New Mexico is a rural state in the United States, covering 121,589 square/miles of land area. It is the fifth-largest US state, composed of 33 counties. HIV/AIDS is an issue of concern for New Mexico. However, the state is regarded as a low morbidity zone. In 2018, over 3,500 people were living with HIV (PLWH), and 122 new diagnoses were reported.
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The state’s population is slightly younger than the overall national average, with an average age of 36.8 years in comparison to the national median of 37.6 years. New Mexico’s median age varies between males and females at 35.4 and 38.3 years, respectively. Therefore, the 15-24 and 25-35 age groups are the most at-risk demographic groups in the state.
Hispanics and whites are the most affected ethnicities with HIV. The state has the highest percentage of Hispanics. In 2014, around 47% of its population comprised of Hispanics and 41% whites. It also has the country’s largest population of American Indians than any other state with 9%, and the African-American demography is relatively lower than other states.
Knowing your HIV status is extremely important. HIV testing is the most crucial first step for PLWH to get proper treatment, access to care, prevent transmission of the virus to others, and controlling the infection rate. If treated timely, PLWH can enjoy a long and healthy life and protect their spouses/partners from this chronic health condition.
In the USA, around 85% of PLWH know they have the virus, and 15% or over 162,500 are unaware of their health status. Reportedly, 40% of the new HIV infections are caused by this 15%. More than half of the PLWH remained infected with the virus for at least three years or more before getting diagnosed and treated. Sharing syringes, needles, or other injectable equipment puts uninfected people, especially people who inject drugs, at a greater risk of contracting HIV, Hepatitis, and other infections. Healthcare providers will be able to diagnose HIV earlier if people choose to get tested.
Testing is important to slow down the spread of HIV infection. Since many individuals remain unaware that they have the virus, they are least likely to take precautionary measures for preventing the transmission of the virus to others. Moreover, early diagnosis usually results in earlier treatment with drugs, which is the key to delay the infection from progressing to AIDS.
The Center for Disease Control and Prevention (CDC) suggests that everyone between the age of 13 and 64 get tested once for HIV. This can be done by visiting a health care provider or via community HIV testing centers.
HIV testing is extremely important for pregnant females because if left undiagnosed and untreated, the virus may be passed to their baby. This could be possible while being pregnant, delivering, or breastfeeding. On their first prenatal visit, females must get tested for HIV so that an appropriate course of medication could be suggested for combating HIV transmission to the baby.
The New Mexico State health department receives funding from the CDC to develop and implement scalable and cost-effective programs and policies to intensify HIV prevention efforts across the state.
Funding supports service delivery to the state’s most affected regions and communities. It also promotes evidence-based monitoring of the disease and routine program evaluation. CDC also provides funding to the New Mexico State education department for assessing health-risk behaviors among adolescents and devise HIV prevention activities. The state health department is also responsible for expanding access to youth-friendly and effective health services and education programs for delaying sexual initiation and reduce the rate of HIV infection.
Furthermore, the state has developed numerous innovative strategies and programs within the last three decades for effectively responding to HIV, reduce new infections rate, and provide quality care. Preventing HIV-related health disparities is another important goal that the state is working to achieve. New Mexico offers targeted confidential testing services across the state to identify PLWH unaware of their status.
The New Mexico Department of Health (NMDOH) HIV Prevention Program, in collaboration with partner organizations, provided over 10,000 confidential HIV tests, including pre and post-test risk-reduction counseling between 2014 and 2015. To ensure access to these services to most at-risk individuals in the urban, frontier, and rural areas, HIV testing service is offered at around 80 partner test sites. NMDOH continues to encourage and expand the use of rapid point-of-care devices. This initiative was implemented in 2008, and by 2015, around 35% of all tests were performed via rapid devices.
The New Mexico AIDS Education and Training Center is the regional partner of the South-Central AIDS Education and Training Center (AETC). The department has partnered with Project ECHO for the creation of the New Mexico AETC-HIV TeleECHO program. It is designed to support providers unfamiliar with HIV so that they become proficient in HIV prevention and treatment in a primary care setting.
In New Mexico, ethnic and racial minorities are disproportionately impacted by HIV. The overall burden of the disease has leveled in Hispanics. However, it has risen dramatically among American Indians. The disease rate is higher among African Americans despite composing a small fraction of the state’s populace. In 2014, around a fifth of all new diagnoses were in the Northwest Region. But the burden of prevalent cases is reported in the Albuquerque metropolitan area.
New Mexico has continually faced unique challenges when it comes to HIV prevention. The state reportedly had the second-highest rate of inadequate parental care, medically uninsured, and poverty-struck children in the country back in 2004-2005. Given the state’s large size and rural nature, most residents must travel long distances to access care. Due to this, access to certain services and treatment choices for the state’s residents has decreased significantly.
According to the year 2018 data from AIDSvu, there were 87.8% males and 12.2% of females living with HIV in New Mexico. Hispanics/Latinx comprised the largest group of PLWH in the state with 48%, followed by whites with 34.3%, and blacks had a relatively low rate of 6%.
In New Mexico, the 45-55 and 55+ age group is the most impacted demographic portion amounting to 27% and 36.3% of all PLWH. The 35-44 age group is the third most affected group of the population with 19% of all reported cases, and people aged 13-24 and 25-34 reported a relatively low rate of HIV infection with 2.8% and 14.6% PLWH in 2018.
The percentage of new HIV diagnoses across the state was highest among males, with 84% in 2018. Approximately 15.6% of all new cases were diagnosed in females. Moreover, Hispanics continued to register a higher rate of new cases across New Mexico, with over 53% of all new diagnoses followed by 18% for whites and 5.7% for African-Americans.
Racial and ethnic diversity has proven to be a huge challenge for New Mexico state health departments in improving HIV prevention services. In fact, it is among the most racially/ethnically diverse states in the country. Most ethnic groups differ in disease burden patterns and respond in a culturally distinct manner to prevention efforts.
In 2005, about 5% of female and 12% of male high school students reportedly have had sexual intercourse before turning 13 compared to the national statistics of 9% male and 4% female high school students. In the same year, 16% of male and 11% of female high schoolers have had four or more sexual partners, while the national rate was 17% males and 12% females. The data indicates that the need to inform the youth about safe sex practices and maintain sexual health is higher. Sexual health education (sex-ed) is the key to achieve this.
There are two kinds of sex-ed options in the USA: abstinence-only programs and comprehensive sex-ed programs. The federal government funds both the programs while state legislatures have to decide what type of sex-ed they intend to provide. Out of 50 US states, 37 require sex-ed to be taught, and 26 of them favor abstinence-only sex-ed. New Mexico does not make it compulsory to offer sex-ed at all. Ironically, New Mexico has one of the country’s highest teen pregnancy rates.
In schools where sex-ed is offered, abstinence is highlighted as the ideal form of preventing pregnancy, and unregulated information is provided. States offering comprehensive sex-ed programs have observed a decline in teen pregnancy rates. However, New Mexico still does not mandate that schools are required to provide sex-ed. On the other hand, the state mandates that schools offer AIDS-related instructions and associated issues described in the Comprehensive Health Education Program. But the state has imposed a condition that the instructions should stress abstinence. The expected outcomes of such instructions include the development of refusal skills, decision-making skills, and the ability to overcome peer pressure.