The estimated annual diagnosis rate for HIV disease in Kentucky state was 7.6 per 100,000 people in 2018. The state ranked 26th in the country with regards to inclining HIV rates. Jefferson County happens to be the hub of infection as it reported the highest number of HIV rates with 4,524 cases diagnosed in the past decade and 2,916 people living with HIV in the area by June 2017.
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HIV (human immunodeficiency virus) rates in Kentucky are on the rise, and there is a dire need to address it. The importance of raising awareness about HIV testing and prevention cannot be overlooked. Routine HIV screening raises awareness to the broader provider community and patients that it's no longer a stigma to talk about HIV or get tested. We need to start talking about HIV more openly and get to know our HIV status no matter which faith, ethnicity, or social class we belong to. With increased access to routine screening, HIV prevention is possible.
Safe sex practices are a suitable method to prevent the virus, but HIV screening can help detect and identify infected patients at the right time. This can help the government deal with the inclining morbidity and mortality rates among those diagnosed with HIV. Most people who tested positive at a later stage were identified as a significant cause of the spread of HIV. So, the only way to contain the virus's spread and treat it before it transforms into a life-threatening disease is testing. Every individual should get tested at least once a year, whether teenager or older adult, male or female.
The Kentucky Department for Public Health HIV/AIDS Section is responsible for assessing the current and future rates/impact of HIV in the state. The Kentucky Cabinet for Health and Family Services Department for Public Health (DPH) has implemented a new program in collaboration with the University of Kentucky called the Kentucky Income Reinvestment Program (KIRP).
This initiative aims to improve health care delivery across the state via disease prevention, education, treatment, and professional services for people living with HIV. This program is launched alongside the existing Ryan White HIV/AIDS funded programs already implemented in Kentucky and harm reduction programs at the statewide operating local health departments.
According to DPH commissioner Jeff Howard, "this collaborative partnership will strengthen our capabilities to combat the spread of HIV in the region. This program is a first step in creating a more innovative approach to reaching at-risk populations, strengthening our public health approaches to disease prevention and providing improved care."
This initiative will entail pilot programs to fund innovative HIV prevention projects across the state and address barriers in access to care and supportive services for high-risk populations and those living with HIV.
Apart from preventing new HIV cases, this program will also attempt to educate existing health care providers/under-training health professions' students to address mental health issues and substance use disorders hindering effective HIV and medical care.
To deal with HIV outbreaks, the state's law allows all county health departments to offer a syringe exchange program to reduce the spread of infection and reduce drug usage.
Another important initiative is Data to Care public health strategy, in which HIV surveillance data is used to identify people living with HIV who aren't in care and link them to health care services. This program is supported by the Centers for Disease Control and Prevention. It also supports them along the HIV care continuum.
In Kentucky state, a disparity is noted in heterosexual black females compared to white females. Black females comprise nearly 47% of all new HIV diagnoses, while 44% were reported among white females. On the contrary, white males reportedly had the highest diagnosis rate with 64%, whereas new diagnosis rates among black males were 30% in 2018. Around 56% of HIV cases in Kentucky were diagnosed in MSM (men who have sex with men), 14% got infected via heterosexual intercourse, 10% contracted the virus via IDU (intravenous drug use), and 5% contracted it through both means between 2007 and 2017.
In 2018, around 7,337 people were living with HIV in the state, and the number of newly diagnosed cases was 372, AIDSVu reports. As per the statistics shared by the DPH for Public Health's HIV/AIDS Surveillance Program, by 2018, around 10,567 total HIV infections were detected among Kentuckians since 1982. This shows, there has been a considerable rise in the infection rate over the past five years.
The department also noted that out of these reported infections, 63% progressed to AIDS. Reportedly, among the 3,924 cases diagnosed since 007, nearly 1,530 or 39% progressed to AIDS by June 2018. The department published its HIV Surveillance Report, 2018, where it was reported that the annual HIV diagnosis rates remained steady between 2007 and 2016, with 7.1 to 9.0 cases per 100,000 people.
However, in Kentucky, injection drug use is a leading risk factor for HIV transmission. As per a cluster investigation carried out in January 2018 in Northern Kentucky, injection drug use was higher in those newly diagnosed with HIV, reported the Kentucky Department for Public Health. Moreover, as noted above, the rate of new HIV diagnoses in white, non-Hispanic Kentuckians is much higher than anywhere in the USA (52% and 26%, respectively). This could be partially attributed to the greater percentage of the White population across the state.
The transmission of HIV disease via injection drug use is a cause of concern for the state's department of health and public health officials. The number of cases reported in Northern Kentucky only increased from 2 in 2014 to 29 in 2018, whereas statewide, HIV cases via injection drug usage rose from 22 in 2014 to 67 in 2018.
According to the HIV Surveillance Report 2018, since the earliest reported cases of HIV back in 1982, most of the diagnoses of HIV among Kentucky residents have been reported in males with 83% (8,739 cases overall). In terms of age at the time of diagnosis, males aged 30-39 comprised 34% of all HIV cases, which is higher than any other age group among males. The same age group accounted for the highest number of cases among White males.
On the other hand, among Black males, 35% of all reported cases in 2018 were diagnosed in people aged 20-29 years, whereas 29% of cases were diagnosed in the 30-39 age group. Around 40% of HIV diagnoses among Hispanic males were identified in the 20-29 age group, and the 40-49 age group reported the lowest number of cases in this ethnicity.
White males between the 40-49 age group accounted for 23% of all reported HIV cases in 2018, while 20% of black males were diagnosed with the virus. Only 6% of blacks diagnosed with HIV were in their teens at the time of diagnosis, and 2% of white and Hispanic males were in their teens, comparatively.
A similar pattern is noted among HIV-infected females. The highest number of HIV cases (32%) were diagnosed in females aged 30-39. The rate was almost similar for Black and White females, whereas Hispanic females aged between 20 and 29 reported the highest number of cases (46%).
The highest number of cumulative HIV cases in 2018 determined the men having sex with men (MSM) as the primary exposure route as 67% of all cases among males had this cause of infection. Around 49% of adult females were exposed to the virus via heterosexual contact with an HIV-infected or high-risk individual, such as those who injected drugs.