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Garry Tolbert: HIV threat in NKY is real, but we can better understand it through testing


Here are a few facts that we know:

Northern Kentucky has the third highest number of individuals infected with HIV in the state, with about 30-35 new cases each year.

Two Northern Kentucky counties, Campbell and Grant, were identified by the Centers for Disease Control and Prevention among 220 in the U.S. with an increased risk of an HIV outbreak. Our region’s high rates of hepatitis C infection are one factor in the CDC’s analysis, as a rise in hepatitis C can be a precursor to an outbreak of HIV.

In Scott County, Ind., a rural community about 30 miles north of Louisville, an outbreak of HIV among individuals who injected drugs resulted in more than 190 cases diagnosed within a year in a county that had previously seen five cases. If an outbreak of a similar nature impacted Northern Kentucky, we’d see more than 3,000 cases at a cost of $1 billion. This is a cost our community cannot bear.

We don’t know yet: The number of Northern Kentucky residents that are infected with HIV, as seven of 10 Kentuckians have never been tested for HIV.

Garry Tolbert

At the Northern Kentucky Health Department, where I serve as Medical Director, we are working with local health care providers to increase routine screening for HIV. According to guidelines from the CDC, all Northern Kentucky adults should get an HIV test once per lifetime, and those with risk factors, which can include substance abuse or sexual activity, should be screened yearly.

At the Health Department’s county health centers, routine screening has been in place since 2011. The Health Department also offers HIV testing on walk-in basis three times per month. For details about testing through the Health Department, visit the website.

HIV tests can be done with routine blood work — the provider just has to check a box to tell the lab to run the screening. It is covered by most health insurance plans, Medicare and Medicaid.

As with many preventative screenings, routine HIV testing can have significant impacts, both on those tested and the wider community.

When an individual with HIV knows he/she is infected, he/she can access treatment. Current treatment for individuals with HIV is effective in improving quality of life. The Health Department’s HIV case management program provides access to health care and support services for more than 250 individuals living with HIV in our region.

Testing for HIV can also offer an opportunity to provide education about prevention. When individuals know their HIV status, they can take steps to stop the spread of the disease to others. When individuals undergo treatment for HIV, they can also reduce the level of the HIV virus circulating in their blood to a point that they are no longer considered infectious. This reduces the likelihood of transmission of the virus to others.

Research has shown that for every person who is HIV positive and knows it, implementing measures to reduce the risk of transmission can prevent between 10 and 300 cases.

Yet fear of a diagnosis of HIV remains. Health care providers may be uncomfortable broaching the topic of HIV with their patients and individuals may be reluctant to ask for screening as well.

One way to address the fear and stigma is to make testing routine for all. We have the systems in place to provide the health care necessary for those diagnosed. Providers should work on testing everyone appropriately, allowing us to gather as much information about our background risk as possible.

We know that collectively, our region is at risk for HIV. Let’s turn that knowledge into power by increasing screening and taking to steps to prevent infection.

Garry Tolbert is medical director for the Northern Kentucky Health Department.


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