Temple University professionals focus on community viral load to combat HIV

World AIDS Day is December 1, but healthcare professionals at Temple University work year-round to combat HIV by focusing on reducing the community viral load, or the severity of HIV in a particular group. This approach has become widespread in the past two years, and it is still evolving and undergoing evaluation.

"If we can get enough people tested for HIV and on therapy for HIV, we can potentially reduce the risk for the community as a whole," said Ellen Tedaldi, M.D., director of Temple's Comprehensive HIV program.

To reach as many community members as possible, Tedaldi and her team work with health centers, churches and schools across Philadelphia to promote awareness of HIV/AIDS, remove some of the stigma attached to the disease and, most importantly, test as many members of the community as possible and get those infected with HIV into treatment.

Their biggest roadblock is misinformation. Common myths include: married individuals don't get HIV and HIV only affects certain races. To overcome such myths, Temple's Program adopted the strategy of bringing its message to the people—at venues like general health fairs or church events—instead of waiting for the people to come to them.

"At a health fair, you'd get a blood screening or a glucose test, so why not get an HIV test at the same time?" said Tedaldi. "Part of the overall goal is to have HIV become a routine test; to have people realize, 'Hmm, I might have been exposed.'"

At these events, representatives of the program set up information booths, hand out educational literature and hold panel discussions led by HIV patients, whose presence helps put a face on the disease.

"The trick is to tailor your message around the mindset of the individuals," said Princess Graham, program coordinator for the Comprehensive HIV Program. With older people, she said, it is important to emphasize the fact that life has not stopped; they are just as vulnerable to HIV as anyone else.

When speaking to teens, Graham encourages them to stop and think. "We try to promote abstinence, but we need to be realistic," she said. "In schools, they almost don't want to hear it, but as they listen, they start to engage more and ask questions. Students come up to me afterwards to ask about getting tested. They're glad they have someone to talk with about it."

"If you can reach the larger community, you can get people who know they're HIV positive and treat them early before they transmit to others in their networks," said Tedaldi.

Making people aware of their HIV status helps stop the spread of the disease in two ways, Tedaldi said. First, those who are unaware of their HIV status and have high viral levels have a greater chance of transmitting the virus to others, especially early in the infection. Once they are aware of their HIV status, people can change their sexual behavior and reduce risk to partners and contacts. Second, after beginning treatment, the viral level decreases, also reducing the risk of transmitting the disease.

This year, on World AIDS Day, The Comprehensive HIV Program will host a six-hour public event at Temple's Health Sciences Center, which will offer free and quick HIV testing, and feature guest appearances from HIV activist Will Brawner, who contracted the HIV from a blood transfusion when he was a child; Joan "Penny" Gandy, co-director of Hope Inspiration & Vision, an advocacy and educational organization; and Anastasia Gray, CRNP, Temple Department of Medicine, Section of General Internal Medicine.

In 2008, more than 24,500 Philadelphians were infected with HIV. Now, Philadelphia's rate of infection is five times the national average.