Georgia

The HIV epidemic is hitting Middle Georgia hard, reports say. Here’s who wants to change that

Expanded HOPE Center offers more resources for Middle Georgians with HIV

Director of the HOPE Center Dale Rigley said additional services at the Macon clinic will help public officials to curb the spread of HIV and AIDS in Middle Georgia.
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Director of the HOPE Center Dale Rigley said additional services at the Macon clinic will help public officials to curb the spread of HIV and AIDS in Middle Georgia.

Charles Klemm has lost more friends to the AIDS epidemic than he can count. Klemm remembers the first few years after he was diagnosed with HIV in the late 1980s, when he’d flip through the obituaries in the newspaper each morning to see if anyone he knew had died. In those days, Klemm attended a funeral or two every month.

“You went to the funeral,” he said, “and you thought, ‘Oh my God, when am I going to go next?’”

Living with HIV was different back then, Klemm said. Treatment options were limited and survival rates uncertain. In 2019, he said, one pill a day and a few doctor’s visits each year can guarantee a long and healthy life.

“Nowadays, I don’t know anybody who’s died from HIV,” Klemm said.

But in Georgia, the HIV epidemic is stuck in the past.

While diagnoses have declined in the Northeast and Midwest in recent years, they’ve remained stable in the South, accounting for more than half of all new HIV diagnoses in the U.S., according to the U.S. Department of Health & Human Services.

Georgia residents face the second-highest chances of HIV diagnosis in the country — behind only Marylanders — at a rate of one in every 51 individuals. In North Dakota, which boasts the lowest rate, just one in 670 residents will be diagnosed with HIV in their lifetime.

Nearly 2,700 individuals were diagnosed with HIV in Georgia in 2017, according to the Georgia Department of Public Health. Though HIV cases are most concentrated in Metro Atlanta, Bibb County is also a hotspot for the virus. In 2015, 761 out of every 100,000 residents were living with HIV, according to mapping tool AIDSVu.

While advances in medical care have drastically reduced the number of HIV-related deaths in the U.S., public health experts in Georgia hope to curb the spread of the virus before more individuals become infected. They’re also working to increase the availability of resources for those already diagnosed. The North Central Health District’s HOPE Center in Macon is at the forefront of the fight against HIV and AIDS.

Director of North Central Health District's HOPE Center at 180 Emery Highway in Macon speaks to guests at a ribbon-cutting ceremony on May 15, 2019.

A ‘one-stop shop’ for HIV care in Middle Georgia

The Macon-Bibb County Board of Health established the Macon HIV/AIDS clinic, now called the HOPE Center, in 1989, to “offer counseling and limited health care to those diagnosed with AIDS,” according to a Telegraph article from July of that year. Health department officials hoped the clinic would also educate the public about prevention methods.

Macon’s first case of HIV had been diagnosed just four years earlier, and local doctors had few resources at their disposal to care for the growing number of HIV-infected patients, said Dr. Harold Katner, who helped found the clinic and still serves as medical director of the HOPE Center.

The only drug available at the time, AZT, could cost an individual thousands of dollars a year, Katner said, and many patients lacked insurance. Through a federal grant from the Ryan White HIV/AIDS Program, the health department opened the clinic to offer treatment to those who couldn’t afford it on their own.

The HOPE Center has changed names and locations multiple times in its 30-year history, but Director Dale Rigley said its mission has always remained the same: to offer treatment and resources to anyone in need.

“We are the only provider in 13 counties that provides HIV infectious disease specialty care that will see people regardless of ability to pay,” Rigley said.

The clinic, located at 180 Emery Highway, provides medical, dental and mental health care to individuals who have been diagnosed with HIV, as well as case management, nutrition counseling, housing assistance and transportation to and from appointments. A new expansion of the center, unveiled at a ribbon cutting ceremony on Wednesday, will also house support groups, yoga and meditation classes, a farmers market, outreach services and a community pharmacy.

Rigley wants the center to be a “one-stop shop” for HIV care in Middle Georgia, where patients can access every resource they might need in one trip. Because most counties in the North Central Health District lack public transportation, Rigley thought it was important to group the services in one space, to minimize patient travel and increase the chances that patients will follow through with treatment.

“HIV doesn’t have to be a scary thing,” Rigley said. But the key to managing the illness, he said, is suppressing the viral load of those living with HIV and preventing the spread of the disease to new patients.

Director of the HOPE Center Dale Rigley said additional services at the Macon clinic will help public officials to curb the spread of HIV and AIDS in Middle Georgia.

‘People don’t believe that this epidemic is as serious as it is’

Multiple factors have contributed to the perpetuation of the HIV epidemic in Georgia and surrounding southern states. High poverty rates, a dearth of public transportation and a shortage of mental health resources in the region all play a role, said Chinekwu Obidoa, an associate professor of global health at Mercer University who studies HIV and AIDS.

Lack of awareness about the scope of the epidemic only exacerbates the issue, she said. Many people don’t realize that infection rates have not decreased in the Deep South like they have in other parts of the country, she said.

“People don’t believe that this epidemic is as serious as it is,” she said. “For those of us who live in the state of Georgia who should actually be worried, the level of ignorance, in general, of the seriousness of the epidemic is probably one of the things that’s driving it.”

When Rigley moved to Macon in 2017 to lead the HOPE Center, he said it seemed as if he’d stepped into another era.

“I felt like I was still back in the early 90s with the community’s view and even our clients’ view of HIV — how you get it, what it does to you, what your life expectancy is,” Rigley said. “All those things have changed, and I really didn’t see a lot of people realizing that.”

Rigley noticed a severe lack of knowledge about the illness in the community.

“Our community doesn’t always know what HIV is, let alone know that it’s still here,” he said.

It’s important to educate people at an early age, said Alvin Lindsey, director of outreach at Fort Valley State University. Lindsey’s office provides a range of HIV-related educational programming for students and community members and will operate a satellite office out of the HOPE Center’s new innovation hub.

“The whole concept of outreach is to make sure that we have those preventative measures in place so that those types of statistics do not follow our students on campus. And if they do, that we have the adequate resources to take care of them and their needs,” Lindsey said.

Many students don’t realize how prevalent HIV is in Middle Georgia, Lindsey said.

“Our wonderful students who are coming on as young adults think they’re invincible,” he said. “It’s really about opening up their eyes to the realities of life.”

Beyond lack of education, the biggest barrier to HIV prevention and treatment, Katner said, is the prevailing stigma surrounding the illness. Many people choose not to get tested or pursue treatment out of fear that someone they know will find out, he said.

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HOPE Center Director Dale Rigley awards a certificate of appreciation to Dr. Harold Katner, medical director of the HIV/AIDS clinic, at a ribbon-cutting ceremony on May 15, 2019. Samantha Max smax@macon.com

Especially in the black community, which is disproportionately affected by the epidemic, he said, prejudice can impede treatment. Black individuals comprise 32% of Georgia’s population but accounted for 72% of new HIV diagnoses in 2017, according to the Georgia Department of Public Health.

Katner thinks more education about HIV and the ways it’s transmitted could reduce stigma in the community. The illness shouldn’t be treated as a leprosy, he said.

Katner tells his patients there’s no reason for anyone to fear contracting the virus — which can spread through sexual contact, childbearing or injection drug use — through face-to-face contact.

“If anybody would have gotten this disease by working with people, by being around people with HIV, it would have been me,” he said. “I’m coughed on, sneezed on, cried on literally every day of my life from people with this infection.”

Treating patients infected with HIV was never a question for Katner, even in the early 80s, when doctors didn’t yet know how it was transmitted.

“In the very beginning, before we even knew it was a virus, we were scared even for ourselves,” he said. “But I took an oath, and I was gonna do what I took an oath to do. And that was to take care of these patients.”

Fighting the HIV epidemic in Georgia

There can’t be just one solution to the HIV epidemic in Georgia, Obidoa said. The first step, she said, will be to conduct more research on the statewide epidemic, to understand the local nuances of the disease’s spread.

“This is the place where we should be having all those NIH (National Institutes of Health), all those CDC (Centers for Disease Control and Prevention) grants, looking on the ground, investigating what’s going on,” Obidoa said. “You can’t copy from New York. You can’t copy from California. You have to understand the reasons why Georgians are exposed disproportionately.”

Obidoa is excited to see how the HOPE Center’s expansion will enhance HIV education and treatment in Middle Georgia. But in order to provide the best care to its 1,001 active patients, Rigley said, it would help to have more staff and lessen his employees’ high caseloads.

HIV and AIDS treatment shouldn’t be confined within the walls of the HOPE Center, Lindsey said. He hopes to reach people at barber shops, clubs and schools, to educate the broader community — something Katner has been working on for years.

Katner developed an educational lecture series full of personal anecdotes about HIV’s impact on patients in 1985, which he’s presented at more than 500 churches, schools and community centers throughout the region. His colleague, Dr. Mike Smith of Mercer University, then expanded the series into the Students Together Against Negative Decisions (STAND) curriculum.

“Until we can talk openly and honestly about sex and sexuality, we can’t fully change this,” Rigley said. “And this — it’s important.”

A long life with HIV

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Charles Klemm was diagnosed with HIV 31 years ago. “HIV is not a death sentence,” he said at the HOPE Center in Macon on May 13, 2019. Samantha Max smax@macon.com

Charles Klemm, who has lived with HIV for 31 years, would love to see a cure for HIV in his lifetime. But until that day comes, he’ll keep taking his pill a day and visiting the HOPE Center for occasional blood tests and checkups.

“HIV is not a death sentence,” Klemm said. “It’s a long-term chronic disease,” one he thinks is easier to manage than diabetes.

Klemm wishes others better understood the illness he’s battled for more than half his life. He wants them to know that his diagnosis does not define him. It’s especially important for those newly infected with the disease to “hear beyond the word HIV,” Klemm said.

“It’s part of your life, but it’s not all your life,” he said. “Don’t let it take control.”

Samantha Max is a Report for America corps member and reports for The Telegraph with support from the News/CoLab at Arizona State University. Follow her on Facebook at https://www.facebook.com/smax1996 and on Twitter @samanthaellimax. You can also join her Facebook group. Learn more about Report for America at www.reportforamerica.org.

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