HIV and you: A Q&A with HOP team members

It’s important to know about HIV, a virus that attacks your body’s immune system so that you can protect your health and the health of others. Fortunately, there are more ways than ever to prevent and treat HIV. In honor of NOLA HIV Awareness week, which takes place each year in early December, Dr. Lauren Richey and Mitch Handrich from our HIV Outpatient Program (HOP) Clinic provide answers to some HIV questions.

Why is HIV important to the people/city of New Orleans?

Handrich: HIV remains an important problem in Louisiana. In 2018, the newest rankings, Louisiana was the 4th highest rate of HIV diagnosis in the US and New Orleans remains the 6th highest city in the US for new diagnoses of HIV. That said many efforts are underway to end the HIV epidemic in New Orleans.

What efforts are underway?

Dr. Richey: Our Mayor has agreed for New Orleans to be a fast-track city that is dedicated to ending the HIV epidemic. As a result, for over a year, community, public health, physician, and political leaders have met monthly to create an end to the epidemic plan that will focus on testing, linkage to care, treatment, prevention, and reduction of stigma.

What are the strategies to end the epidemic?

Dr. Richey: The two main strategies: are prevention and treatment.

When a person living with HIV is treated with effective medications to treat HIV, the amount of virus in their blood can be reduced to undetectable. This means they can safely have sex without transmitting the virus to others. This is called treatment as prevention or undetectable equals untransmissible. This is one of the key strategies to end the epidemic. If every person living with HIV was on effective treatment, then the transmission would end. However, there remain many people who have not been tested and are not aware of their status. There are also people living with HIV who are unable to access or adhere to medicines.

How about prevention, how can people protect themselves from infection?

Handrich: The other main strategy is prevention. This entails both regular HIV testing and knowing the status of yourself and your partners. Using condoms when the status is unknown. And lastly, Prep, which is a daily medicine, call Truvada, that can be taken to prevent the acquisition of HIV. When taken daily it is highly effective.

How has HIV treatment and outcomes changed since the early days of the epidemic?

Handrich: I have been in HIV treatment for over 25 years. First as a nurse and now as a Nurse practitioner. I personally tested HIV+ in 1985 and figured I would only have a few years to live. I became a nurse and decided I wanted to take care of persons with HIV because I was hearing that nurses and medical staff were refusing to care for these patients and I wanted to help give them good care. We used to keep a scrapbook in the clinic and on the inpatient unit of the obituaries of persons who we took care of who died. We used to have memorial services at our clinic to help our staff deal with all the death we were dealing with. This no longer is the case. Now HIV is a very treatable infection and people can live full normal lives. I have several of my patients whose one partner is positive and on treatment and undetectable and their partners are negative, and they are able to have unprotected sex and get pregnant and have babies and raise families. We provide primary care at our clinic, meaning we take care of all their health needs, this means not only HIV but their diabetes and high blood pressure, etc. Taking care of HIV is the easy part. It is all the other health problems that they get that are the same that persons without HIV get that is the hard part to take care of.

What resources are available?

Dr. Richey: A program called Ryan White exists and several clinics including ours. At the Infectious Disease Clinic at University Medical Center, we are able to provide free medical care and medications to people living with HIV. Our clinic can be reached at 504-702-4344.

Dr. Lauren Richey, Dr. Lauren Richey is an Internal Medicine and Infectious Disease specialist in New Orleans, Louisiana. She has more than 12 years of diverse experience with HIV and other infectious diseases.

Mitchell Handrich is a nurse practitioner in the Infectious Disease Clinic. Mitch was recently appointed by the Governor to the Louisiana Commission on HIV, AIDS, Hepatitis C Education, Prevention, and Treatment.