The once-certain fatal disease continues its march through the regional population because of many factors, said Kim Nesvig, CEO of Special Health Resources for Texas CEO. But high regional poverty is a major factor.
“We probably have, overall, about 1,200 patients that are currently enrolled and in treatment,” said Nesvig, whose center serves 23 area counties. “It’s fairly flat. It’s not, like, skyrocketing. What bothers you is the number of other sexually transmitted diseases that are going up.”
Those diseases include hepatitis C and chlamydia, both of which can spread along the same pathways as AIDS — unsafe sexual behavior and intravenous drug abuse.
Its rate of 376.9 people per 100,000 population living with HIV, or 465 cases, made Gregg County sixth-worst statewide. Smith County showed a rate of 197.6 people per 100,000 population — 450 cases.
Gregg County had 23 new HIV diagnoses in 2017, while Smith County had 20. HIV is the infectious condition that can develop into AIDS if left untreated.
That data was according to the annual AIDS/HIV report by the Department of State Health Services, called the Texas HIV Surveillance Report. The report was for 2017, the most recent data available.
Nesvig conceded those high numbers for the two most populous counties in the region may be due in part to free testing available at Special Health Resources for Texas. The fact the nonprofit medical agency does its actual diagnosing in Longview, Tyler and Texarkana could be part of the reason.
“That might be one perception,” Nesvig said. “But I think also that it’s a high poverty area. There’s a fairly high degree of poverty.”
A ranking of 16th worst in the state in Marion County, which historically has posted some of the worst poverty numbers in Texas, appears to bear out Nesvig’s AIDS-poverty link. Marion County reported a rate of 208.7 people per 100,000 population — 21 cases.
“I really do think it’s the levels of poverty,” Nesvig said, adding that 1 in 4 people in his service area live below the federal poverty level. “Poverty has several effects on a community.”
Another factor typically rides shotgun with poverty.
“You look around here, and we have high incidence of homelessness,” Nesvig said. “There are going to be a number of dynamics and social factors that contribute. … The upswing in heroin use, that’s had an impact — and, of course, meth.”
He added another somewhat ironic factor in the spread of HIV/AIDS.
Medical research has turned AIDS from an almost certain death sentence to a manageable disease. Sexually active people in high-risk ages, meaning younger people, missed the 1980s when the only potential hope to stop the disease was consistent condom use.
New patients, Nesvig said, “are usually young folks.”
Other Northeast Texas counties fared better in the ranking than Gregg and Smith.
Upshur County had a per-100,000 incidence rate of 101.7 and 42 people living with HIV as of the end of 2017.
Rusk County ranked worse than Upshur with a rate of 117.4 per 100,000 and 62 people with HIV. Next was Harrison County with a rate of 144 per 100,000 people and 96 residents with HIV as of the end of 2017.
There were 38 people with HIV in Panola County by the end of 2017, for a rate of 163.5 per 100,000 population.
Special Health Resources treats people regardless whether they have health insurance. And Nesvig said many who can afford insurance are diagnosed and treated by a personal physician. Doctors still report diagnoses to the state health department.
“Some (of our patients) have insurance,” Nesvig said. “A lot don’t. So a lot of those who come to us can’t afford private insurance.”
Nesvig concluded that factors that lead to HIV have not changed since they were identified once the virus itself was isolated.
Something else hasn’t changed, either, he said.
“I don’t think people have changed a whole lot,” he said. “Back (in the 1980s), HIV was mostly a death sentence. I think there’s probably been a degree of more carelessness.”
Multiple attempts in the past week to discuss the report with Longview-based Wellness Pointe, which also treats and works to prevent HIV/AIDS, were not successful.
Author: Glenn Evans