Hoping to curb the spread of the virus that causes AIDS, Hennepin County officials Thursday launched a new effort to contact some 2,000 county residents who are HIV-positive but who've dropped out of care or never received it.
Early and sustained medical treatment is now considered the key to stopping the spread of HIV because drugs have proven so effective. For people with the infection, powerful medications can suppress the virus to the point that they're unlikely to spread it. Drugs can also protect people from acquiring the virus if they're at high risk for becoming infected.
But they have to seek treatment. Those who don't are the most likely to spread the virus to others, said Jonathan Hanft, the Ryan White HIV Services coordinator for the county and one of the leaders of the new Positively Hennepin effort.
With 4,349 cases diagnosed infections in 2014, Hennepin County accounts for more than half of the state's HIV cases.
"Whatever we do in Hennepin County is going to have a very significant impact overall on HIV and the epidemic in Minnesota," Hanft said.
Launched on the 28th annual World AIDS Day, Positively Hennepin hopes to refocus existing HIV spending on three main goals: reducing the number of new infections, eliminating huge disparities in infection rates both by race and sexual orientation, and connecting people with medical treatment quickly after diagnosis. Officials also hope to break down barriers to housing, transportation, chemical dependency and mental health services.
Despite major HIV treatment advances, new infections have remained steady in Minnesota for years. Half of new cases are people who live in Hennepin County.
"It's been hard to find folks who, for whatever reason, have either moved or dropped out of care," said Nick Vogenthaler, medical director of Hennepin County's Red Door Clinic and the Positive Care Center at Hennepin County Medical Center.
Attempts to track down people in other cities have met with mixed results, because it's labor-intensive work that depends on access to good data, he added. Most health clinics don't have the resources to follow up with patients that drop in and out of care.
Hennepin County deserves credit for pressing the work, he said.
The county already has a system to keep up with patients tested and treated at its Red Door Clinic to make sure they don't fall away. Now the county is gaining access to state data on all county residents who are HIV positive.
The Minnesota Department of Health has been reluctant to release the data due to privacy concerns. But the arrangement with Hennepin County should withstand any legal challenges, said Deputy Commissioner Paul Allwood.
The department is still trying to figure out the best way to share its data statewide, he added.
For now, the focus is on Hennepin County, the epicenter of HIV infections in Minnesota and home to the greatest numbers of people most disproportionately affected by HIV. It's not simply an issue for the county's gay and bisexual residents.
People of color in Hennepin County account for only 30 percent of the population, but fully half of the county total living with HIV. The infection rate for African-Americans and African-born residents in Hennepin County is four times the rate of white residents.
Socio-economic conditions, cultural sensitivities and stigma have made it more challenging to get some populations connected to care, Allwood added. "I think that's a large part of the answer in terms of why it is that we are not achieving the success that we expect."
Correction (Dec. 2, 2016): Due to an editing error, an earlier version of this story misstated the number of HIV cases across Minnesota in 2014. The story has been updated.