Can I Sign New Mexico Banking NDA

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local programming on krwg public media made possible in part by viewers like you thank you [Music] hello and welcome to fronteras changing america i'm anthony morneau in el paso and in the surrounding borderland region a new initiative is underway to help reduce new hiv infections called vamos biencon prep the campaign highlights the teleprep program which is available remotely to individuals with no in-person doctor appointments pre-exposure pro-prophylaxis or prep is a once-a-day pill that has shown to reduce the chance of individuals contracting hiv joining us to talk about the program and how it can be used to prevent hiv infections in the borderland region is dr leandro mena who is an std hiv clinician and public health advocate dr mena is based in jackson mississippi where he is the medical director at crossroads clinic and open arms healthcare center he is also an associate professor of medicine within the division of infectious diseases at the university of mississippi medical center and he serves as the director at the center for hiv research education and policy at a local institute for the elimination of health disparities dr amanda thank you so much for joining us and i i want to start off we've seen an increase in the hiv latino population so how do you feel this program can address that issue with within the latino population hi uh uh thank you so much for the opportunity and invitation to be here and share with us talk to your audience and with you um i think you know um that it is true you know in the past you know several years or we have seen in the united states it has been a progressive you know while you know the overall number of neutral infections have been decreasing you know for totally you know and for many you know key you know populations um we have seen the rates of hiv infection increasing among the latino population and an increasing among the latino population you know among youth increasing among men who assist with men who are who identify as latino or latina you know transgender women so what's important is that science has given us the tools you know to really end hiv today in one side we have treatment of hiv you know that not only can prevent people in developing aids it can also you know by treating industries who are living with hiv can really you know um a stop the transmission of hiv from someone who is infected who's almost uninfected in the other side you know prep is this you know amazing tool you know that we have for the first time in almost four decades of hiv epidemic that by taking it every day individuals who you know may have an indication you know for prep individuals who uh may be an increased risk of becoming hiv infected can then suddenly significantly reduce the risk of hiv the change that we are sorry go ahead now i mentioned that at the beginning um you know what prep was the the once a day pill but can you give us some more information on what exactly uh prep is and how it works to stop the potential infection of hiv right so prep is a strategy i the strategy you know consists you know right now in the united states there are two drugs that have been approved by the federal you know for the fda effect of drug administration you know to be used for pre-exposure prophylaxis you know prophylaxis is something that you do before you know an event happens so you can protect yourself so the analogy that sometimes i like to use is that if you compare with uh birth control you know birth control you know some different ways but imagine the appeal that women take once a day they take it every day it can significantly reduce the risk of becoming pregnant prep is a pill you know it's an hiv medication that is can be used also we have a lot of experience you know in its safety and its effectiveness to treat hiv but for individuals who are not infected with hiv when people who test hiv negative they can receive a prescription and take the spill every day if they do that that can significantly reduce the risk of becoming hiv infected because it's a prescription you know you have to say you know be seen by a clinician a doctor a nurse practitioner a physician assistant someone who has a license to prescribe medication and this medication this prescription is given for about 90 days every 90 days you come back to the doctor you get tested for hiv making sure that you continue to be hiv negative and and you take it for as long as you need it different to hiv treatment which people have to take for the rest of their life you know prep is something that people takes you know for seasons of risk you know there are times where you may not necessarily you know need to take prep because you may be in a monogamous you know um relationship with someone who is you know hiv negative you know there are times where you basically are testing the grounds and it makes more sense you know for you since trusting someone and really getting to know someone takes time making sure that you are protected by taking bread so who should consider taking prep or giving it a try you know prep is for everyone um the cdc recommends spread prep for individuals who are substantial risk of becoming hiv infected but we talk about there are certain key populations that we know that um have a higher chance of um meeting you know sexual partners that potentially you know could be living with hiv those are men who are having sex with men you know but heterosexual individuals you know who may be having you know sex with uh other people who they do not know the hiv status you know if they're having sex without condoms um people who have recently tested positive for any stds and individuals who um have you know wait have have sex you know under the influence of either alcohol or uh drugs that which may affect the judgment you know what people do and uh and there's evidence that individuals who have been recently incarcerated or people who may have sexual partners who have been incarcerated are all in a group you know that can really benefit you know from taking prep to reduce the chances that they will become infected now you mentioned people incarcerated do they have access to prep um in the u.s what incarceration in general they don't right you know most jails you know will not really admit that people have sex you know while incarcerated there are few very noble programs in our country that actually are providing prep you know for individuals incarcerated while incarcerated but this is something that you know when a health centers you know that are caring for people who have recently been incarcerated i mean depending on populations and we know about our um a correctional system that is proportionally you know affects racial ethnic minorities and people have recent history of incarceration are people who should consider you know starting pre-exposure populations now hiv infections in new mexico in 2018 according to the department of health there were new cases of hiv a 9 over 9 decrease from the year before 80 percent of those new infections that the department of health listed were males and 54 of those infected with hiv were hispanics so even though there was a drop is there any specific population that you think this new program could help teleprep could help here in new mexico because we do have a lot of rural areas in the state so absolutely you know i think as i say you know when you look at total numbers sometimes can be misleading sometimes you have to break it down you know okay there was a total you know decrease because sometimes certain populations experience you know a bigger decrease i mean i know nationwide that the total number decreased because there was a decrease in the number of hiv infections among women there was a decrease in the number of hiv infections about among uh many men you know who are white race i mean there was no change about black men west bank and there is an increase in latinos so once you break it down you know by race by by age what you may find is among latinos especially young latino assassin men you know the race didn't increase the decrease they actually the rates actually increased so again you know we're living in a world you know where the risk you know every new infection of hiv you know you can argue that it's a preventable infection so every person who perceive you know who who who thinks you know that they can benefit you know from taking this you know pill to reduce the risk which i think should be able to have access to this we know that individuals you know who live in rural areas because prep you know is something that we're doing you know to reduce uh the the consequences of having sex and because you know talking about sex sometimes is something that is very stigmatizing you know in our communities uh so if you are to that talking about sex with men in our culture in latino culture right can be you know very stigmatizing there's a lot of homophobia and even when you may have access you know to a clinic where the prep can be provided you know people sometimes it's not people is not always comfortable coming there uh disclosing their behavior in the same way providers are not comfortable taking care of people so we know that individuals who live in rural areas very often have challenges i mean there is transportation because the clinic that may provide prep may not be maybe you know one hour distance they may not have a transportation if they have transportation they they may have to rely in a family member or a friend you know to whom they may or may not want to disclose the reason why they're coming to the clinic um the other thing is that sometimes there are issues around confidentiality you know people may not want to go to that only clinic where a a family member or a family friend or someone that they know you know works in the clinic so they're concerned about the confidentiality so what um vamos being compressed and they um and the program right he's trying to do is uh uh use a telehealth as a safety net you know so people can go into the website the website is uh teleprep.org anyone can go in and get information about what prep is you know and then if you're interested in more education or interested in making an appointment you can make an appointment so what we do is that we connect to via telehealth which is almost like a facetime visit and uh and if people you know is interested in getting on prep and what we do is that we send people home a little test kit a box you know where people can do all the testing that normally would have been done in a clinic you know we tested for um hiv with testing for um gonorrhea chlamydia simply some of the common stds we also testing you know to make sure that the kidneys are working normally and and after all this testing is done via telehealth we start people on medication without having to step you know into a clinic into natural cleaning so that you know provides a tremendous uh make things you know a lot easier for people who may feel you know uncomfortable walking into a clinic or people who who because of uh uh structural reasons you know lack of transportation um maybe you know they don't have health insurance you know to cover the cost of prep in the one clinic you know that is close to them may not be able to um use those choices yeah we have a pandemic going on right now as well so there is a additive incentive obviously for a lot of folks i i want to talk about affordability how affordable is this program to folks who may be at risk of catching hiv how can they get some help right that's a fantastic question you know we know that um cost you know is is one of the most important concerns that people have when it comes to a using you know pre-exposure prophylaxis i mean the drugs that we use you know for prep are expensive there's a hiv medication that costs you know over a thousand dollars but um but luckily you know there are programs um that that will cover you know the total cost of the medication for both individuals who have insurance so they don't have to have any kind of out-of-pocket cost and for people who are insured the manufacturers of these uh medications have a patient assistant program that will give the medication for free to anyone who does not have any karaoke who does not have insurance coverage and and uh prep is uh something that is endorsed by the united states preventive task force um which means that all um affordable care certified um health plans you know should cover prep without any kind of um requiring anywhere any any co-payment so in other words um there is some cost but the program and the a teleprep.org make sure that regardless you know of your ability to pay you will make you'll get prepped now you mentioned that within the latino community there may be a stigma with talking about this issue but what about health care providers are they mentioning prep as an option in the u.s so so you know it's a little bit of a paradox i mean and we know that over time you know prep is something that you know we're still talking about it right you know the first you know drug uh approved for pre-exposure prophylaxis was approved by the fda in 2012 so it's been eight years you know and what we have seen in the past eight years has been a a significant increase you know in the number of providers who are you know providing pre-exposure populaces yet this number continues to be you know significantly significantly you know small uh we know in this data from 2018 that uh the cdc estimated that in the united states about 1.2 million people you know could benefit from prep out of which um 25 you know of that 1.2 million people were individuals you know latinos right so at that time only four percent of latinos who have prep indication were actually taking pre-exposure prophylaxis there have been some recent um surveys that have shown that in some geographic areas you know especially in large metropolitan areas the proportion of latinos who have indication for prep you know have increased but still you know it's probably only 10 15 percent of what it should be you know if you move now into the rural areas and less popular areas in the south that you know um gap is even bigger according to the 2019 hiv surveillance report in the state of texas from their department of health and human services in 2018 there were 137 people diagnosed with hiv in el paso county that's up from 120 the previous year could you give us some analysis on how at risk the borderland region where we are at right now is um dealing in dealing with the hiv infection rate so yeah absolutely i mean you know looking at diagnosis rates it's a little bit tricky right you know because when you diagnose someone with hiv it just means you tell someone you have hiv right but when people get infected you know we know that uh it takes eight to ten years from the moment that people is infected with hiv to the moment that people develop aids right so people may have had hiv for many years before they're diagnosed in general we know that um you know a proportion of people especially younger people people you're 30 years old typically get diagnosed a little bit earlier you know people who get diagnosed in their 40s or 50s probably have had hiv for quite some time and and what's important sometimes increase diagnosis rates is a reflection of increased efforts right to test more people and test people more frequently what is no doubt is that we know that the rates of hiv are increasing particularly in the border area there are factors that contribute to the increase of hiv infection we know that among young people um the hiv testing rates among latinos in general you know the hiv testing rates are relatively low you know cdc recommends that everyone should be tested for hiv at least once in their lifetime and cdc recommends that people who are at risk of hiv infection people who can you know who have certain behaviors i don't like using the word risk you know because uh people tend to exclude themselves no one is at risk i mean people tend to underestimate the actual risk but if you are having sex you know without a condom with someone that you don't know the hiv status you are a risk i only need one partner i always you know remind people that in the united states you now most people who become infected to hiv you know only have one main partner i mean only have one partner you know because those are the people that you love those are the people that you care about those are the people that you crowd trust right and the people with whom you know because you trust them you don't think about wearing condoms right so so so in the in the in the um among latinos the problem is that there is very high low rate of awareness of their own hiv status i mean people who are living hiv and it gets worse you know in the younger population we know that in the people who are younger than 24 half of people living hiv have no clue that they're living hiv right they have not been tested for hiv so again getting tested is the first step you know to start controlling our hiv epidemic we know also that lack of health insurance i mean texas it's like mississippi my home state you know has not expanded medicaid and we have a tremendous proportion of our population who don't have health insurance so we know that lack of health insurance is an important factor that limits you know people access you know to health services including hiv tests right so to complicate that we know that poverty we know that low education we know that stigma i mean the aggressive homophobia that you know that is you know a very um prevalent in our communities right makes people more calm uncomfortable to get invested people don't get tested not because they are or are not gay right they don't want people to you know they're afraid that what people may think if they see me getting tested right that's the stigma around hiv does they you know they internalize you know and the stigma around homophobia that exists in our communities that we have to address so so in the in the border area you have you know all these factors yeah and then you have to add the the the the um the issues are out there by could they both cultures whether biculturalism the binational and not necessarily by cultural issues but the financial um issues that happen in the border where you have the traffic of you know individuals from one side to the other you know um what i've experienced in my several businesses you know for example to el paso is that in el paso you have a community that is relatively you know conservative right you know and very often you know why is across the border becomes a risk space i mean of this community where people go across the border right to to spend the weekend to have a good time right and to do things that sometimes they may not want to do in their own communities because they are afraid about what others will say now that we obviously have a pandemic happening right now and people may not be traveling out and about and obviously they can't cross the border unless it's for essential reasons at this time thanks to uh the the shutdown at the border but do you think that this is going to uh slow down the infection rate for hiv and aids uh that's an interesting question you know we have you know we we have been doing some surveys asking people you know as a matter of fact asking our patients with prep right what are they doing and what we have seen is that many of our patients you know are reporting that their um opportunities for missing partners have decreased you know i've had patients who have called me and tell me hey doc you know i don't think i'm going to call i think i want to stop you know taking prep because there's really nothing going on right now uh nevertheless you know uh as things are normalizing you know in terms of uh people is coming back one way or the other you know to their normal life you know things will come back so so going back in the short hours i think that initially you know with the pandemia and uh with the response you know to the to the kobe pandemic um we there probably was some kind of decrease you know in people's interaction but probably you know a will have created opportunities for hiv transmission um but i think that that can probably decrease you know a a having sex you know and and the sexuality of humans is part of who we are right you know and it will find its way you know up to the surface now obviously there's a lot of reporting on how people are living longer with hiv due to medication and what's available do you think that this could be potentially causing more people to have unprotected sex because they know people are living longer with hiv yes absolutely i mean i i i think you know what one thing that we're seeing you know in the backdrop is that we have a for the past five six seven years we have had an increase in the rates of sexually transmitted infections right you know and sexually transmitted patients you know a especially among men who associate men you know and some people have talked about you know perhaps they if this has been an effect of prep but if you look at when rates obviously start increasing in the us was way before 2012. i think there has been an effect you know of the reality that medications you know for hiv i really allow people to live in a productive lives outside at the beginning of our conversation treatment is prevention if you're taking you know treatment for hiv and you're living with hiv and your viral load the virus everything you is suppressing other medications you can pass hiv to orders i mean so because of that we know that um um that that that that while you know treatment of hiv and prep can significantly reduce you know the incidence of hiv they do nothing for sexually transmitted infections i mean i think it's a consequence of that that's one of the factors at least that is contributing to the increase in the um rates of uh other sexually drastically infections in the country now we just have a uh less than two minutes left but i'd like to hear from you on what folks can do if they are interested in finding out more resources on if they should consider teleprep or prep absolutely um so there's a website you know um my suggestion again you know new mexico any uh new mexico department of health office i mean las cruces or anywhere in new mexico you know you can go there they have a fantastic program you know there is a teleprep.org you can go on the web you can get information you can make an appointment if by any chance for example you prefer to get your prep delivered to you via telehealth you know not everyone is comfortable in the same way receiving you know a testing box at home are doing it from home but if you are and you have the facility you know to have this tele-health visit you know that's a that's a an opportunity and that's an option for you so it's teleprep teleprep.org okay dr leandro mayna i want to thank you so much for joining us and sharing so much information about uh teleprep thank you thank you for having me it's a pleasure and we want to thank you for joining us for fronteras i want to let you know that we always want to hear your thoughts and feedback you can email us at feedback at nmsu.edu we're always looking for potential story ideas as well and remember we're on social media you can keep up with us by liking us on facebook you can follow us on twitter you can also follow us on instagram and you can subscribe to the krwg news youtube channel where you can watch past episodes of fronteras changing america i want to thank you for joining us and we'll see you next time