At a time when the California Department of Public Health (CDPH) reports a 30 year high in STIs in California —particularly syphilis, gonorrhea, and chlamydia—Desert AIDS Project (DAP) affirms that in addition to HIV and HCV, these are among the most serious public health issues facing Californians today.
DAP is in a unique position to apply the lessons it has learned over 35 years in HIV prevention, testing and treatment. With the increasing prevalence of Californians suffering from two or more of these infections simultaneously, we must no longer approach HIV, HCV, and STIs as if they belong in separate silos. Nor can we continue to overlook the roles that poverty and social isolation play in this crisis.
To end these epidemics, Californians need:
• Routinized education, testing and treatment for all five infections: HIV, HCV, syphilis, gonorrhea, and chlamydia.
• Access to ongoing medical and behavioral healthcare, and stable housing.
• Community and wellness services for psychosocial support to avoid isolation and poor medical treatment adherence.
We represent our community’s voice in state and federal discussions, and constantly looking at new developments, models and funding sources to deploy new efforts in the Coachella Valley. Regardless of access to funding, our commitment to outreach through our community health department enables us to reach at-risk populations.
DAP is also part of End The Epidemics, a statewide working group of approximately 160 public health and community organizations urging Governor Newsom and the California Legislature to empower key stakeholders as soon as possible to fund and implement California’s strategy to end the HIV, HCV, and STI epidemics.
“Funding is essential to fight the spread of newly acquired STIs in California, but it will not fix the entire problem,” said Carl Baker, director of legal and legislative affairs at DAP. “To test and link people to care, we have to meet them where they are; not where we wish they were.”
DAP staff provide testing and education in jails, prisons, drug rehabilitation centers and where our homeless neighbors live.
It also links clients to Pre Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) as key strategies to decrease new infections. We know that regular STI testing that is part of the PrEP protocol identifies people who are infected with STIs who would not have been tested otherwise.
In the Coachella Valley, and Palm Springs in particular, STIs are historically higher than the rest of the county, and have been rising steadily. Higher poverty rates than in the rest of California, plus a thriving tourism industry create an atmosphere for STIs to spread.
In 2018, Riverside County reported syphilis cases ran about 12 per 100,000 people. In the Coachella Valley: 32 cases per 100,000.
The numbers sharply increase in Palm Springs, with over 100 cases per 100,000, and especially North Palm Springs, with 185 cases per 100,000 people. (Riverside University Health System)
To address this trend, in May 2018 DAP lowered the price for testing and treatment for STIs to just $25, and no charge in extreme cases of lack of funds. Access to these services at other organizations in the Coachella Valley cost about seven-to-ten times as much, and prevents many from accessing testing and treatment.
Currently we are noticing about 30 additional clients per week at The DOCK for STI testing and treatment.
“Who knows how many of our clients would wait longer to get screening and treatment if they had to pay as much as ten times what The DOCK charges?” said C.J. Tobe, interim director of community health. “If our clients test positive, we can get them on treatment which is vital to stop the epidemics, and we can even go further, offering them ongoing primary medical and behavioral healthcare and other services.”
DAP knows from experience, and the CDC agrees, that our clients experience better health outcomes when they can access stable housing, and when they receive support to fight drug abuse, poverty, and stigma.
Besides accessing primary and behavioral healthcare, nutritious food and fighting isolation by connecting to other humans is also essential. Wellness services like yoga and chiropractic, and re-entering the workforce have shown to be essential to our clients as they rebound from an array of health challenges.
What Is A Syndemic?
Together, HIV, HCV and STIs create a syndemic—a set of linked health problems that interact synergistically and exacerbate poor health outcomes.
For example, having an STD increases the likelihood of acquiring HIV. Among people who are living with HCV and HIV, HCV progresses faster and more than triples the risk for liver disease, liver failure, and liver related death. These epidemics are also driven by similar social and economic conditions and disproportionately impact many of the same disadvantaged communities.
About End The Epidemics
The California HIV/AIDS Policy Research Centers, together with HIV, viral hepatitis, and STD community-based organizations across California, have launched a community-driven effort to inform development of a statewide plan to end the HIV, HCV, and STD epidemics in California. What makes this initiative innovative and unique – in addition to community leadership – is its ambitious goal of addressing these health conditions as a syndemic – a set of linked health problems that interact synergistically and exacerbate poor health outcomes. The syndemic approach differs from the biomedical approach in that it treats diseases concurrently and also addresses the social determinants of health that drive these epidemics. To learn more, visit: www.chprc.org/end-the-epidemics/
About Desert AIDS Project
Desert AIDS Project (DAP) is a Federally Qualified Health Center in Palm Springs, CA offering DAP Total Care – a combination of medical, dental, counseling, social services, support groups, alternative therapies, in-house pharmacy and lab, and other health and wellness services. DAP’s sexual health clinic, The DOCK, offers STD testing and treatment for only $25 per visit, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and HIV and HCV testing. DAP’s Get Tested Coachella Valley campaign, the nation’s first region-wide free HIV testing and access to care initiative, was recognized by the White House for helping to bring about an AIDS-free future. DAP has earned a “Four Star” rating from Charity Navigator for the sixth consecutive year – landing DAP in the top 6% of nonprofits rated. The distinction recognizes that we exceed industry standards in terms of our financial health, accountability, and transparency.