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90-90-90 Plan Takes On The Spread Of HIV, AIDS In San Antonio

The number of people testing positive for HIV is on the decline nationally and across Texas, but not in Bexar County. 

Robin Gonzales is getting tested for HIV. She has her arm extended and doesn’t flinch when the blood draw begins. Tattoos of roses cascade across her shoulders, a reflection of her view on life.

“I have a lot of tattoos so I’m not scared of needles,” she said. 

As a former crisis intervention counselor for teenagers, she said she lost people in her life to AIDS.

Gonzales' HIV test is conducted in the San Antonio Metropolitan Health District’s mobile STD clinic, a 44-foot truck equipped with multiple rooms, including one for treatment and two smaller rooms for blood tests.

The mobile unit makes rounds around town to anywhere there are people gathered, including the downtown public library, the Adult Megaplex and the South Side Lions Senior Center.

On this day, parked at the annual San Antonio Pride Fest, there's a special emphasis on promoting sexual health and testing for HIV. 

“We’re using rapid testing so people actually get the results on the spot,” said Jose Conteras, HIV prevention director at BEAT AIDS, a San Antonio non-profit promoting AIDS education, prevention and treatment for over 30 years.

Rapid testing only needs a finger prick. A positive result would only be a preliminary finding and a full blood sample is needed to know for sure.

“In a year’s span, we look at about 45 positives a year,” Conteras said.

But that’s just for one testing organization – all together there are about 360 new people diagnosed with HIV in the county each year, according to Metro Health.

This is worse than the national and state infection rate. The Centers for Disease Control and Prevention reports the number of new HIV infections has risen 12 percent between 2014 and 2015 in Bexar County.

To combat this, the City is launching theFast Track Cities initiative, a global partnership to help high HIV burden cities to accelerate local response to the virus.

“The first thing that we need to do is to pull the community together for what’s called the 90-90-90 plan. 90 percent of the who are HIV positive know their status. 90 percent of the people who are HIV positive will be taking the medication to reduce their viral load. And of those who are taking the medication, 90 percent will have reduced their viral load to zero,” Metro Health Director Colleen Bridger explained.

When a person has HIV but their viral load is zero, they are called “infected but not infectious to others.”

“So their ability to transmit HIV to other people is virtually eliminated,” she said.  

Metro Health will be working with area doctors and asking them to make screening for HIV a more common practice.

Bridger said some patients show up with flu like symptoms but are actually dealing with the acute effects of AIDS. However, they were not given an HIV test.

“And so we want to make sure that whenever a person goes to a health care facility and gets blood drawn, that HIV tests just become a default test that gets done.”

There remains a demographic that is most at risk for infection, according to Bridger.

“We do see the majority of our HIV cases among those who have sex with men – especially younger men who have sex with men – ages 20 to 24. But the bottom line is that anybody who has a sexual relationship with somebody needs to get an HIV test,” she said.

Back at the mobile STD clinic, Gonzales says others should make it a habit to have their sexual health tested. She thinks she knows why they don’t.

“Because they are afraid, because they’re scared," Gonzales said. "I think they are scared of the outcome, what do I do if I do have it?”

Today, there are medications that can treat HIV and stop its spread. For Gonzales, the test came back negative.

The goal is to make an HIV positive test result a rare occurrence in San Antonio.

David Martin Davies can be reached at dmdavies@tpr.org and on Twitter at @DavidMartinDavi