SIKESTON -- When it comes to preventing and educating the high-risk HIV/
AIDS communities, Southeast Missouri health officials have their work cut out for them.
Unlike the state's other regions, which have a majority of cases clustered within a few counties, Southeast Missouri's cases are spread out with one or two cases in most of its 20 counties.
"It makes it much more difficult to do education and prevention when we don't have a large community to look at that's infected," said Rhonda Wilkes with Southeast Health Education/Risk Reduction in Poplar Bluff -- a satellite office of the St. Francois County Health Center.
Today marks the 18th World AIDS Day -- a day to raise awareness and education regarding HIV (human immunodeficiency virus) infection and AIDS (acquired immunodeficiency syndrome).
The international theme is "Stop AIDS: Remember the Promise," which speaks to governmental promises to provide greater funding for HIV/AIDS prevention and treatment. In the United States, the theme is "Action Makes a Difference."
While Southeast Missouri hasn't had any big increases or decreases in cases, trends have definitely emerged. "In this region we have a high number of African American women who have become infected with HIV," Wilkes said.
In 2004, heterosexual contact was the most common risk factor reported in females, according to the 2004 Epidemiologic Profiles of HIV Disease and STDS in Missouri.
So where are the male partners of the infected heterosexual African-American women?
"Women get tested more," Wilkes said.
In 2004, HIV was prevalent in 38 heterosexual contacts in the region. Among African Americans with HIV who reported heterosexual contact as their mode of transmission and were still alive at the end of 2004, 26.7 percent were living in Mississippi County when diagnosed and 20 percent were in Scott County.
Among whites diagnosed with HIV who reported heterosexual contact as their mode of transmission and were still alive at the end of 2004, 13 percent were living in Scott County and 8.7 percent were living in Mississippi County.
Also according to the 2004 Epidemiologic Profiles, 50 percent of heterosexual cases were 25 to 44 years old.
"We've, of course, had problems with increased sexually transmitted infections as the drug use increases," Wilkes said.
Often times HIV/AIDS cases involve dual diagnoses, meaning another sexually transmitted infection is also present. Hepatitis C is the main additional infection, but chlamydia and gonorrhea are also common.
"Once you're exposed to HIV, it can take anywhere from two to 12 weeks, generally, for your body to build up antibodies. Any test for HIV checks for antibodies in the system," Wilkes said.
Wilkes also said she wanted to dispel any myths that HIV can be dormant.
"If you were tested three months after exposure, you would known then," Wilkes said.
Wilkes' role is to provide outreach counseling and testing in Southeast Missouri. Cases Wilkes predominantly works are in Cape Girardeau, St. Francois, Butler, Dunklin, Pemiscot, New Madrid and Mississippi counties. Another part of Wilkes' job as regional planner is to go into the community and look at the high risk areas and plan a course of action for prevention and education.
"We predominantly do a lot of work up and down Interstate 55," Wilkes said. Communities are considered high risk if they're an area well-known for drug use, where people might exchange sex for drugs and if there's an area known for sex trade workers, Wilkes said.
And there are other areas that are considered high risk.
"It seems a lot of sexually transmitted infections occur where there's a high unemployment rate and poverty because people aren't protecting themselves when they have sex," Wilkes said. "And there's a lot of cultural barriers in region as far as protection goes and getting tested and talking about prevention."
Wilkes said she thinks people are aware that HIV/AIDS cases are present in the area.
"I think they know there are people with HIV, but they don't want to talk about it. Or they think, 'Well it's not going to happen to me, and if I don't know about it or talk about it, then it's not real.'"
In 2004, there was a flux of 10 cases, but the number of HIV/AIDS cases are staying fairly steady.
"Some people move from categories or they die or move out of the area," Wilkes said.
The cumulative total for HIV and AIDS cases over the past 10 years in Southeast Missouri is 403; 130 were initially diagnosed with HIV, and 273 of these were initially diagnosed or progressed to AIDS.
There were six new HIV cases diagnosed in 2004 -- a 25 percent decrease from 2003 and two new AIDS cases in 2004, or a 50 percent decrease from the 2003 total.
In comparison to 2003, there were 40 percent fewer HIV cases and 60 percent fewer AIDS cases, resulting in a 46.7 percent decrease in the number of newly diagnosed HIV disease cases in this region in 2004.
But a lot of the statistics have to do with people's willingness to be tested, Wilkes noted.
Rachel Gilooly, a registered nurse at Mississippi County Health Center in Charleston, said not that many people get tested for HIV at the office.
"We offer HIV tests every day, free of charge and to anyone. They don't have to live in this county, but we still don't get many who want tested," Gilooly said.
A health worker at the Scott County Health Center in Sikeston also said free HIV blood tests are administered every Thursday, but very few people get tested.
"The thing I hear constantly is, 'I know my partners' or 'They look clean,'" Wilkes said. "And that's not the way to judge health risks."