HIV Specialist - June 2021 - 41

People with HIV in Puerto Rico
throughout the island soon.
Access to PrEP will be critical for those
most at risk for HIV, including men who
have sex with men (54%).2 There is also
increased risk for people participating in
intravenous drug use.
In my clinic, I see a range of ages from
16 to 6 5. One of the biggest problems I see
is with the young population. They have
what I call " superhero syndrome. " They do
not believe they are at risk, think HIV can
never happen to them and do not fear the
virus if they do become infected. They say
to me " We have medications available, only
one pill daily keeps us healthy and alive, so
we don't have any fear or problems if we
have HIV. "
I understand that, in part, this is a
positive point of view because if managed
properly, HIV is no longer a death sentence.
This outlook can help with stigma.
However, the young people I see do not
consider that this is a lifelong condition
that will always need care. They do not
think ahead to the future to consider the
co-morbidities that might complicate their
health as they age.
We are currently working with universities,
pharmacies, the HIV Treaters
Association and the government of Puerto
Rico on a public health campaign targeted
to young people and the general population
to encourage testing and to know your HIV
status. We also raise awareness of prevention
options like PrEP.
The campaign connects PWH to support
groups throughout the island, helping
members of the group fi nd access to care,
work opportunities, housing options and
general emotional encouragement. These
support groups are also a safe place to
address stigma, an issue that continues to
plague Puerto Rico, the rest of the U.S. and
many other countries worldwide.
Many of the support groups, such
as COAI and APPIA, are localized with
the communities. Other centers have
support for transgender people, such
as Translucent and PRCONCRA. Ryan
White clinics also off er support groups
for all their patients, off ering resources
and special events, while at the same time
building trust and maintaining better
retention in care.
Like in the continental U.S., the
political policies in Puerto Rico need to
better protect against health inequities
and health disparities. While we are a U.S.
territory, we don't necessarily have the
same policies or are as equally represented
as a U.S. state. Because we need
better representation within the U.S.
government, often we have to make our
own policies to ensure our citizens are
safe. On December 1st, 2018, our governor
signed a letter stating the rights of PWH.
The letter protects the rights that PWH
have for housing, access to medications
and treatments. It denounces discrimination
of all kinds. This is a step in the right
direction.
We need to have better tools for improving
patient care in order to attract a
new generation of doctors who will fall in
love with HIV care like I did. It is hard to
medical schools to showcase the passion
and satisfaction many of us feel for our
jobs. It is important for them to understand
that PWH are not just patients.
They are our friends, sons, daughters,
siblings and parents. We care about our
patients; we love what we do. HIV
DR. VILMARY SIERRA ROSA is
president of the HIV Treaters
Association of Puerto Rico, Chair of
the American Academy of HIV
Medicine's Puerto Rico Chapter,
Medical Sub-Director of Concilio de Salud Integral
de Loiza and is in private practice.
REFERENCES:
1. Centers for Disease Control and Prevention. HIV
Surveillance Report, 2017; vol. 29. http://www.cdc.gov/
hiv/library/reports/hiv-surveillance.html. Published
November 2018. Accessed [11-15-2018].
2. HIV/AIDS Surveillance System, Epidemiology Division,
Puerto Rico Department of Health
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