They’re hoping it’s a fluke – an anomaly. But a surge in HIV cases in Kalkaska County is catching the attention of the medical community. Health officials say they’re alarmed by a spike in HIV cases in the small rural community east of Traverse City. So much so – that they’re urging residents – and people in surrounding counties – to get tested.
Dr. Jennifer Morse is the Medical Director for District Health Dept. #10, which covers Kalkaska. She says data from 2019 has just been reported by the state. “Usually we hardly see any cases diagnosed, usually no cases, maybe one case a year.” But now, there’s a big increase for what Dr. Morse calls such a small area. “Usually those numbers are really low, and we don’t want to identify anyone. But the rates of new diagnosis of HIV in Kalkaska around 2019 were four times the rate we see in the general population of Michigan.
“The counties around Detroit are usually the heaviest hit by HIV. The rate in Kalkaska was three times the rate in the Detroit area,” she adds. “Usually our cases are zero to one a year. With so few cases it’s hard to see patterns. With this cluster they did extensive investigation and interviews with individuals and they really had a hard time finding any kind of pattern. So it makes it difficult to target interventions.”
Things are improving since 2019, but the data is still alarming. “Things have slowed down since then but we’re still really worried that there may be people out there that may be positive and don’t know it. So we really want people to be aware of this,” Dr. Morse says. “Seeing these increased cases make us more concerned that there definitely could be a risk for an HIV outbreak related to drug use.”
People can get or transmit HIV through common risk factors: “Men that have sex with men. Anyone who has any heterosexual sex that might be higher risk. Multiple partners. Intravenous drug use. People that may have had a transfusion pre-1980’s.
“Any sexual encounter, and drug use encounter, anything could really put them at risk. If you have any concerns about high risk behavior…it’s good to get tested,” Dr. Morse says.
But HIV infections are dispelling myths and stereotypes. It’s also present in certain body fluids like blood, and even breast milk. Annette Marin is an RN with the Kalkaska Co. Health Department. “Now we see that people that have been in married relationships have had HIV. So it can touch all walks of life. Not just those certain stereotypes.”
Victoria Cammarata is the Early Intervention Specialist at the Thomas Judd Care Center, which also hosts the PREVENT Clinic in Traverse City. “There are certain behaviors that people engage in that make their risk higher. So that’s sex, obviously. That can be heterosexual sex or MSM, which is men having sex with men. Or you can also get it through breast milk or perinatal. And the IV drug use is obviously a huge risk factor as well.”
Health officials are saying that now that we know some of the numbers for Kalkaska County, the next step is to encourage more testing. Dr. Morse says, “It used to be really scary to get tested for HIV because it used to be, basically a death sentence.” But that’s changed since the height of fears and misinformation about HIV and AIDS in the 1980’s. “It used to be really scary to get tested… People were really nervous to do that. It is now extremely treatable. People have the same life-expectancy as everyone else, if it’s diagnosed early and treated well.”
Marin says, “HIV testing has always been available but a lot of people feel it doesn’t apply to them. They look at HIV as kind of a stereotype illness, and ‘it’s not important to me, I’m not at risk.’ What we’d like is for everyone to test at least once in their lifetime. Just to know. Was something that you’ve done in your past actually a risk you were not aware of?”
And testing shouldn’t be limited to Kalkaska residents. The Prevent Clinic in Traverse City sees patients from all across the Grand Traverse Region. Cammarata says, “We know that it’s not likely contained just to Kalkaska County. Because people have sex outside of their county all the time… So we’re hoping to increase testing everywhere.”
On the one hand, testing may have decreased since COVID. Marin says, “We’ve been very busy with COVID. So a lot people have not (gone) in to their doctors, because of the unsafe feeling of going to a facility, so they haven’t done their annual exams. And a lot of people have not come into the health department because we haven’t really had any clinical services or they’ve been very limited.”
On the other hand, the latest data is pre-COVID, from 2019. And in Kalkaska some physicians were actively testing their patients. Cammarata says, “We know there are some providers that are doing the screenings more frequently.”
Testing has gotten easier over the years – rapid testing can give you results while you wait, and home testing kits are also available. Cammarata says, “Knowledge is power. And when you know your status you know how to move forward. Testing is very easy and there’s a ton of availability. There’s mail-in self-testing kits that you can contact us, and we can mail it to you at your home address or another address that you choose. Or there’s a rapid test where you get a finger prick and you know in 20 minutes.
“You can get (home kits) here, or at your local health department. Your primary care provider could also do a blood draw, whether or not your provider asks – or if you ask your provider,” Cammarata adds. She says some physicians will suggest the test for their patients, other times you just have to ask.
A medication known as PREP can also reduce your risk of getting HIV if you are at high risk. Cammarata says, “We do offer pre-exposure prophylaxis (medications) for HIV. And then if you do have an exposure, within 72 hours that you know of, we offer post-exposure prophylaxis.
“Sexually transmitted infections are on the rise as well. Syphilis and Gonorrhea have increased all over the state of Michigan. So getting tested for everything is a great idea. What we like to tell people is that knowing and taking care of yourself is a great idea all around,” Cammarata says.
For more about the PREVENT Clinic, . For questions call 231-935-7548
From District Health Dept. #10:
Anyone can get HIV, but you can take the following steps to protect yourself:
- Get tested for HIV. Talk to your partner about HIV testing and get tested before you have sex. Use this from the Centers for Disease Control and Prevention (CDC) to find an HIV testing location near you or call your local health department.
- Choose less risky sexual behaviors. HIV is mainly spread by having anal or vaginal sex without a condom or without taking medicines to prevent or treat HIV.
- Use condoms every time you have sex. Read from CDC on how to use condoms correctly. Order free condoms online by filling out this and DHD#10 will mail them right to you.
- Limit your number of sexual partners. The more partners you have, the more likely you are to have a partner with poorly controlled HIV or to have a partner with a (STD). Both of these factors can increase the risk of HIV transmission.
- Get tested and treated for STDs. Insist that your partners get tested and treated, too. Having an STD can increase your risk of getting HIV or spreading it to others.
- Talk to your health care provider about pre-exposure prophylaxis (PrEP). PrEP is an HIV prevention option for people who don’t have HIV but who are at risk of getting HIV. PrEP involves taking a specific HIV medicine every day to reduce the risk of getting HIV through sex or injection drug use. For more information, read the on Pre-Exposure Prophylaxis (PrEP).
- Don’t inject drugs. But if you do, use only sterile drug injection equipment and -water and never share your equipment with others. Find a near you.
DHD#10 offers confidential HIV/STD testing at low or no cost. Contact us at 888-217-3904 to schedule an appointment.
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