Program Description

Overview: Update

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Program Transcript

[IN ORDER OF APPEARANCE]

Perry: I think about all the people that I'll never meet because of—all the people that won't want to be my friends, or all the people that will talk about me because I am HIV positive.

Monroe: HIV/AIDS is everywhere in North Carolina according to health leaders, and it's taking a toll on everyone.

Witt: I think it's important for people to recognize that people who are living with AIDS are their sons, their daughters, their parents, their grandparents.

Monroe: Numbers of new cases keep growing and AIDS advocates say does the stigma surrounding the disease.

Gleeson: People are afraid of being thrown out of their homes or being ostracized by their church family.

Monroe: In the next hour you will meet the people who live with HIV and AIDS in North Carolina. You'll see firsthand the efforts to educate them.

F: Saying the word, "AIDS", will not kill you, but in the knowledge, it will kill you.

Monroe: Eradicate.

Vanhoy: If we had a vaccine that would stop infection tomorrow, it would have a tremendous impact.

Monroe: And inspire.

Slovensky: We can beat this. We may not be able to overcome it, but we don't have to lay down to it.

[THEME MUSIC]

Monroe: Hello, I'm Claire Monroe. Thank you for joining us as we explore the new age of HIV and AIDS in North Carolina. This will an in depth and frank discussion about the epidemic and we ask you to be aware, some of our content might not be appropriate for all ages.

HIV, of Human Immunodeficiency Virus, is an infection transmitted through blood and other body fluids. It attacks the body's immune systems and ultimately leads to AIDS, a disease in which immune function fails and the person develops opportunistic infections that cause death.

We talked the experts on HIV and AIDS at leading research institutions such as the University of North Carolina and Duke University. We also went to the state's HIV/STD prevention's care branch international research organizations and community based agencies all across North Carolina to learn how the disease affects North Carolinians.

Who is at greatest risk and why? See how what was once just a big city problem now also affects small towns and rural areas. Who pays for preventing and treating HIV? We'll talk about what scientists are doing to stop it and see where people living with HIV find the strength to fight it everyday.

Doctors reported the first case of AIDS in North Carolina in 1983, but epidemiologist believed the disease was here as early as 1980. In the years immediately following it affected primarily white gay men, but not anymore. This is the new age of HIV and AIDS.

Wiggins: I kept on going to the hospital week after week and coming down in these flu-like symptoms, and I really didn't know what it was.

Monroe: That was 10 years ago. Franklin County native, Fred Wiggins, had moved west for the bright lights of L.A. where he says he lived the stereotypical Hollywood lifestyle filled with sex and drugs. But when he came back home, doctors gave him devastating news. He had AIDS.

Wiggins: I asked to be left alone for a moment, and of course a tear or two came out, and after that I picked myself up and said, "Hey, I slept in the bed. I made it, you know? This is some of the consequences."

Monroe: Fred Wiggins is just one example of how the HIV/AIDS epidemic has changed dramatically in North Carolina. Doctors say this disease now affects every segment of the population in ever-increasing numbers.

According to the State Department of Health and Human Services, about 29,500 North Carolinians live with HIV/AIDS. Since the epidemic began more than 20 years ago, AIDS has killed nearly 9,000 people in our state. And the number of new HIV and AIDS cases keeps growing, up about 13% since 2001. That year 1,594 people were diagnosed in North Carolina. By 2005, there were 1,806 new cases. There was a spike in 2003 when the number jumped to 2,100. But epidemiologists say that was because of increased surveillance efforts, not more people contracting HIV.

In this new age of HIV/AIDS African Americans account for a majority of new infections. In 2005, 63% of those diagnosed where black, 28% white, and 7% Latino. Men represented 72% of new cases, women 28%. Most contracted HIV through sexual activity. Among men, 69% said having sex other men put them at risk. Another 23% believe they got HIV from sex with women. Just 8% say they contracted HIV through injecting drugs. Among women, 83% got HIV from heterosexual sex. And injecting drugs accounted for about 12% of new cases.

Dr. Peter Leone, medical director for the state's HIV/STD prevention and care branch, says those numbers prove these days HIV is everyone's problem.

Leone: You should care, because if you're sexually active, you're potentially at risk for HIV. This epidemic is far from over in the United States.

Monroe: The statistics show that in this new age of HIV/AIDS minorities bear a disproportionate share of the disease's burden. Experts say their culture, lifestyle, and socioeconomic status all play a role in contributing to the spread of HIV.

We look now at why, and what some of minority communities are doing to educate themselves and stop HIV.

Williams: Minorities make up approximately 25% of the state's population, but the proportion of new HIV/AIDS reports that we see--we see around 75% of those reports are from 25% of our population.

Monroe: Epidemiologist Dr. Del Williams says HIV is hitting African Americans especially hard. State statistics show the rate of infection for all African Americans is seven times greater than for whites. For black women, the rate is 12 times higher than for white women.

Mickens: This is my number right here. So if you guys ever want to get tested or if you just got questions, give me a call.

Monroe: Guilford County outreach worker, Lloyd Mickens, says a lack of empowerment is part of the reason why.

Mickens: Women have always been real good about taking care of their health except for this area with some women that aren't assertive, and some women that have low self esteem, that are afraid that if, "Well if I ask him to use a condom, he's going to leave me or he's not going to want me anymore."

Monroe: AIDS educators say among black men there are some who secretly have sex with other men but live a straight lifestyle, which puts them and their partners at risk.

Williamson: It's very difficult to reach those people because there is no place that they commune together. There is no place where we can go and say, "Hey all of you people right here, this is a message." We have to kind of target the population as a whole, but make it reach those people as well.

Monroe: Sexual behavior is not the only risk factor. Dr. Del Williams says socioeconomic status plays a part too. People at the bottom of the socioeconomic ladder typically have less access to high quality health care, which puts them at greater risk for health problems such HIV.

Williams: The unfortunate reality in North Carolina is that our African American community does have overall, at least on average, a lower earning capacity than the white population or the majority population.

Monroe: Milford Evans agrees when it comes to preventing HIV and AIDS, money matters. He has worked as a benefits advocate, helping hundreds of people living with HIV. Evans and Dr. Williams agree when people don't have the money to take care of their basic needs, much less their health, they are at greater risk for getting HIV.

Evans: Well, it's real hard for the poor to have the access to these resources, where they can be compliant with their medication. Because I mean as far as like even treatment goes, prevention, they come to my office for condoms because they don't have it in their budget to buy condoms. They don't.

Williams: One of the things that happens is that if you don't have money for all of your necessities, you try to prioritize. And generally food is going to come first. Health care may comes last.

[CROWD CHANTING, "PREVENTION AND CARE"]

Monroe: That's why advocates organize rallies like this one in Raleigh, to call for more awareness, more funding, and more support for HIV/AIDS in the African American community. And state health leaders say they hope to see similar efforts among Latinos, where they say the new age of HIV/AIDS could someday soon be an AIDS crisis. Epidemiologists say the number of new cases among Latinos jumped from 15 in 1998 to 125 in 2005. That's an eight fold increase. Latinos represent 7% of all cases in North Carolina.

Williams: The actual numbers are still relatively small, but the disturbing is that we're seeing an increase every year, and it's not going to be too long before that increase really, unfortunately I think, will start to take off.

Monroe: That expected increase is a red flag to Dr. Rafael Torres. He's an HIV specialist at Tri County Community Health Center in Sampson County, where he cares for more than 250 HIV and AIDS patients. Many of the Latinos he treats are migrant farm workers whose lifestyle he says puts them at risk.

Torres: If all your family is back home, you're working seven days a week; you have half a day to do recreation. Probably the most common cause of happiness will be alcohol. With alcohol comes care free behavior. And probably you'll be missing your wife. You'll be engaging in situations that might endanger your health.

Monroe: Dr. Torres says bilingual access is an obstacle to HIV education and care for many Latinos. That's why Tri County has a bilingual outreach team, which will go almost anywhere to educate people and test them for HIV.

F: Can you tell me? Do you know how can get HIV?

Bass: We get on to the migrant camps. We go and we set up at churches. We've set up at the college, at the Indian Tribal Center because we have a large American Indian population.

Monroe: Outreach worker Adolfo Aguilar agrees education is critical to stopping HIV among Latinos, and he says it's most effective when it happens where the people are. He works for the Chatham Social Health Council in Siler City, where the Latino population has grown rapidly in recent years. He targets factories, soccer leagues, and Latino grocery stores.

[OFF MIC SPANISH DIALOGUE]

Monroe: He gives out free condoms and tells people how to reduce their risk for HIV. He says he's made significant progress in educating the community.

Aguilar: Three years ago they wouldn't think about it, not even think about. They'd say, "AIDS and HIV is only for gays. Gays is a big problem, only the Americanos," they would say, "can get AIDS." Now people, they're really open. I mean you can walk on the street and talk about condoms like talking about the weather. So now they feel comfortable.

Monroe: Making people comfortable is also the idea behind El Centro Hispanos's Project Life in Durham. Promo torres, or peer educators, go door to door in their own neighborhoods where residents know them and are likely to trust them. But health educator, Oscar Garcia, says building trust is just one barrier to overcome. There is also a unique cultural sensitivity.

Garcia: One of the obstacles that I see is religion because, you know, most of Latinos are Catholic, you know, and Catholics don't believe in condoms, you know, protection. So sometimes when I like, even when I go to the clubs and I give out like, because we do outreach at bars, you know, and I give out like the condoms. They're like, "Oh, you just disrespected me, you know?"

Aguilar: Well, and HIV and STDs is one of the hardest things to talk about because it involves sex, and sex is kind of not allowed in our community, not much to talk about it.

Monroe: One place many people say you can talk about sex is a college campus, where attitudes about sex are often more open, but talk is not enough to stop the disease from spreading because doctors say the new age of HIV/AIDS has seen a rapid rise in new cases among college students in North Carolina.

Jonathan Perry is one of the people infected. He got the disease from the man he'd been dating.

Perry: I had asked him before we'd had sex if he was HIV positive, he had anything I could contract, and he told me, "No."

Monroe: Perry thought he was protecting himself. He and his partner used a condom, but it broke. Then he found out his partner had not told the truth about his HIV status.

Perry: I asked him why he lied to me and he was like, well because he figured I wouldn't want him if, you know, I knew he had it.

Monroe: Perry is a recent graduate of Johnson C. Smith University in Charlotte. Researchers at UNC Chapel Hill, who are studying an HIV outbreak on college campuses, say he is one a growing number of students diagnosed with HIV.

Leone: What we found was very few cases in 2000, but a gradual increase from 2000 through 2003. So then by 2003 we had 30 new cases of HIV in college students that had been diagnosed that year.

Monroe: Doctors Peter Leone and Lisa Hightow say over those four years a total of 84 men at 37 colleges statewide contracted HIV. And by examining the men's sexual patterns and partners, they found links to similar outbreaks in five other southern states.

Hightow: When you look at the number of colleges that are involved, the number of students, we see a trend. And our goal as public health practitioners is to prevent the numbers to be getting into the range of the hundreds and the thousands.

Monroe: The researchers say a critical part of that effort will be getting students to realize they are at risk. Dr. Leone says many newly diagnosed students met their sex partners in bars or over the internet, and most grossly underestimated their own vulnerability.

Leone: Even though they were engaging in relatively high risk sexual behavior, and what I mean by that is we're talking about 30 to 40 % of these students engaging in unprotected, receptive anal intercourse, probably the highest risk activity you can engage in, and yet none of them, zero, thought that they were likely, or very likely, to contract HIV.

Monroe: Changing that belief has become Jonathan Perry's mission. He has spoken at national conferences and was featured on the Oprah Winfrey show talking about the college HIV outbreak.

Perry: We have to create some drama, how we have to stir in some mess. We have to do nontraditional things to get nontraditional results.

Monroe: Nontraditional things like tailoring prevention messages specifically to black students. Just like the larger HIV epidemic, the college outbreak disproportionately affects African Americans.

State figures show 88% of the students diagnosed with HIV from 2000 to 2003 were black. The state's response is an initiative called Project Commit to Prevent which targets the state's 12 historically black colleges and universities or HBCUs.

Gray: Some of the campuses have actually had contests to see who could develop the best safe sex message. Some campuses send out email messages to their entire campus membership, you know, things that they need to know about HIV and STDs.

Monroe: At Johnson C. Smith University, an HIV 101 class is mandatory for freshmen. The university hosts safe sex parties to teach all students about prevention in an easy going atmosphere. And peer educators work to dispel the myths about HIV.

Charleston: You put a face on it. You can say, "Hey, it can happen to anybody whether you're pretty, whether you're not, whether you're smart or not, it doesn't matter. It doesn't have a face. It's not a preference. Anybody can catch that disease."

Gray: If only one quarter of the organizations did one thing related to HIV prevention, how many students could be impacted?

Monroe: Forums like this one at North Carolina A&T in Greensboro also give student the chance to hear the facts about HIV and suggest ways to increase AIDS awareness and testing.

M: They take shuttles to the clubs; why not take shuttles to the Department of Health?

Monroe: State health leaders say it's important to realize the HIV outbreak is a problem not just at HBCUs, but on all campuses.

Hightow: We wanted to emphasize that it's not one campus. It's not, you know, even one part of the state. And it's, you know, it's certainly not just, you know, one demographic. It's anyone who is having, you know, unprotected sex certainly can be at risk.

Monroe: That's where UNC Chapel Hill's safe sex squad comes in using another nontraditional tactic to help reduce the risks.

M: Just to go over a few rules before we go out this evening. If you like to engage in discussions, feel free to. However, don't force anything on anybody.

Monroe: Once a month students hit the streets to pass out safe sex kits to anyone who will take them.

Each kit contains condoms along with instructions on how to use them and information about healthy relationships, abstinence, and HIV testing. Educators say this prevention effort and all the others on college campuses are vital because lives are at stake.

(continued...)