Contrary to popular belief, the story of HIV in Atlanta has never been about white gay men with resources. The story is black gay men with few resources. If you’re wondering why that’s important, here’s your answer: The vast majority of people newly diagnosed and living with HIV are African American and living in metro Atlanta.
That might not surprise a lot of people, but maybe this will. An end to the epidemic might be near.
Give the county five years and the spread of HIV will be over, according to Derick Wilson, director of sexual health promotion for the Fulton County Board of Health.
The temptation is to break out the bells and whistles, but that’s a tall order, especially in a county that leads the nation in the rate of new HIV infections.
“If you look at new diagnoses around the country, no other large county has the same rate of new HIV infections,” said Wilson. “Sixty-nine of every 100,000 people in Fulton County were newly diagnosed in 2017. That compares to 29 per 100,000 in Kings County, New York, and 50 per 100,000 in Dade County, Miami, all with large, diverse populations similar to Fulton County.”
End the epidemic in Fulton County, and we end it in the country. Until then, Wilson said, there’s little hope of ever ending it anywhere else.
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That explains in a nutshell why his office has drafted a “Blueprint for Ending HIV in Fulton County” and is working collaboratively with other county officials, including the Fulton County Board of Commissioners, to get people tested and in care.
The blueprint, which spells out where the county is and where it needs to be, calls for decreasing by 25% new HIV infections by 2023; and getting 90% of people living with HIV to know their status, 90% retained in care, and 50% of those at risk of getting the disease on a daily dose of PrEP.
“If we hit those goals, we basically end the HIV epidemic,” Wilson said.
As part of its effort, the agency opened a PrEP Clinic in 2015 that provides free Pre-Exposure Prophylaxis medication and three years later hired a transgender coordinator, a first for any public health department in Georgia and maybe the Southeast.
Trans outreach was one of Wilson’s first priorities when he joined the county health department in 2017.
That’s significant because one of the highest risk groups for HIV infection is the transgender community. Continuing stigma associated with being transgender and the social alienation they face put them particularly at risk for infection.
“To get them into treatment, we needed someone from the community to provide outreach and let them know there are safe spaces for them to come and talk about testing, PrEP, and treatment in a way that is respectful and authentic,” Wilson said.
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Until the introduction of PrEP seven years ago, the most public health officials could do to prevent the spread of HIV was encourage condom use. That proved ineffective because people either didn’t want there to be a barrier during sex or in the heat of the moment, weren’t able to make the decision.
“PrEP is an absolute game changer when it comes to HIV prevention,” Wilson said. “Taking one pill once a day can stop the virus from creating infection in the body.”
Despite high rates when Wilson arrived here, few people were talking about HIV. It was as if high infection rates were an acceptable norm.
It didn’t take long for him to realize that needed to change.
And so along with a new PrEP outreach coordinator, Wilson launched the #STOPHIVATL campaign to remind people that HIV is out there and to let them know efforts were unfolding to end this crushing epidemic.
Every day his office is putting out social media messages encouraging people to get tested and seek treatment. Those messages feature real people from metro Atlanta’s gay community so that they see themselves reflected in the campaign.
“We can’t end the epidemic if people don’t think there is one or don’t think we can do anything about it,” Wilson said.
While it’s still too early to tell if efforts are paying off, Wilson is confident they will.
It’s why he left Philadelphia to come here in the first place.
RELATED: Who, besides the CDC, didn't know black gay men needed HIV outreach?
Just as he arrived in 2017, Centers for Disease Control and Prevention funding to the county was cut 33% from $6 million to $4 million. However, by the end of his first year in 2018, the new system of HIV testing he implemented had more than doubled the number of new HIV diagnoses from 40 in 2017 to 95, which reflects significant growth in success in finding people who were unaware that they were HIV-positive.
Credit: The Atlanta Journal-Constitution
Credit: The Atlanta Journal-Constitution
On top of that, he said, his staff and funded providers were able to double their rate of HIV testing, providing results for almost as many people in 2018 as they did in 2017 even with the reduction in funding.
“By reprioritizing the way we do HIV testing, we’ve already done the impossible,” Wilson said. “We focused on communities most impacted by HIV infection and limited funding to partner agencies that had a history of working with those communities. Once we found people, we got them into treatment.”
The county’s work hasn’t gone unnoticed. For the first time in the history of the epidemic, both the city of Atlanta and the county Board of Commissioners recently gave nearly a million in funding — $250,000 from the city and $700,000 from the county — for HIV prevention.
In addition, Wilson said his office is working now with Ryan White Care Program officials to find people when they drop out of care and get them reconnected.
Right now, the county is leading the nation in the rate of new diagnoses. Wilson wants to lead the way in ending the HIV epidemic.
“We have the ability,” he said. “We have the resources and we’re getting more. This is something that we have to do. There is no other option.”
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