HIV In The Mountain State: April Finds Recovery But Laments The Infected Who Are Still On The Streets
Dr. Christine Teague is the head of the Ryan White Program at Charleston Area Medical Center. The program is a clinic that provides treatment and prevention to patients with or with a high risk of contracting HIV/AIDS.
Teague has been with the program for 20 years. But her first experience with HIV dates back to 1992.
“It was actually someone that I knew personally, and he ended up passing away.”
Around that time, Teague was in pharmacology school and started to become interested in infectious diseases. She decided to begin her residency at an AIDS clinic.
“The people, the relationships that I made with the people in the clinic, these were people that I saw regularly, and then they passed away. At some point, you have to decide. You want to give emotionally. And, you want to establish a relationship. But you have to have some sort of emotional boundaries. Because if they pass away, then that's devastating.”
Prior to 1995, an HIV/AIDS diagnosis was a death sentence, Teague said. Nearly everyone who contracted the disease would die not long after. However, breakthrough discoveries around that time allowed doctors to successfully treat the disease.
But, according to Teague, the days of being able to control a patient’s HIV/AIDS symptoms are slipping away. The rise of HIV transmission due to intravenous drug use has complicated treatment. Teague said there are a multitude of other health problems that come with intravenous drug use.
“They don't die of HIV, they die of addiction. A lot of people are passing away from overdose, from septic shock, from endocarditis. And, a lot of people are going to continue to pass away.”
The current outbreak in Kanawha County is taking Teague back to a dark place––the early years of the HIV epidemic. “Getting back into that mindset of, you know, ‘I'm probably going to lose a lot of people here’ again. Am I ready for that? Can I do it, emotionally? A lot of my patients are probably going to pass away.”
This summer, the CDC sent researchers to investigate the outbreak in Kanawha County. They talked with healthcare professionals and people who use drugs to figure out what’s fueling this crisis. Problems highlighted in the report included stigma in the healthcare industry, unstable housing, laws that make it illegal to give people sterile syringes and mental health issues.
But, none of these factors came as a surprise to April Dawn.
“I've had a lot of bad things happen. I have physically disfigured my face. I have lost a finger. I caught HIV. Even then, all of that wasn’t rock bottom. It wasn't enough to make me stop.”
April was living in Charleston, West Virginia in 2019 when she found out she’d contracted HIV.
“It was very, very scary to hear those words. I never knew anybody that had it. Now I know a lot of people that have it, you know? Myself.”
Now, April is in a recovery program in Huntington and has consistently taken medicine to treat the disease. Her viral loads are so low that she’s “undetectable”––meaning traditional blood tests can’t detect that she has HIV/AIDS.
“As long as I take my medicine, I'm good. It's not scary. I know that I’m good. What is scary, April said, is the current number of people living in Charleston who have HIV/AIDS and don’t yet know it.
After being diagnosed, April didn’t stop shooting up heroin. But she did make it a point to try and get as many people as she could tested. She told anyone she would inject drugs with about her diagnosis and used her own syringe.
“I was out there killing people’s buzzes.”
April said very few people were willing to go get tested. She said when she’d bring it up, people would express two reasons they didn’t want to go: a fear of being treated poorly by healthcare workers and not wanting to face the fact they might already have HIV/AIDS.
Wanting to save her friends, April began to take mouth swab tests with her. She recalls helping test a friend shortly after they both shot up.
“I swabbed his mouth. And 20 minutes later, I yelled for him. I guess he forgot that we did it because we were high. He looked at me and just looked at his face. He was like, “I got it. Don’t I?” I was like, “Yeah. It's going to be alright though.” And, my pills that I had––I started giving him mine. And, I was trying to get him to go to the doctor because he literally lived right beside the hospital.”
But, April says even when someone knows they’ve contracted the disease, it’s not easy for people with substance use disorder to seek out treatment for HIV/AIDS.
“Even though they do offer transportation and stuff, it's just trying to take the time to find a phone to use it––if somebody will let you use their phone. There's a lot of hectic stuff you got to go through out there because you don't have anything. You have nothing. They're just focused on getting their money and getting their dope for the day.”
April says when the Kanawha Charleston Health Department stopped being able to give out clean syringes in 2018, people turned to sharing used ones. And she says the problem’s gotten even worse since the City of Charleston criminalized syringe distribution earlier this year.
“There's so many I can't even count.” When the number 10 was suggested by this reporter, April responded, “Oh, I was gonna say like 100.”
She added “I was all over the streets. I know a lot of people in active addiction. And with all the trap houses I've been to––there are different people in each one. I was out there for almost eight years. So I know every single one of them. That is a lot of people. And only four of us that I know are on [HIV/AIDS] treatment. And two of us are in recovery.”
Since moving to Huntington, April has begun to work a full-time job now as a waitress and has her own apartment. Earlier this month she got engaged to her boyfriend who she met in recovery.
For April, HIV isn't just “manageable” — it’s something that barely crosses her mind. Except when she thinks about all the people she knows on the streets of Charleston. To her and to Teague, the current HIV statistics for Kanawha County are just the tip of the iceberg.