Some 301 people were newly infected with HIV in Minnesota in 2013, a 4 percent drop compared to 314 a year earlier, but a worrying trend persists among the Liberian immigrant community, according to a recent report released by Minnesota Department of Health (MDH).
"Although we saw a slight decrease in the overall HIV case reports, there are certainly some increases occurring among our communities of color and men who have sex with men that concern us," said Dr. Ed Ehlinger, Minnesota Commissioner of Health.
MDH says that 14 persons from Liberia were diagnosed with HIV last year, making Liberians the immigrant group with the highest new HIV diagnoses in Minnesota.
Currently, there are reportedly 146 Liberians living with HIV/AIDS in the state. Of that number, 33 were known to have been HIV positive when they arrived, the MDH surveillance report shows.
“Since 2010 we no longer get information regarding HIV status at arrival from immigration because the travel ban on HIV positive people was lifted,” said Jessica Brehmer, MDH Epidemiologist. “We also may not know if someone was positive upon arrival if they first arrived in another state and then moved to Minnesota. So that number may be an underestimation of who was positive upon arrival.”
The majority of the HIV positive Liberians, 107, live in the northwest of the Twin Cities metro, 34 live in the cities of Minneapolis or St. Paul and the remaining 5 live in greater Minnesota.
Health experts say the increase is closely linked to the inability of infected Liberians to seek treatment, lack of testing and prevention measures for those at high risk of contracting the disease.
“I have spoken to a few HIV positive Liberian women that have Liberian sexual partners (husbands, boyfriends) who refuse to be tested for HIV. I have also had HIV positive Liberian women who are reluctant to access health care,” said Cathy Stephens, a disease investigator at MDH.
But, many local Liberian leaders, including pastors interviewed for this story blamed lack of information tailored to their community, alongside lower awareness of HIV/AIDS through media coverage as a whole. They added cultural barriers and lack of outreach services have sent HIV rates among Liberian immigrants soaring. With a population of more than 30,000 and growing, Liberians in Minnesota are arguably the largest in the Diaspora, but with poor community leadership have struggle to contain rising HIV infections and other sexually transmitted diseases like syphilis and chlamydia.
"The stigma of being HIV positive in the Liberian community is the driving force behind the reluctance to getting tested," said Dr. Alfredmy Chessor-Samukai, a former physician at Park Nicollet Clinic in Brooklyn Center, Minnesota who now runs the Family Health Center in Paynesville, just outside of Monrovia.
"Additionally, a lot of Liberians continue to remain in denial about the existence of HIV. I've dealt with patients whose sexual partners are completely unaware of their partners’ HIV positive status. And, there are no laws to encourage mandatory reporting so these partners can be informed on treatments themselves," Chessor-Samukai said.
Health experts noted that HIV infection can be prevented. One of the best ways to prevent the spread of HIV is for those living with HIV to be in treatment for it. "People in treatment can significantly reduce the risk of transmitting HIV to their sexual partners," said Ehlinger. "Getting tested for HIV is the best place to start if you are sexually active."
Other prevention strategies include practicing safer sex, including using condoms and limiting the number of sexual partner. Annual HIV screening is recommended for those at risk who have had unprotected sex, a new sexual partner, or shared needles or equipment to inject drugs.
MDH officials expressed concern that recent increases in the rates of other sexually transmitted infections (STIs) could have negative impact on HIV rates. Chlamydia, gonorrhea and syphilis all increased in 2013, reports MDH. "Some of these STIs can increase HIV transmission or the likelihood of getting infected by 2 to 5 times," said Ehlinger.
To help curb the epidemic, MDH says it funds 21 community-based programs and the Office of Minority and Multicultural Health funds 6 additional programs for HIV prevention and/or testing work.
Wynfred Russell is a health journalist and the publisher of peppersoup.org. He can be contacted at[email protected].