Officials say post-Katrina HIV population still low
Officials say post-Katrina HIV population still low
Latest hurricanes highlight PLWHA's vulnerability
The Louisiana Office of Public Health in New Orleans, LA, continues to face challenges with HIV/AIDS surveillance data three years post-Hurricane Katrina.
Hurricane Katrina devastated most of the New Orleans area's eight parishes after hitting the coastline on Aug. 29, 2005. The hurricane and subsequent flooding displaced 1.3 million people, disrupted HIV/AIDS services for months, and has had a long-term impact on HIV/AIDS surveillance.1
The office estimates that 3,380 persons of the original 5,200 persons living with HIV/AIDS (PLWHA) have returned to the Orleans parish, says Beth Scalco, MPA, MSW, director of the HIV/AIDS program of the Louisiana Office of Public Health.
In the entire New Orleans metropolitan statistical area (MSA) there are about 5,550 people with HIV/AIDS who have returned, compared with 7,068 people with HIV/AIDS pre-Katrina, Scalco says.
Since HIV clients, like the general population, have returned to the areas that have rebuilt housing, the Orleans parish has suffered greater losses than have some other parts of the city. And there are some parishes that now have even more HIV/AIDS clients than they did before Katrina struck. Scalco adds.
"We've certainly seen some HIV clinics open up in areas post-Katrina where they weren't located pre-Katrina," she says. "In addition, a community-based operation that had a small clinic pre-Katrina now has a mobile clinic post-Katrina, and they've had an increase in the number of clients they're taking care of."
Community-based clinics are providing more care for HIV/AIDS patients than are public hospitals, and this trend has increased post-Katrina, particularly in the suburbs, says DeAnn Gruber, PhD, LCSW, an assistant professor at the Louisiana State University Health Sciences Center. Gruber also is an evaluation manager with the state's office of public health's HIV program.
Right after Katrina, Louisiana HIV/AIDS officials assessed the impact of the evacuation on its HIV/AIDS population, says Billy Robinson, PhD, an assistant professor at the Louisiana State University Health Sciences Center in New Orleans, and a biostatistician for the state's office of public health's HIV program.
"We identified two separate methods for estimating the impact on the population or the prevalence of people living with HIV/AIDS in the metro area at six months [post-Katrina]," Robinson says.
The idea was to assess how the hurricane's population migration affected the HIV/AIDS surveillance system, he adds.
"We were fairly successful in going ahead and developing methods to figure out how many people had returned," Robinson says. "Since then, we've continued to apply those methods and used them to monitor the return of people to the area."
The HIV/AIDS registry system is a dynamic database, he adds.
"Since then, we've come to the conclusion that people with HIV/AIDS have been returning to New Orleans at the same rate as the general population," Robinson says. "As of February, 2008, there were close to 60% of the Orleans Parish who had returned, and we figured that 3,000 of the original 5,200 people with HIV/AIDS in the Orleans parish had returned."
Louisiana has been collecting HIV surveillance data since 1993, when the disease first became reportable in the state, Scalco says.
Labs have had to report any positive HIV test since 1996, she adds.
After Hurricane Katrina, the surveillance office had to find those with HIV to determine if they'd moved out of state or into the area or if they'd returned to New Orleans, Scalco says.
Other challenges included finding ways to let HIV clients know where services were available and connecting them to clinics and medication, she notes.
"After Katrina, HIV clinics did a lot of outreach to let people know they were up and running and open," Scalco says.
"Immediately post-Katrina we had a huge issue with medication because there wasn't an operating pharmacy," she explains. "The AIDS drug system was distributed through the public hospital system, which was badly damaged and didn't have an operating pharmacy for several months."
For several months, the state HIV/AIDS office staff and workers with a contracting program had to drive antiretroviral and other prescriptions from a pharmacy about 70 miles away back to New Orleans, Scalco says.
"We had some assistance from a community-based organization, but we mostly had people in our program or contractors program, who would drive down and drive back up," Scalco says.
Reference:
- Robinson WT, Wendell D, Gruber D, et al. Estimating the return of persons living with HIV/AIDS to New Orleans: methods for conducting disease surveillance in the wake of a natural disaster. Am J Pub Healt. 2008;98(4):666-668.
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