Standing Strong Together: A Community Conversation on HIV and HCV

Co-authored by Hadiyah Charles

There are moments that transpire annually that seek to remind us of the importance of work, conversation, and community. Every year on February 7, National Black HIV/AIDS Awareness Day reminds people of African descent to get tested for HIV. The day looks to highlight, raise awareness and spur folks to action on HIV and AIDS in the Black community. It reminds us that we, as community members, can work together to tackle larger health problems and ensure a better future for the next generation. By engaging communities in HIV/AIDS prevention, care and treatment, we hope to make a difference in the course of the epidemic.

But there have been companion epidemics running alongside HIV, which affects not only HIV positive individuals, but also the HIV-negative population. The overlapping nature of these diseases, and the path they take through communities, make it necessary for us to begin to draw these conversations together. We have to raise our awareness together, to do better for the health of our community.

National Black HIV/AIDS Awareness Day reminds us that we should always be aware and in tune with our overall health. Another blood-borne disease that Blacks should consider getting tested for is hepatitis C (HCV). Like HIV, HCV is spread through contact with contaminated blood, and less commonly, through sex. It is important to note that there is currently no vaccine for HCV, and treatment options, while available, offer a cure for HCV, but are more limited than HIV treatment. As with HIV, HCV also disproportionately affects Blacks. These diseases require of us that we work together, support one another, and to make empowered health decisions.

The conventional wisdom is that you must know your enemy in order to fight it -- as a community, we have to understand the nature of our intertwining epidemics in order to change their flow. Currently the HIV/AIDS epidemic in this country has plateau'd at roughly 50,000 new infections each year, with roughly 1.4 million people living with HIV. However when you look closer, the virus has found places and populations to truly bear the brunt of disease. Blacks make up 14% of the U.S. population, but they represent 44% of new HIV cases. The picture is even bleaker in black women, teens, and children. In 2009, the CDC estimates that the rate of new HIV infections among Black women was 15 times as high as the rate for white women. In 2011, the CDC released data that showed that Black men who have sex with men (MSM) accounted for the largest estimated number and percentage of diagnoses of HIV infection (11,805, 39%), followed by white MSM (10,375, 34%) and Hispanic/Latino MSM (6,949, 23%). Young Black MSM's are most affected accounting for 48% of the increase in new HIV infections. And for hepatitis C virus (HCV) we see similar patterns.

According to the Department of Health and Human Services, Blacks make up roughly 22 percent of the estimated 3.2 million persons with chronic HCV infection. For the Black community, chronic liver disease, often Hepatitis C-related, is a leading cause of death among persons aged 45 to 64 years. In both cases, there are overlapping and contributing factors that help to offer partial explanations for these high rates. Additionally, according to the CDC, about one quarter of HIV-infected persons in the United States are also infected with Hepatitis C virus (HCV). But most people living with HCV, have no idea that they are infected with HCV. This is a serious issue because more people are now dying as a result of HCV infection annually than from HIV.

All of this amounts to understanding that there are critical steps we can do as a community to help turn the tides of these two epidemics. There are some large, structural areas that can be addressed that will make a big difference in change these two epidemics. Surprisingly, these two epidemics can have some similar crossover the battles to improve lives, ensure the betterment of the future.

One of the major structural barriers for both HIV and HCV is lack of health literacy and health agency. Low levels of health literacy can create barriers to fully understanding one's health, and treatment. Misperceptions of treatment in the case of HIV infection can impede a patient's ability to have their best health outcomes. Even the lack of not knowing what to ask when at doctors appointment, or feeling comfortable enough to ask for the HCV and HIV test that can help, increase one's health outcomes.

What we do know is that studies suggest that more than a third of American adults -- some 89 million people -- lack sufficient health literacy to effectively undertake and execute needed medical treatments and preventative health care. The only way we can begin to make strides against this trend is to find ways to spark discussion and break down what's happening in the lives of individuals. Just like we take a car in and have it fully looked at, or our home checked out before we go in. We need to take the same level of care when it comes to our bodies. We have to remember that it's a partnership our provider and us. That, we together each have a piece to add to the discussion about what makes us healthy, and how to ask for the important information to keep us healthy.

These tests are just some of many important health decisions you make regarding your health. At the end of day, it's your body and your choice -- so why not choose you? Choose to know everything, and to get all the facts. Changing the conversation is what will help to change the future. But it comes with condition that you must play an active role. Each of us must become more empowered health consumers to truly make a difference in tipping the balance. Because if we don't, we know the alternative will be a continuance of the status quo.

Knowing both your HCV and HIV status is now easier than ever. New rapid tests can provide HIV and HCV results in 20 minutes. Knowing both your HIV and HCV can save your life. If you are a baby boomer -- born between 1945 and 1965 -- or if you have ever injected drugs, even once, ask to be tested not only for HIV but also for HCV.

With the new found knowledge of your status you will have options. Science has taken us further then we could have ever envisioned. Additionally, new treatment options in HIV have allowed for those living with the virus to live relatively comfortable lives. Revolutionary break-through in HCV sciences have begun to bear important fruit. New regiments of treatment offer shorter and more tolerable courses with much higher cure rates. The new treatment has the potential to vastly change nature of the HCV in this country. Coupled with HCV testing being more accessible, never has the potential for successful treatment been so promising.

All of the innovations in both diseases hinge on one critical piece, us, the community. We owe it to ourselves and to our future generations to seize these critical opportunities to help change the course of the HCV and HIV epidemics. We have to take the time to ask for the test, to have the information re-explained if we don't understand. There is no shame in not knowing, and there is true bravery in asking. So take the time today to get educated, arm yourself with questions and make choices to improve your health outcomes. Because these awareness are days on, not days off.

Hadiyah Charles is a passionate health policy advocate with a deep understanding of regulatory and legislative policy analysis and community engagement. She is a highly motivated, versatile government relations professional with expertise in the areas of minority health - particularly around HIV/AIDS and Hepatitis C. Ms. Charles is the Harm Reduction Coalition's Hepatitis C Advocacy Manager.