A day at The Damien Center

Picture a day with us. Our lobby is packed. Both client computers are in use for job searches. A young woman is requesting an emergency appointment with housing, since her job ended unexpectedly. A gentleman has re-entered care and our staff is walking him through available services.

A woman has visited the food pantry and now waits for her appointment in the medical clinic. One patient is learning about health insurance options while the partner of an individual living with HIV is learning about preventive medications. The testing center is busy, helping clients learn their status and explore different prevention methods.

Then, an HIV+ patient, Michelle*, steps out of her care specialist's office, a mix of relief and pride on her face. In 2013, she re-entered care after having dropped out of care years before. Her viral load was dangerously high - over one million. Don't know much about HIV viral loads? The number represents the amount of HIV in the body, and Michelle was in risky territory.

Our intense personalized plan to support Michelle included daily phone calls to be sure she stuck to her strict medical regimen and weekly home visits. We walked alongside her, helping her eliminate the barriers to care that she was contending with.

That's how our approach works - every patient works with our staff to develop an individualized care plan that provides the specific support they need to get their health back on track. The end goal? To empower patients to get in care and stay in care.

It's been six months, and Michelle has just learned that she has achieved an undetectable viral load. The most amazing thing about Michelle's story? It's not unusual for our patients. The most effective way to prevent new HIV infections is to identify every individual living with HIV and provide them with the support they need to achieve undetectable viral loads. Our staff has helped Linkage to Care patients achieve an average viral load reduction of 93% within their first year in the program precisely through stories just like this one.

Our comprehensive approach changes lives, and remarkable outcomes like this are our norm. On our website, you can explore more about what we do to empower our patients as well as help us restore health to our patients and eliminate the threat of HIV for future generations. Help us make more incredible stories like Michelle's possible in 2015!

*Client's name has been changed.

Damienpalooza: Art + Women and Girls HIV/AIDS Awareness Day

According to CDC estimates, roughly 280,000 (or one in four) people living with HIV/AIDS in the United States are women, 15% of whom don’t know they’re infected. Damienpalooza 2014 will bring education and art under one roof as The Damien Center and collaborating artists focus the conversation on National Women and Girls HIV/AIDS Awareness Day through music, dance, theater, real-life testimonials, and more.

On March 8 - that's this Saturday! - we invite you to join us as we take in performances by dance company Create Freedom Arts Projects, local band I Dream in Evergreen, actress Ali Curtis of The Theatre Within, singer/songwriter Jamie Nichole, and spoken word artist Charlene White as well as the powerful story of Stephanie Brown from the Alicia Keys Empowered campaign. Stephanie contracted HIV as a young woman and has dedicated herself to fighting HIV and the stigma it carries. Inspired by art and moved by the stories of real women affected by HIV, we hope you'll leave empowered to take a stand for women and girls and informed about what they can do to fight HIV and its stigma in our community. 

The historic Athenaeum Theatre in Indianapolis will play host to Damienpalooza 2014, and the $5 admission fee as well as cash bar proceeds will benefit The Damien Center. Spirits Sponsor Ketel One supports The Damien Center throughout the year. We hope to see you there!  

Event                  Damienpalooza

Date/Time          March 8, 2014 at 7:30pm

Cost                    $5 (at the door)

Location             The Athenaeum Theatre, 401 E. Michigan St., Indianapolis 46204

Details                damien.org/damienpalooza       

It's National Black HIV/AIDS Awareness Day

In 2013, more than 40% of individuals who got tested for HIV at The Damien Center were black.*

Black youth ages 13-24 represent 57% of all new HIV infections among young people.*

Blacks represent only 14% of the U.S. population, but 44% of all new HIV infections.*

Do we have your attention yet? Today is National Black HIV/AIDS Awareness Day, and it's time for us all to take a closer look at how HIV and AIDS affect the black community. It deserves our attention. Whether you're black or white or Latino or from Mars, it's easy to see that this issue is important not just in the United States, but right here in our community.

Stigma, socioeconomic factors, high prevalence of STDs, and drug use are just a few of the complex issues that the black community faces in the fight against HIV.

Learn more and find out what you can do at blackaidsday.org/.

*CDC Fact Sheet - HIV and AIDS among African Americans

Back to Basics: HIV 101

There are certain things that we know about HIV that we hold close and turn to for support when we advocate for our cause. For example, here in Indiana, we know that 10,000 people are living with HIV, and that roughly half of those people are right here in Marion County. The CDC also tells us that one in five people (an astonishing 20%) who are living with HIV don't even know they're infected. Powerful statistics, no doubt. But let's get back to something even more basic, something that can help us all understand what we're fighting for and why we care about this issue. What is HIV, and what is AIDS?

Thanks to AIDS.gov, an official U.S. Government website managed by the U.S. Department of Health & Human Services, we've got an easy breakdown of answers to these questions.  (Just to be clear, the content below belongs to AIDS.gov. Please see .aids.gov/hiv-aids-basics/hiv-aids-101/ for more great resources and information on HIV.)

***

First, what is HIV?

To understand what HIV is, let’s break it down:

H – Human – This particular virus can only infect human beings.
I – Immunodeficiency – HIV weakens your immune system by destroying important cells that fight disease and infection. A "deficient" immune system can't protect you.
V – Virus – A virus can only reproduce itself by taking over a cell in the body of its host.

Human Immunodeficiency Virus is a lot like other viruses, including those that cause the flu or the common cold. But there is an important difference – over time, your immune system can clear most viruses out of your body. That isn't the case with HIV – the human immune system can't seem to get rid of it. Scientists are still trying to figure out why.

We know that HIV can hide for long periods of time in the cells of your body and that it attacks a key part of your immune system – your T-cells or CD4 cells. Your body has to have these cells to fight infections and disease, but HIV invades them, uses them to make more copies of itself, and then destroys them.
Over time, HIV can destroy so many of your CD4 cells that your body can't fight infections and diseases anymore. When that happens, HIV infection can lead to AIDS.

Got it. So, what is AIDS?

To understand what AIDS is, let’s break that down, too:

A – Acquired – AIDS is not something you inherit from your parents. You acquire AIDS after birth.
I – Immuno – Your body's immune system includes all the organs and cells that work to fight off infection or disease.
D – Deficiency – You get AIDS when your immune system is "deficient," or isn't working the way it should.
S – Syndrome – A syndrome is a collection of symptoms and signs of disease. AIDS is a syndrome, rather than a single disease, because it is a complex illness with a wide range of complications and symptoms.

Acquired Immunodeficiency Syndrome is the final stage of HIV infection. People at this stage of HIV disease have badly damaged immune systems, which put them at risk for opportunistic infections (OIs).
You will be diagnosed with AIDS if you have one or more specific OIs, certain cancers, or a very low number of CD4 cells. If you have AIDS, you will need medical intervention to prevent death.

For more information, see CDC’s Basic Information About HIV And AIDS.

***

We'll pick this topic up again in a few weeks to talk about how HIV works in our bodies, how it's transmitted, and other important basics. The more you know, the better you can protect yourself and others, care for those who need support, and rally around the fight to end AIDS in our community.  

25 Stories: Elaine Cox

Dr. Elaine Cox has been an HIV care provider for 16 years, specializing in pediatric HIV. She only planned to do it for a short time, but it quickly became her life’s work. She remembers when even doctors were afraid of people with HIV 16 years ago, and how end of life care was the only option.

“Our biggest sadness is when our patients leave pediatric care and go to the adult side – which is a great problem to have!” Dr. Cox says, smiling. With the current medications on the market for HIV, these children can go on to have a long, healthy life.

But Dr. Cox notes that though HIV is a medical disease, there’s an entire social aspect to it. “We do still see some bullying and ostracizing. We see some families where, if a family’s [HIV] status gets out, an apartment is suddenly no longer available.”

Despite the hardships, Dr. Cox knows that there’s hope. Her patients are going to college, getting scholarships, and doing very well. “They’re overcoming all sorts of obstacles!”

Like her patients, Dr. Cox is also conquering hurdles; to combat stigma and normalize HIV testing, she helped start a legislative effort to get prenatal HIV screenings for pregnant mothers. It passed.

Pausing to reflect on her work in the HIV community, she remembers thinking that being in the HIV field in the 1990s was just a phase in her career. “Sometimes, you fall into the best of things without ever knowing it.”


Share your story with us! Leave a comment or email Brenden Hudson at bhudson@damien.org.

The Damien Center Honored with Grant Awards

The Damien Center relies on funding from many sources to provide the high quality programs and services that help us meet our mission.  In recent months we have received several grants from private foundations that will help us continue to improve our services and meet the needs of our clients. We have recently received notification of funding awards for three now positions that will expand our services to our HIV clients:

• Marion County Public Health Department has awarded The Damien Center through Ryan White funding a full-time Mental Health and Substance Abuse Counselor as well as a full-time Medical Case Manager.
• MAC AIDS Fund has awarded The Damien Center with a part-time Housing Case-manager.

In addition to these exciting new positions, The Damien Center was recently awarded the following grants:

• The Indianapolis Foundation, a CICF affiliate:  $40,000 for general operating support
• Christ Church Cathedral:  $10,000 for general operating support
• The Realtor Foundation – $3,500 to provide one transitional housing unit for the transgender population
• Canfield Memorial Trust - $1,500 to support Kids Club programming

We are grateful to these funders for recognizing the importance of supporting HIV/AIDS programs in our community and for their confidence in The Damien Center’s ability to provide these services.  

HIV/AIDS Timeline

In June of 1981, five gay men were diagnosed with what we now know as AIDS. In celebration of the past 30 years of HIV/AIDS and the 25th anniversary since The Damien Center was founded, here’s a look at how far we've come:


• 1982: The disease is named AIDS, or Acquired Immune Deficiency Syndrome; new cases of AIDS in infants are reported.

• 1983: Dr. Robert Gallo suggests that a retrovirus probably causes AIDS. The CDC identifies all major routes of transmission and rules out transmission by casual contact, air, water, food, or environmental factors.

• 1985: ELISA, the first commercial HIV blood test is licensed by the FDA. At least one case of HIV has been reported in every region of the world. Indiana teen Ryan White contracts AIDS due to a blood transfusion for his hemophilia and is refused entry into his middle school.

• 1986: The International Committee on the Taxonomy of Viruses declares that the virus causing AIDS will be known as HIV, or the Human Immunodeficiency Virus. The Surgeon General urges parents and schools to teach children about AIDS and condom use.

• 1987: The first drug antiretroviral drug treatment, AZT, is approved by the FDA. The FDA also approves the Western Blot Blood Test Kit, a more specific test for HIV antibodies. The Damien Center is founded.

• 1989: The number of AIDS cases in the United States reaches 100,000.

• 1990: The US Congress enacts the Americans with Disabilities Act (ADA) that prohibits discrimination against individuals with disabilities, including people living with HIV/AIDS.

• 1991: Earvin “Magic” Johnson announces that he is HIV-positive.

• 1992: AIDS becomes the #1 cause of death for men ages 25-44.

• 1993: The CDC expands the definition of AIDS, declaring anybody with a CD4 count under 200 to have AIDS. Three new clinical indicators of AIDS are added.

• 1994: AIDS becomes the leading cause of death for all Americans 25-44. The FDA also approves an oral HIV test, the first non-blood-based antibody test for HIV.

• 1995: Olympic Diver Greg Louganis announces that he is HIV-positive. The FDA approves the first protease inhibitor, ushering an era of highly active antiretroviral therapy (HAART). 500,000 cases of HIV have been reported in the US.

• 1996: The number of new AIDS cases declines for the first time. It is no longer the leading cause of death for Americans 25-44, though it remains the leading cause for African Americans in that age group.

• 1997: HAART becomes the new standard of HIV care. AIDS-related deaths decline 47%, but drug resistance has become more common.

• 1998: The CDC issues the first national guidelines for antiretroviral therapy. The US Department of Health and Human Services determine that Needle Exchange Programs (NEDs) are effective and do not encourage the use of illicit drugs. The CDC reports that AIDS-mortality in African Americans are almost 10 times that of Whites.

• 1999: The CDC gives a new HIV case definition. The WHO announces that HIV is the fourth biggest killer worldwide, and the #1 killer in Africa. WHO estimates 33 million people are living with HIV worldwide, and 14 million have died of AIDS. VaxGen begin the first human vaccine trials in Thailand.


• 2000: The US declares HIV/AIDS as a threat to US national security.

• 2001: The US Health Resources and Services Administration begins to focus on individuals who are HIV+ but are not receiving services. The CDC announces a new plan to cut annual HIV infections in the US in half within five years.

• 2002: The FDA approves the first rapid HIV testing kit. Unlike other tests, this can be stored at room temperature and requires no specialized equipment, allowing for more widespread HIV testing. Worldwide, 10 million people 15-24 and 3 million children under 15 are living with HIV. 3.5 million new infections will occur in sub-Saharan Africa this year, and 2.4 million Africans will die of AIDS.

• 2003: The CDC estimates that 27,000 of the 40,000 new infections that occur each year are the result of transmission by individuals who do not know they are infected. VaxGen announces that its vaccine trial failed.

• 2004: The CDC approves the use of oral fluid samples with a rapid HIV diagnostic test kit that provides results in 20 minutes.

• 2006: The CDC revises HIV testing recommendations, advising routine HIV screening for all adults 13-64, with a yearly screening for those at high risk. The University of Chicago finds that medical circumcision reduces the risk of acquiring HIV by 53% during heterosexual intercourse.

• 2007: The CDC reports that over 565,000 people have died of AIDS in the US.

• 2008: The CDC releases new data for HIV in the US, suggesting that the incidence of HIV in the US is much higher than previously thought. (56,300 new infections per year vs. 40,000.) These new estimates are not an increase in HIV infections, but reflect a more accurate way of measuring new infections. A spearate analysis suggests that theannual number of new infections was never as low as 40,000, and that it has been relatively stable since the late 1990s.

• 2009: President Obama calls for the first National HIV/AIDS Strategy for the US. The CDC finds that Washington DC has a higher rate of HIV prevalence than West Africa. The FDA approves the 100th antiretroviral drug. President Obama modifies the ban on federal funding for needle exchange programs.

• 2010: The US lifts the HIV travel and imigration ban and releases the first comprehensive National HIV/AIDS Strategy for the United States. Antiretroviral-based vaginal microbicide is found to be safe and effective at reducing risks of new HIV infections in women by 39%; when used as directed, it ould reduce risks by 54%. The National Institute of Health announced that a daily dose of HIV drugs reduce the risk of HIV transmission in men who have sex with men by 44%.

• 2011: Public debate begins on whether the longstanding ban on transplants of HIV-infected organs should be dropped. The US Department of Health and Human Services launches a comprehensive response in the 12 jurisdictions with the highest AIDS burden.

The Season of Giving

Did you know that we're the largest and oldest HIV/AIDS service organization in Indiana? Here are ten reasons to give a little extra this holiday season:

YOU can help make a difference!
Make a donation at www.damien.org/donate

#10: You can help serve the most people infected and affected by HIV in Indiana. Last year, we helped 1,230 people with HIV/AIDS; this holiday season, we expect to serve nearly twice as many people in December as we did last year.

#9: You can help end hunger. People living with HIV need nutritious meals to help their immune system fight the disease. We gave out over 150,000 pounds of food through our pantry this year.

#8: You can help shelter people with HIV. Stable, affordable housing helps people with HIV stay on medication. We helped house 70 families in 2011.

#7: You can help prevent the spread of HIV. We provided more than 2,000 free and confidential HIV tests so far this year - up from last year's total of 1,533.

#6: You can help keep young people safe from the disease; individuals 20-24 account for the highest rates of new infections. We reached more than 700 young people with information on how HIV is transmitted and how to keep themselves safe this year, and we expect that number to double in 2012.

#5: You can help end stigma and discrimination. We provide legal services for people infected or affected by HIV with discrimination issues, living and legal wills, and various other civil legal matters.

#4: You can help people with HIV get jobs. As medications get better, more people with HIV are living healthy lives they didn’t expect to have; we teach skills that help them reenter the workforce.

#3: You can help formerly incarcerated individuals receive interventions that reduce substance abuse and other risky behaviors. We help these individuals keep themselves and others safe from HIV.

#2: You can help link people with HIV to health insurance that makes life-saving medication affordable.

#1: You can help us end HIV. We distribute more than 5,000 condoms every year; without a cure, condoms are one of the only sure-fire ways we can stop the spread of HIV. 

World AIDS Day - ten ways to get to zero!

HIV is a worldwide epidemic, and it’s affecting every part of our local community; in Indiana, there were 9,837 people living with HIV/AIDS in 2010. This year, World AIDS Day on December 1 is all about “Getting to Zero” – that is, zero HIV-related deaths, zero new infections, and zero stigma. Here are ten ways you can help observe World AIDS Day, make a difference, and help your community get to zero:

1. Talk about it openly and honestly. HIV isn’t something to be ashamed of, but there’s a lot of stigma surrounding the disease. Just being open to talking about it can make people less afraid and more proactive in protecting themselves and their loved ones.
2. Wear a condom. This is the best way of protecting yourself – and it can be the most fun! Ribbed, magnum, ultra-thin - there are hundreds of different kinds of condoms from which to choose, and there’s a perfect condom for every situation. Don’t forget about insertive/female condoms! Many public health, family planning, and HIV/AIDS service organizations give out quality condoms for free.
3. Get tested. Many people don’t show symptoms of HIV for 10 or more years; nation-wide, one in five people don’t know that they’re HIV+. The only way to know for sure is to get tested, and many places just need a swab – no blood necessary! Remember that getting tested means checking in to see if you’ve been doing a good job; testing doesn’t prevent the disease from happening. The Damien Center has free and confidential HIV, STD, and pregnancy testing. (www.damien.org)
4. Get involved. There’s dozens of events each year that you can participate in to raise awareness – and many are listed in your local community calendars! Some events, like Dining Out for Life, make it easy to participate. Many local businesses, like Just Pop In located in Broad Ripple and the airport, donate proceeds from sales year-round to local HIV/AIDS service organizations. (Just Pop In is helping The Damien Center get to zero on December 1 – check it out at justpopinonline.com!)
5. Educate yourself. Talk to your doctor or a local HIV/AIDS service organization to learn more about the disease. Know that it’s not transmitted through casual contact like hugging or coughing, but rather through an exchange of body fluids like semen, blood, vaginal fluid, or breast milk. Go to AIDS.gov for easy HIV basics!
6. Drink in moderation. Consuming alcohol can impair your judgment, leading to unsafe sex or other decisions you might not normally make. Have fun, but always keep a clear mind!
7. If you’re HIV+, be sure to take your medications on-time every time. This helps reduce the amount of virus in your body, which also lowers the chances you’ll transmit HIV. Just remember that you can still transmit HIV to your partner even if you have a low viral load – so always use a condom.
8. Volunteer. It’s one of the best ways to see the impact you’re making in the lives of people infected or affected by the disease. Most HIV/AIDS service organizations couldn’t survive without the help of generous volunteers!
9. Donate. Volunteering goes a long way toward helping people, but monetary contributions are essential. With funders cutting back on their grant money due to the recession, nonprofits helping HIV/AIDS patients are relying on individual contributions more than ever.
10. Spread the word. Educating a friend about HIV/AIDS could save their life – and you might never know it. Even a simple Facebook status or tweet about wearing a condom or getting tested helps raise awareness. Connect with organizations like The Damien Center on Facebook or through Twitter @damiencenter for ways you can help spread the word and get Indiana down to zero!

World Hepatitis Day

This Thursday (July 28) is World Hepatitis Day! Hepatitis is when your liver is inflamed, and five viruses are known to cause it. Here are our top five reasons we care.

1) A lot of people with HIV are also infected with hepatitis because it's a similar mode of transmission. In fact, the CDC reports that 50-90% of people who contracted HIV through intravenous drug use are living with the hepatitis C virus (HCV).

2) One in twelve people in the world are infected with either hepatitis B or C, according to the World Hepatitis Alliance.

3) At a presentation by ViiV today at The Damien Center, hepatitis drugs can often interfere with HIV drugs. Sometimes, this makes doctors choose between treating HIV or treating the hepatitis.

4) The CDC also notes that HCV is more serious in people who are also infected with HIV. A coinfection (when a person has more than one infection) leads to quicker liver damage.

5) Your liver is part of what cleans your blood and gets rid of toxins. If left untreated, people with viral hepatitis can have liver scarring (cirrhosis), which can lead to liver cancer, liver failure, death, and more. The good news is that we have vaccines for hepatitis A and B and treatment for all forms of viral hepatitis - you just need to get tested and know!

6) (BONUS!) A bonus reason that we care about hepatitis is because some people can go for years without having any symptoms. It's very important that you are tested for hepatitis as regularly as you're tested for HIV!

For more information about World Hepatitis Day, please visit the World Hepatitis Alliance.

Have you had your vaccinations for hepatitis A and B? Have you also been tested for hepatitis C? What are you doing to stay safe? Let us know!

Sneak Peek at our 2010 Report!

We're still processing some data for our 2010 Annual Report, but here is a sneak peek some exciting statistics that will be included!

• 98% of our clients rate their overall satisfaction of our food pantry as either neutral, somewhat satisfied, or highly satisfied. 78% of our clients said they were highly satisfied.
• Of our clients who responded to our survey and visited other food pantries in the Indianapolis area, 82.5% believe that our food pantry is at least as good, if not better, than other food pantries.
• The food pantry was accessed 4,416 times in 2010 and distributed 154,560 pounds of food.
• In 2010, we administered over 1,500 free HIV tests. Compared to the 974 free HIV tests administered in 2009, this is an increase of over 54%!