About 8,000
HIV-positive people who were displaced by Hurricane Katrina
now face the massive challenge of trying to manage their
disease without their doctors, their clinics, and
their support systems.
"I'm very
frustrated right now," said Noel Twilbeck, executive
director of the New Orleans AIDS Task Force, the oldest AIDS
service organization in the Gulf South. "We absolutely
have to get people their medication. This is a
frightening situation."
When
Michael-Chase Creasy, 49, fled New Orleans, he brought his
anti-HIV medicines--but not a lifetime supply. And
when he saw television footage from the safety of a
Houston hotel room of flood waters rising above his
own 1820s Canal Street home, he knew he would not be
returning soon and that he was in serious trouble. He
needed to ensure that his prescriptions would not be
interrupted: "These medicines are what keep me healthy
and ultimately alive. If I go too long without it, I can
really atrophy or descend rapidly."
HIV-positive
people typically take a regimen of medications that can
include upward of 20 pills a day. When patients go off their
medications, the virus can multiply, and they develop
resistance to the drugs. Studies have repeatedly shown
patients have a better chance of keeping their HIV
under control by not missing doses.
The NOAIDS Task
Force has found a temporary home at the Montrose Clinic
in Houston, a medical center that specializes in the needs
of lesbian, gay, bisexual, and transgender people.
Montrose executive director Katy Caldwell said
evacuees have been arriving by the dozens.
Creasy was one
who found help there. Doctors swiped the saliva on his gum
to confirm he is HIV-positive and then loaded him up with
prescriptions and free samples. His problem is solved
for now. But his health insurance is set to run out
September 15, when the trade exchange where he worked
as a media broker goes out of business.
Caldwell said
lack of funds will not affect anyone's access to care.
"We treat them first, worry about the money later," she
said.
"Thank God for
Katy," said Twilbeck, sitting by her side and
recalling his own dash out of New Orleans with 25 family
members, eight dogs, and a lizard in tow to avoid
the hurricane.
The AIDS Alliance
for Children, Youth, and Families estimates at least
8,000 HIV-positive people are now trying to get care. The
organization is working to get money and supplies to
providers, who are struggling to find their patients.
Federal officials say they're doing their best to
streamline care to HIV-positive people, and several drug
companies are offering free medication. Meanwhile,
providers in Florida, Tennessee, Alabama, Mississippi,
Georgia, and beyond report that displaced patients are
showing up at their clinics and asking for new
prescriptions, quickly.
On a billboard in
the Houston Astrodome, posters—as well as on-site
medical providers—are advising HIV-positive people to
go to the Thomas Street Health Center for a quick HIV
antibody test, a physical examination, and a
month's supply of their medications.
The U.S. Health
Resources and Services Agency, the federal agency that
provides health care for HIV-positive people, completely
lost its service centers in Biloxi, Miss., and
New Orleans. The centers in Hattiesburg,
Miss., and Mobile, Ala., are flooded and lack
power.
Social stigmas
may also limit some access to care."People are not
going to walk up to the American Red Cross and say, 'Hi, I
have HIV.' More likely they're going to try to find an
HIV provider," said Diana Bruce, a spokeswoman for the
Washington, D.C.–based AIDS Alliance for
Children, Youth, and Families.
Those evacuees
who do seek medical assistance from providers at emergency
centers may end up with doctors who have no experience
caring for people with HIV. Nicholaos Bellos, MD,
president of the Dallas-based Southwestern Infectious
Disease Associates, helped launch an online triage
program for Hurricane Katrina survivors. The program advises
doctors working in emergency clinics how to care and
medicate HIV patients. Their Web site also provides
patients with information about where to find
specialized care, including maps.
Bellos said
HIV-positive people have complex medical histories, which
are often well-documented at their clinics. It's hard
to treat them without this detailed background, he
said. "Not many of these people had a chance to go by
and pick up their medical records on the way out of
town," he said. "One of our biggest problems, right off the
bat, is just documenting their HIV-positive status."
Viral load tests,
to see how much HIV is in someone's bloodstream, as
well as CD4-cell tests, to determine the strength of the
immune system, are important factors when deciding
what to prescribe.
Kaye Ray, who
runs a 10-clinic family HIV program out of Hattiesburg,
Miss., said that it took eight days before even their first
clinic could reopen. Staff members drove door-to-door
checking on patients until they ran out of gas. Late
last week she received some much-needed funds from the
AIDS Alliance Emergency Fund to buy diapers and
transportation for families affected by HIV, many of
whom have lost their homes.
Many advocates
said this week that with an impending public health
disaster looming in the Gulf region, they feared that people
living with HIV and AIDS might slip through the
cracks."There are many immediate, midterm, and
long-term issues that will literally be life and death for
people living with HIV/AIDS," said Terje Anderson, executive
director of the National Association of People With
AIDS in an urgent letter seeking help from federal
Health secretary Michael Leavitt. (AP)
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