GREENVILLE — In 1983, scientists discovered the virus that causes AIDS. A relatively unknown disease in the early 1980s, people were grappling with understanding how its contracted and treated.
Now, more than three decades later, AIDS is no longer a feared topic of conversation, treatments have advanced and those diagnosed are able to lead a lengthier and healthier lifestyle than before.
According to the Centers for Disease Control and Prevention, an estimated 1.1 million people are living with HIV in the United States with fewer than 200,000 new cases diagnosed per year. While there is still much to do, great progress has been made in the prevention and treatment of HIV/AIDS.
“HIV/AIDS is a chronic disease that is very well manageable if patients stay in care and take their medications every day and come to their appointments,” said Dr. Nada Fadul, director of the Ryan White Program at East Carolina University.
ECU’s Ryan White Program is the largest provider of HIV care in eastern North Carolina.
Ryan White, a teenager from Indiana who made national headlines in the 1980s for being denied readmission to school following his AIDS diagnosis, is credited with changing the public’s perception of people with the virus.
The Ryan White Program is a federal effort that provides a comprehensive system for diagnosed patients that includes primary medical care and essential support services for people living with HIV who are uninsured or underinsured. In addition, a portion of the program’s funds provide technical assistance, clinical training and the development of innovative models of care.
”We serve about 1,500 HIV-infected patients in the region, and we provide a one-stop shop where patients can come in, get their medical care and see their doctor, but also we provide a multitude of services for these patients,” said Fadul.
Eighty-five percent of the program’s patients are able to achieve control of their HIV or viral suppression, which has been shown to improve health outcomes and reduce the transmission of HIV to uninfected patients. This rate exceeds the state and national averages.
”The life expectancy for an HIV patient is very similar to somebody who does not have HIV,” she said. “The treatment has progressed so far that patients are able to take one pill once a day, and be able to manage their disease long-term without a lot of complications from the HIV itself.”
Making sure patients have access to that life-supporting care, regardless of their health insurance situations or the challenges of serving rural areas, is the mission of the Ryan White Program.
The Collaboratory of AIDS Researchers for Eradication (CARE), examined the prevalence of HIV/AIDS throughout the 50 states in conjunction with researching reports by each state Department of Health and Human Services to determine the most prevalent counties where HIV/AIDS exists.
CARE determined the top five North Carolina counties with an HIV/AIDS presence were Mecklenburg, Edgecombe, Cumberland, Durham and Guilford.
The North Carolina Public Health Department reported at the end of 2016 there were 36,700 people living in North Carolina with HIV/AIDS.
“Eastern North Carolina is a very rural part of our state and most of the counties we provide services for are rural,” said Dr. Diane Campbell, Ryan White Program administrator and treatment adherence director. “When we look at our patient population, probably one-third of 500 of our clients don’t have any type of health coverage.
“To have a preventable disease that you can actually provide treatments for and have clients not have access to care is really a barrier for the treatment process.”
The Ryan White Program at ECU is the largest HIV clinic east of Interstate 95 in North Carolina with a service area of 28 eastern counties. The majority of the program’s clients are minority, underserved and live at or below the federal poverty limit. The N.C. Public Health Department reports that HIV rates are highest among African-Americans and those living in impoverished neighborhoods. Ninety percent of women with HIV in the state report they were exposed through heterosexual contact, while 80 percent of men report they were exposed through male-to-male contact.
The program provides holistic HIV care that includes primary HIV medical care, mental health and substance abuse, case management and patient navigation services, transportation and medication assistance, and nutrition services on site. It also includes a referral network for medical, dental and vision. In addition, the Ryan White Program receives grant funding the N.C. Department of Health and Human Services and the Health Resources and Services Administration.