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The Plague No One Talks About, but everyone worries about.
County Health Department hopes for state figures on Westchester HIV-Positive residents for first time in 2001.
3,570 AIDS cases in County since 1982. 1,653 still living.
Vast majority are 30-39, Black or Hispanic. 25% are women.
County: Heterosexual women at risk.
Computer models estimate 3 HIV-positive residents for every living AIDS-positive resident.
HIV-Positive residents started to be counted by state only in July, 2000.
Majority of AIDS cases in Port Chester, Mount Vernon, Yonkers and "along the river," plague creeping up from the city.
Interview with Karen Rhines, County Department of Health with John F. Bailey
CityLine: January 26, 2001 - New Rochelle
One month ago Gay Men's Health Crisis telephoned WPCNR in a fundraising drive.
The solicitor for the organization asking for a donation, said that the number of HIV-Positive cases was growing in New York City by 5 persons a week. I wondered what the rate of HIV-positive infection was in Westchester. I asked the County Office of Communications and they referred me to the County Health Department.
Last week, stories in the New York Times and WINS Radio reported on a survey done by the New York City Department of Health which said that 33% of 500 gay black men had tested HIV-Positive. (Contracting the HIV virus leads in most cases to full-blown AIDS.) This report added to my curiosity as to why more information was not available on the potential spread of this disease.
Friday WPCNR got to talk with Karen Rhines, of the Westchester County Health Department to get some facts about AIDS and HIV in Westchester County.
She is Program Administrator for the Health Department Division of Disease Control, and she was reached at her office in New Rochelle.
County tracking only AIDS cases since 1982, not HIV-positives.
Rhines, too was concerned about the NYC Health Department survey. "It concerns all of us," she said.
She told WPCNR that there was no current data on the number of persons testing HIV-Positive in Westchester County.
The reason, she said was that, in the past, the state legislature and health department was concerned about individuals with HIV Positive being discriminated against. She said the legislature had been lobbied hard by citizens groups that reporting HIV-positive cases would compromise personal privacy and subject HIV-positive individuals to prejudice.
She said this policy was changed in 1998 when the legislature voted to collect HIV-positive statistics, but only beginning June 30, 2000.
As a result, the county and the New York State Department of Health has only been collecting data on HIV-positive individuals, anonymously, for six months, while the AIDS phenomena has been a concern for twenty years.
Rhines said the county has not received any data from the state yet, and did not have any figures from the county AIDS-testing facilities. She has them but says citing the sheer number of multiple repeat HIV-positive testings conducted as yielding meaningless data. She said many persons testing anonymously test several times, leading to inflated figures that did not present a true picture of HIV-positive individuals. The expected state count will provide a definitive figure, she hoped.
She said she was "eagerly awaiting" figures from the state, but had no date when she expected the state would report the number of persons testing HIV-Positive in the county since last June. She said the Department of Health is pushing for release of the HIV figures as soon as possible.
She said the county reports HIV-Positive persons testing "confidentially," where they give their name, (but does not report those testing HIV-positive anonymously) to the state Health Department which then collects the data and is responsible for reporting it. She could not say how detailed the reports would be.
1,653 living AIDS-infected persons in Westchester as of July 1, 2000.
Ms. Rhines said that through June of 2,000 there were 3,570 documented AIDS cases in Westchester County: 2,678 men and 892 women. She said more than half, about two-thirds of the men were injected (intravenous) drug users whom she said contracted the disease from infected drug needles. However, she said that 25% of the total were heterosexual women.
She reports that in the early years of the AIDS plague, most of the women diagnosed with AIDS contracted the disease through intravenous drug use. Now, it has turned around, according to Rhines: More women, "slightly more than 50-50" are contracting AIDS by having sexual relations with HIV or AIDS-infected drug users.
Minorities most at risk.
She reports that the typical demographic age of the AIDS cases was 30 to 39, and pointed out that once you contract the HIV virus it usually takes as long as 10 to 12 years for AIDS to develop. For example, she says, if a person contracts the HIV virus in their 20s, they could develop AIDS by the time they reach their 30s. If they contract HIV in their teens, perhaps they would be diagnosed with AIDS in their 20s.
Rhines said most of the persons with AIDS in Westchester County are persons of color, and that the biggest risk factor for contracting the HIV virus is injection drug use. Of the 3,570 AIDS cases reported in the county,1,223 are Caucasian, and 2,347 were Afro-American or Hispanic, she reports. This reflects the national figures.
She said that the county is seeing "higher proportions" of women who report contracting the HIV-positive virus through heterosexual activity with injected drug users.
"We need to do more effective outreach to people of color and, particularly women," she said.
Estimate of HIV-Positive carriers:
Rhines said that the Department of Health has sophisticated computer models they use in conjunction with the National Center for Disease Control that the county uses for AIDS planning. She said that these models indicate to the county that for every documented AIDS-infected case, there are 3 HIV-Positive-infected persons.
This would mean that as of June 30, 2000, there could be 4,549 persons who are HIV-Positive in Westchester County, some of whom do not know it. Rhines said it could be as many as 5,000 or 6,000 persons.
City-adjacent areas heavily populated with AIDS cases.
In Westchester, she said, the largest concentration of AIDS residents are in the cities bordering New York City: Mount Vernon, New Rochelle, Port Chester, Yonkers, with some cases spreading north up the Hudson River. She says the same AIDS case distribution is found on Long Island with Queens and Nassau County along the Queens border the location of most AIDS-cases.
Westchester offers "anonymous" and "confidential" testing.
Rhines reports there are three designated AIDS Care Centers in Westchester County where any person can go to be tested, free of charge, if they think they may have contracted the HIV virus.
Testing can be undertaken on either an anonymous or confidential basis.
HIV-testing on an anonymous basis is often done two or three times or more by individuals, Rhines says, so keeping statistics on anonymous tests can be misleading. Persons test more than once due to their sexual activity, or to confirm a positive result, or just as a precaution, and this is why it is difficult to draw meaningful statistics from the amount of anonymous tests conducted, Rhines said.
If a person opts for testing confidentially, the county records their name. If the individual tests HIV-positive, the Department of Health will counsel and work with them to arrange for medical treatment. Rhines says that women particularly are carefully counseled, to determine if their partners might have the potential for domestic violence towards the woman or her children, if the partners are notified. Rhines says they wait 30, 60, as much as 90 days before notifying a partner, but only with the HIV-positive person's consent.
"We are aggressive, careful and supportive," Rhines says. "We get the job done in a careful and compassionate way with the individual and their partner so we can build a trusting relationship."
Only individuals opting for confidential testing have their HIV Positive results reported to the State Department of Health under the new HIV-positive reporting procedure begun in July, 2000.
Rhines said that since the beginning of the AIDS plague, only 42 babies have been born with AIDS. She attributes this to the county work with pediatricians and health care providers in the late 1980s and early 1990s to counsel women at pregnancy clinics and family planning centers about the disease.
The HIV-testing centers -- Numbers to call.
The AIDS-Care Centers where HIV testing is available free are at Mount Vernon Hospital, Yonkers General Hospital, and the Westchester County Medical Center.
HIV-testing esting can be done free at virtually any hospital or at the County Department of Health offices in White Plains, Port Chester, New Rochelle or Yonkers. Testing is also available on the campus of SUNY Purchase for students of that university only.
Ms. Rhines suggests that persons wishing for a referral to a testing center where they can be tested for the HIV virus should contact 914-637-4915.
If you would like a speaker to address your group about AIDS and the prevention of AIDS, Ms. Rhines suggests you call 637-4700 and ask for the speakers bureau.
