The DPH’s Nicole Kolm-Valdivia says cases dropped by 12 to 125 in 2017. The numbers had increased by 10% in 2016 and she says it’s hard to tell exactly why the numbers have been up.
“We have a lot of outreach and media efforts — and so we think those are working — and we think people may also have increase access to healthcare and are getting tested that way,” Kolm-Valdivia. “So, even though it can sometimes seem alarming that we are having more people who are being diagnosed, it can actually mean that there’s just more people who are aware of their status who can get into healthcare and access those services.”
Kolm-Valdivia says they want to continue letting people know about the importance of knowing their status. “The ultimate goal is for people who have HIV to get diagnosed soon after they acquire the virus,” Kolm-Valdivia. “Because we see that once people become virally suppressed — meaning the level of HIV in their blood is really low — they cannot sexually transmit the virus and their health outcomes are improved.”
She says the IDPH is targeting the African-American and Latino populations because they have a disproportionate number of cases for their population size. “We do see that African-Americans make up about three percent of Iowa’s population, but about 30% of people who were diagnosed with HIV last year. Latinos are about six percent of the population in Iowa — but about 13 percent of people who are diagnosed,” according to Kolm-Valdivia. “And so, we see a lot of different factors that are associated with those rates like higher rates of poverty, immigration, historical trauma, segregation, compounded by things like racism and homophobia, stigma.”
Men who have sex with other men continue to be the largest number of Iowans diagnosed with HIV at 56%. Kolm-Valdivia says the state has some tests sites they fund to do testing in this group.
“They do specific outreach with populations such as men having sex with men to ensure that they are getting testing that they need as well as access to condoms and then pre-exposure prophylaxis– which is medication that can prevent HIV,” she says. Kolm-Valdivia says all Iowans ages 15 to 64 should get tested for HIV at least once in their lives. People who do not use condoms during sex or inject drugs should be tested more frequently.
“We know there are over 400 Iowans which HIV who have not been diagnosed,” Kolm-Valdivia, “And so we recommend that everyone get tested and learn their status. And if they have HIV, get into medical care.”
Kolm-Valdivia says the treatment of HIV has advanced dramatically since the disease was first discovered.
“HIV is treated much more like a chronic disease now. So, people go into their provider once or twice a year and are on medications and the side effects are minimal and the health outcomes are much improved — similar to someone who doesn’t have HIV,” Kolm-Valdivia explains.
Kolm-Valdivia says they recommend that health care providers ask patients about their sexual health or drug use to help assess their risk for HIV.