September 12, 2005
"People living with HIV who stop antiretroviral therapy against medical advice can and will get very sick, and some will die," according to Academy of HIV Medicine president Dr. Howard Grossman. "Antiretroviral drug therapy requires a high degree of adherence. HHS has long considered HIV treatment a high-priority, and now they must do everything in their power to ensure Katrina survivors have continued access to medicine and care."
Community-based organizations have been told by Health Resources and Services Administration staff that no provision has been made for emergency flexibility of Ryan White CARE Act funds to allow neighboring states to care for HIV-positive Katrina survivors. "Valiant AIDS service organizations from the affected states are operating in exile in hotel rooms and makeshift offices. Organizations in neighboring states are providing care and treatment for evacuees, even without identified financial resources," Terje Anderson, executive director of the National Association of People with AIDS, reports. "AIDS Drug Assistance Programs (ADAPs) in affected states are starting to get HIV medications to evacuees. But even before this disaster, Alabama's ADAP had more than 500 people on a waiting list, and the rest of the affected and neighboring states were already filled to capacity. It's vital that the ADAP program and the other parts of the Ryan White CARE Act receive immediate federal emergency supplemental funds for folks to remain in care."
Diagnosing HIV-positive Katrina survivors who don't know their HIV status is another urgent public health need. "People with damaged immune systems are far more likely to suffer from dysentery, tuberculosis, specific pneumonias and diseases caused by exposure to pathogen-laden flood waters," according to Julie Davids, executive director of the Community HIV/AIDS Mobilization Project. "And medical personnel may not realize that one in four HIV-positive people in our country don't know they are infected. Thus, the risks for Katrina survivors remaining unaware of their HIV status are serious and enormous. The CDC must step up efforts to provide an adequate supply of rapid HIV testing kits to community organizations throughout the region and around the country to ensure that counseling and testing are available for evacuees near and far from the disaster and educate providers about how to recognize infections in immune-suppressed people."
"People living with HIV/AIDS who have been evacuated from New Orleans or elsewhere are going to need housing and transportation to get to medical appointments. The affected states will need new medical and social service facilities. People will become infected with HIV without access to HIV prevention information and services," according to states Damon Dozier, Congressional Liaison for the National Minority AIDS Council. "If you have HIV/AIDS, you still need everything you needed before Katrina. Preserving life and health for people living with HIV/AIDS must be a top recovery priority, or we will pay a far greater price soon enough."
Recommendations for the triage of HIV-positive patients, released by the American Academy of HIV Medicine and the HIV Medicine Association are particularly useful for front-line providers without experience treating HIV disease and are located on either organization's Web sites.