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Spokane, Washington  Est. May 19, 1883
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It’s optional, but HIV test is a must

Dr. Stacie Bering The Spokesman-Review

I remember standing in my bedroom/study in Houston, Texas, scanning the Dec. 10, 1981, New England Journal of Medicine.

There were three articles about gay men who got really bizarre diseases, the kind we residents never saw except in cancer patients whose immune systems were toast.

Then there was this thing called Kaposi’s sarcoma. We’d learned about that in medical school. It was an indolent skin cancer found mostly in Africa. But these patients were previously healthy young white men. They were also gay, and their Kaposi’s wasn’t indolent at all. The acronym GRID was coined: Gay Related Immunodeficiency.

GRID became AIDS, as doctors found out that it wasn’t just gay men who were affected. IV drug users and hemophiliacs, who received multiple transfusions of blood clotting factors, were also at risk, as well as their partners. Pregnant women who were HIV positive could transmit the infection to their child during birth.

HIV is the sexually transmitted disease that can kill you. In Africa and Asia, transmission occurs mainly through heterosexual transmission – you know, a man and a woman. And increasingly, that is what is happening in the United States.

In another example of life’s unending unfairness, women are more vulnerable to HIV infection than men. In other words, if the guy is HIV positive, his female partner has a higher chance of becoming infected than if things were the other way around.

Unfortunately, for any number of complicated reasons, partners often don’t know the HIV status of the person they’re sleeping with – even their spouse. Increasingly, women are finding out about their positive HIV status when they get an HIV test during pregnancy. Suddenly, in the midst of the excitement over pregnancy comes the devastating news: You are HIV positive, and your partner gave it to you. Your partner who didn’t tell you he was using IV drugs, or sleeping with a prostitute, or having sex with men on the side.

HIV testing as part of pre-natal care is still optional here in Washington state. Despite the fact that the American College of Obstetricians and Gynecologists recommends universal HIV testing for all pregnant women, doctors often succumb to the same misconception that many of their patients do: This woman doesn’t have any risk factors for HIV; she doesn’t need to be tested. But here’s the motto I’ve used with my patients for years while discussing any sexually transmitted disease: In terms of risk, you’re sleeping with everyone your partner ever slept with.

Where does a person who’s just discovered that he or she is HIV positive go to find help and support and a shoulder to cry on? Here in Spokane, in a sweet little house on the South Hill, the Spokane AIDS Network provides services to people living with HIV/AIDS and educates the community about HIV disease, transmission and prevention. To say they do this on a shoestring budget would be overestimating the resources available to them.

This year, the city of Spokane failed to grant SAN the $14,000 it had requested, despite regularly providing funds to the agency in the past. (Mayor Jim West should know better.)

Prevention funds from the Centers for Disease Control are shrinking. Yet we know that until a vaccine is approved, prevention education is the best strategy we have for preventing the spread of this canny disease.

There are more than 300 people living with HIV/AIDS in Spokane. Case management, available through SAN, helps them access health care and other services in the most efficient way.

As the Bush administration increasingly demands that the “private sector” (that’s us) take on the responsibility for helping those in our community in need, nonprofit agencies like SAN need our help.

A fun way to do that happens this Friday at “Stem & Stein,” a wine and beer tasting at Northern Quest Casino from 6 to 10 pm. Tickets ($35) are available at Vino’s, Huckleberry’s and at the door. Or call SAN at 455-8993 ext. 320.

And congratulate SAN on its 20th anniversary of serving folks in the Inland Northwest.

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