo Positivo in Madrid who [during his presentation] put up the slide: It's "all about STIGMA" (pictured). That's usually my theory. But I could also see where, if you can get past that enough to get people tested, and have them coming in for testing frequently, and do that counseling and that risk reduction frequently, that can raise education, awareness, break down the stigma -- it can do so much. I was really into that information.
Image credit: Olivia G. Ford.