The number of reported chlamydia cases in Flathead County nearly doubled in July and August, while HIV cases continue to steadily increase, according to officials at the county’s health department.
And last week, two harm reduction specialists from a Bozeman-based group called Connections came to Kalispell to discuss the widespread prevalence of hepatitis C, a virus that attacks the liver and is commonly contracted through shared needles.
Complicating matters is a recent decision by the Centers for Disease Control and Prevention to not renew a grant to the Montana Targeted Prevention (MTAP) program, which deploys outreach workers – including one in the Flathead – to test for HIV and hepatitis C. Disease specialists worry that the funding cut will significantly inhibit both testing and education efforts across the state.
Linda Bodick, a disease intervention specialist at the Flathead City-County Health Department, said her agency saw 30 reported cases of chlamydia in July and 24 in August. Bodick, who has been with the department for 26 years, said the chlamydia figures are nearly double the average rate.
Most of the infected are between the ages of 17 and 26. Bodick said she can’t fully explain the trend but said the cases are often related to young people partying, making bad decisions and having unprotected sex. There have been isolated cases of other sexually transmitted diseases such as gonorrhea, she said, but nothing out of the ordinary.
Bodick encourages people of any age to come to her agency for free and anonymous disease testing. She said minors have a right to testing without parental consent.
“People just need to call and make an appointment,” she said. “It’s strictly confidential.”
Holly Jordt, a registered nurse who works in HIV services at Flathead Family Planning, said she has seen a steady increase in HIV and AIDS cases. When she took her position three years ago, Jordt had 12 caseloads through the Ryan White case management program, which uses federal funds to provide HIV medical services. This year, her caseload spiked to 35 and is currently at 25.
According to the Montana Department of Health and Human Services, 955 cases of HIV infection and AIDS were reported to the agency since reporting began in 1995 through 2009. Of that number, 445 people are known to be living with HIV infections in the state.
The number of new infections is growing each year, Jordt said, including a statewide rise from 22 in 2008 to 31 the next year. She said those figures are low compared to many other states, but worrisome nonetheless. Of particular concern, she said, is the high number of cases being diagnosed as AIDS instead of HIV, “which means their immune systems are in worse condition.”
Of the 22 new infections reported statewide in 2008, Jordt said one-fifth occurred in the Flathead Valley.
“That seems pretty significant to me,” Jordt said. “When you look at the little town of Kalispell and the valley, compared to the whole population, a fifth of them coming from here, to me, is alarming.”
Jordt adds that the majority of people with HIV infections aren’t accounted for because they haven’t been tested. She points out that her department’s testing – free and anonymous – can be done with a cotton swab to the mouth, instead of a needle.
“They say one in five who have HIV don’t know they’re positive,” Jordt said. “And that one in five is responsible for half of new infections, because they’re not taking measures.”
Homosexual men continue to make up a large percentage of HIV cases, but Jordt has seen a notable rise in diagnoses related to heterosexual activities and intravenous drug use. Jordt said meth use has gone down, but more people are abusing prescription pills. For intravenous use, users cook down pills to prepare them for injection.
“There’s definitely a lot of OxyContin out there; that’s the big one,” Jordt said. “We’re seeing less meth, but people are still abusing it.”
Casey and Eddie Rudd, of Connections, told a group of social service managers at the county health department last week that meth use is declining statewide but, as Jordt said, prescription pills are widely abused. Casey Rudd said “Skittles” have become popular, where people – especially teenagers – raid medicine cabinets, compile a mixture of pills and then grab a random handful for ingestion.
“Who knows what you have in that hand,” Casey Rudd said. “You could be OD’ing tonight.”
Eddie Rudd was diagnosed with the hepatitis C in 1999 and since then the Rudds have become known for their educational and testing efforts related to the virus, though their work spans HIV and other diseases.
As harm reduction specialists, they specialize in reaching out to high-risk populations, using their own past experiences to relate to drug abusers in their environments. And like other outreach workers, their work is endangered by the MTAP funding cut.
Hepatitis C is transmitted through blood, making intravenous drug use a major culprit in the virus’s spread. The Rudds focus on improving drug users’ high-risk behavior. For example, while it may be unreasonable to tell a junkie to quit cold turkey, the Rudds can promote the use of clean needles, not sharing vessels to snort drugs or other ways that a user can prevent disease infections.
“Sometimes they don’t even realize what they’re doing and that they’re at risk,” Casey Rudd said.