Health District issues call-to-action to achieve 90-90-90 goal in Nevada

By Dr. Joseph Iser Chief Health Officer, SNHD Member Since 2013

By Dr. Joseph Iser
Chief Health Officer, SNHD
Member Since 2013

The Southern Nevada Health District issued a call-to-action to community partners and health care providers to implement HIV/AIDS interventions and strategies to achieve the goal of 90-90-90 in Nevada. The 90-90-90 concept is part of a broader framework of goals introduced by the United Nations to eliminate HIV/AIDS as a public health threat. It is based on the principle that 90 percent of people who are infected with HIV will be diagnosed, 90 percent of those diagnosed will be treated with antiretrovirals, and 90 percent of those receiving treatment will be virally suppressed.

One in seven people living with HIV in the United States is unaware of his or her status. Young people between the ages of 13 and 24 make up 20 percent of all new HIV diagnoses, Black/African American populations have the highest rates of diagnoses – nearly half at 44 percent – but represent only 12 percent of the U.S. population, and in Clark County rates of new diagnoses have remained flat while rates have declined throughout the rest of the country. Clark County also bears most of the disease burden for the state. The county’s population represents 73 percent of Nevada’s population, but it accounted for 90 percent of the state’s new HIV diagnoses in 2017. Eighty-five percent of people living with HIV in Nevada reside in Clark County.

Clark County also experiences the same racial disparities evident at the national level. Blacks/African Americans represent 11 percent of the county’s population but accounted for 32 percent of the new HIV diagnoses in 2017. In contrast, whites represent 46 percent of the county’s population but only accounted for 32 percent of new HIV diagnoses in the same year. Adults between the ages of 25 and 34 have the highest rate of new HIV diagnoses. However, the rates for this group have remained stable for the last five years.

If Southern Nevada continues to hold its current course in terms of strategies and treatment plans, it will fall behind in its response to this epidemic. The tools to eliminate HIV as a public health threat in our community are available. It’s time for health care and public health professionals to leverage their resources to ensure fewer people are being infected, more people are being diagnosed, and once diagnosed they have access to effective treatment.

The Health District is doing its part to address this challenge with the implementation of several initiatives. Health District staff are completing Academic Detailing courses. This training will teach staff how to build stronger partnerships with the medical community, leading to increased patient interventions and expanded use of biomedical interventions such as PrEP (Pre-Exposure Prophylaxis).

PrEP is offered to people who do not have HIV but who are at risk of getting it to prevent infection. The medication is taken once a day, in combination with other medicines. When taken consistently, the medication has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92 percent. People who are at high risk include those exposed to HIV through sex or injection drug use. People who use PrEP must take it every day and see a health care provider for follow-up every three months.

The Health District began offering PrEP to clients in 2018 as part of its efforts to reduce HIV acquisition in the community. In 2019, the Health District is committed to expanding and enhancing clinical services and access to care beyond its public health centers. The Health District is looking forward to working with its medical partners to expand PrEP services in their practices and will be working to provide them with the resources to do so.

More information on 90-90-90 is available at theconversation.com/hiv-aids-and-90-90-90-what-is-it-and-why-does-it-matter-62136. More information about PrEP is available on the Centers for Disease and Prevention website at www.cdc.gov/hiv/risk/prep/index.html.