Claude Genzel(Photo: THE LEAF-CHRONICLE/STEPHANIE INGERSOLL)Buy Photo
Story Highlights
CLARKSVILLE, Tenn. – Claude Genzel is not dying of AIDS. More than 17 years after testing positive for the virus that causes AIDS, the Clarksville man is among more than 350 men and women now living with HIV in Montgomery County.
Last year, 24 new cases of HIV were diagnosed here, according to state Health Department records. That was the most recorded in a single year since before 2004. And 20 cases have been diagnosed so far in 2014.
While those numbers might sound grim, there is hope. Early detection through more widespread testing means those who are diagnosed with HIV today may never develop AIDS.
"For the first time in the history of the HIV/AIDS epidemic, we are poised with the opportunity to end AIDS," said Patrick Luther, chief program officer of Nashville CARES, an advocacy and care program that helps people living with HIV throughout Middle Tennessee, including Clarksville.
"While HIV will always be a part of our culture in America, the immeasurable work done by scientists, advocates, medical and social service providers over the last 30 years has created the environment where anyone living with HIV need never progress to the debilitating disease state called AIDS."
No longer a death sentence
In the early and middle 1980s, HIV almost always led to AIDS, or acquired immune deficiency syndrome, the final stage of the disease that causes severe damage to the immune system.
In those days, a positive HIV test was considered a death sentence. It wasn't the disease that killed, but the damage to the immune system that left patients vulnerable to other illnesses – like the pneumonia that struck Luther's brother, Mark, in 1987. His brother was diagnosed in the hospital and died of AIDS-related complications within a year.
But today, people like Genzel have far more control over their condition. With the right combination of medication and care, many people diagnosed even 30 years ago are living with HIV without developing AIDS.
Today, Genzel is an advocate and educator. As a volunteer for Nashville CARES in Clarksville, he urges people to get tested for HIV and he performs those tests for free in just 20 minutes with a simple cheek swab – no blood draw required.
HIV testing in Cllarksville is easy and free. Stephanie Ingersoll
Testing everyone
Genzel doesn't limit his efforts to those at the highest risk for HIV, but instead he urges everyone to get tested once a year, regardless of whether they are even having sex.
Getting tested makes it easier for people to talk to others about whether they have been tested, he said. About one in six people with HIV in Tennessee don't know they have the virus. And the number of young people testing positive for HIV has grown significantly in recent years.
In 2013, young adults between the ages of 15 and 34 represented 58 percent of new HIV infections in Middle Tennessee. One in five of those were women. Minorities were at a higher risk than whites.
The disease does not discriminate. Those living with HIV in Tennessee include people of all ages and races, straight and gay. Some, like a married grandmother who tested positive in Clarksville, had none of the usual risk factors.
Testing is now so easy, Genzel said there is no excuse to not get tested. To those who say they know they are HIV-negative, he simply says, "prove it."
“The Health Department was testing in a bar one night. I was tossing a few back, just like everyone else, and thought 'Sure, why not get tested?'”
Claude Genzel
A test in a bar
Genzel's attitude today is far different from what it was in 1997 when health care workers came into a bar and offered him and others a free test.
"I never went out to get tested. I wasn't sick," he said. "The Health Department was testing in a bar one night. I was tossing a few back, just like everyone else, and thought 'Sure, why not get tested?'"
He was told to call for his results a week later. When he did, he was told to come to the office in person.
He arrived before the office opened the next day, waiting to learn his fate.
"I was sitting in the parking lot waiting for someone to open the door," Genzel said. "They escorted me to a nice, quiet room in the back and informed me I was HIV-positive."
At first, Genzel numbed his feelings with alcohol and cocaine.
"It didn't feel like a death sentence but it felt like an isolation – the shame, the fear and the stigma and not really wanting to tell anybody," he said.
"I knew there was treatment, but I didn't know what all was involved because, frankly, I didn't bother educating myself. 'Bury your head in the sand, and if you ignore it, it won't affect you.'"
But then Genzel got serious about his health. He set out to learn about his disease, get medical help and address his alcohol and drug addiction.
Pill overload going away
By the late 1990s, there were drugs that could help keep HIV under control. But it wasn't easy.
"I was taking 18 or 19 pills a day depending on what day of the week it was," he said. "One prescription was Monday, Wednesday and Friday. Another prescription was two capsules, three times daily, one hour before, two hours after food – which means I needed to take them at 6 a.m., 2 p.m. and 10 p.m. to stay compliant with the way they were prescribed.
"Half the pills I was taking were to counteract the side effects of the other pills I was taking – the nausea, the acid reflux, the diabetes."
There has been a lot of progress in the years since.
“We can't get rid of the virus HIV, but we can make sure that everyone who has the virus doesn't progress to the disease state called AIDS.”
Patrick Luther, Chief Program Officer, Nashville CARES
Thanks to Truvada, which is one pill with two drugs, and other new medications, many people with HIV can take far fewer pills. But, more importantly, it now appears possible to keep the virus from replicating and keep the immune system healthy, Luther said.
The drug can also be used as a preventative by people at high risk of getting HIV. If they take it as prescribed, they are unlikely to become infected, Luther said.
"We can't get rid of the virus HIV, but we can make sure that everyone who has the virus doesn't progress to the disease state called AIDS," Luther said. "Our new strategic goal is to end the AIDS epidemic."
That is no small task.
Since the AIDS epidemic emerged in the early 1980s, more than 9,300 Tennesseans with HIV or AIDS diagnoses have died, and more than 16,000 people in the state are living with HIV today.
Even with help available, hundreds die each year. There were more than 250 deaths across the state in 2013.
Anyone diagnosed with HIV can get medication, regardless of their ability to pay, Luther said. There is support available for people from all walks of life. Medicine and care have changed the landscape, and those who want to live, can live, he said.
"Now, for the first time in the epidemic, we can say we can end AIDS," he said. "Now it's a realistic goal."
Buy PhotoA quick, free HIV test is available and takes only 20 minutes. Free condoms are also available and can help prevent the spread of HIV and AIDS.(Photo: THE LEAF-CHRONICLE/STEPHANIE INGERSOLL)
Prevention still best option
Montgomery County Health Department Public Health Director Joey Smith said preventing the spread of HIV is still imperative.
"One thing we stress at the Health Department is prevention," he said. "You'll see a lot of times folks are talking about treatment. We always lean toward prevention."
He noted the spike of new cases in Montgomery County last year. According to his records, there were 27 new reported cases, which is two more than state records show. In both 2012 and 2011, there were 17 new cases.
He doesn't know if more cases are being spread or more testing is leading to the higher numbers.
With the opening of the Nashville CARES office in Clarksville in June 2013, testing has been more accessible and promoted more heavily.
The previous record had been 20 new cases, set in 2008, and Montgomery County had reached that number by early November with several weeks still left in the year. It can be difficult to track cases, because some who test positive here may move away, or HIV-positive people may move into the area.
"What we look at at the local level is, is it getting better or worse?" Smith said.
The department stresses the importance of protected sex or abstinence.
"The vast majority of deaths we see every year from AIDS could have been prevented," Smith said. "HIV is spread primarily through unprotected sex and injection drug use, both of which are avoidable behaviors."
He also said that while there have been advancements in treatment, there is still no cure.
"The reality is a large number of those who become infected with HIV will endure suffering and a premature death," Smith said. "There is still no cure for AIDS and no vaccine to prevent HIV infection, but it is possible to protect yourself and others from HIV. Everyone who is sexually active should know his or her HIV status. Learn about HIV and avoid any behavior that can transmit HIV."
Anyone who wants condoms can pick them up at the Health Department in Veterans Plaza, free of charge.
"When people come in and ask for condoms, we don't ask their name," Smith said. "We just hand them a bag."
“Everyone who is sexually active should know his or her HIV status. ”
Joey Smith, Montgomery County Public Health Director
Where to go
Free testing is available at the Health Department. Mouth swabs can be taken to test for HIV antibodies or blood can be drawn.
Testing is also available at Nashville CARES in Clarksville at its office inside Trinity Episcopal Church on Franklin Street. The organization also provides support for those who test positive, including counseling, support groups and nutritional supplements for those in need.
Luther said that under the Affordable Care Act, most insurance companies also offer HIV testing as part of routine screening, without a co-pay. That could lead to an increase in testing and HIV diagnoses this year and in the near future.
Testing and treatment for HIV can and will save lives, he said. In fact, many of the people who have been living with HIV for three decades are now facing a whole new host of health problems, like everyone else – issues related simply to aging. Some would call it a good problem to have.
"Ending AIDS means overcoming the emotional barriers to HIV testing and accessing all of the life-giving resources available to assure people living with HIV are thriving and healthy for their foreseeable futures," Luther said. "This was once merely an aspiration. Today, it is a reality."
Stephanie Ingersoll, 245-0267
City government and crime
singersoll@theleafchronicle.com
Twitter: @StephLeaf
FREE HIV TESTING
•Nashville CARES in Clarksville
Trinity Episcopal Church, 317 Franklin St.
Wednesday and Friday, 10 a.m.-3 p.m.
•Montgomery County Health Department
Veterans Plaza
Monday-Friday, 8 a.m.-4:30 p.m.
•Matthew Walker Clinic
210 Dover Road
Saturdays, 9 a.m.-noon
STATEWIDE STATS
Race, gender, sexual orientation
•17 percent of Tennessee's population are black or African American, however, this demographic represented 63.4 percent of new HIV diagnoses in Tennessee in 2013.
•4.4 percent of new HIV diagnosis in Tennessee were among Hispanic people.
•Last year, 20 percent of new HIV diagnoses were women. Black women represented 75 percent of new HIV diagnoses among women in Tennessee.
•In 2013, men who have sex with men represented only 58 percent of new HIV diagnoses in Tennessee.
Age
•25 percent of new diagnoses were 15-24.
•56 percent were 34 and younger.
•26 percent were over 44.
•10 percent were 55 or older.
Deaths
Although people are living longer and fewer people die each year as a result of HIV/AIDS:
•In 2013, there were 250 deaths among persons with an HIV diagnosis in Tennessee.
•Since the beginning of the epidemic, there have been over 9,300 deaths among persons with an HIV diagnosis in Tennessee.
Source: Nashville CARES. For information, call the Nashville CARES Heartline 1-800-845-4266
Read or Share this story: http://leafne.ws/1rFSn39
Story Highlights
- In the early and mid 1980s, HIV almost always led to AIDS; a positive test was a death sentence.
- Today, new drugs make it possible to keep the virus from replicating and progressing into AIDS.
- Growth in Montgomery County HIV-positive numbers may be related to increased testing.
- Free HIV tests are available at Nashville Cares in Clarksville, Health Department, Matthew Walker.
CLARKSVILLE, Tenn. – Claude Genzel is not dying of AIDS. More than 17 years after testing positive for the virus that causes AIDS, the Clarksville man is among more than 350 men and women now living with HIV in Montgomery County.
Last year, 24 new cases of HIV were diagnosed here, according to state Health Department records. That was the most recorded in a single year since before 2004. And 20 cases have been diagnosed so far in 2014.
While those numbers might sound grim, there is hope. Early detection through more widespread testing means those who are diagnosed with HIV today may never develop AIDS.
"For the first time in the history of the HIV/AIDS epidemic, we are poised with the opportunity to end AIDS," said Patrick Luther, chief program officer of Nashville CARES, an advocacy and care program that helps people living with HIV throughout Middle Tennessee, including Clarksville.
"While HIV will always be a part of our culture in America, the immeasurable work done by scientists, advocates, medical and social service providers over the last 30 years has created the environment where anyone living with HIV need never progress to the debilitating disease state called AIDS."
No longer a death sentence
In the early and middle 1980s, HIV almost always led to AIDS, or acquired immune deficiency syndrome, the final stage of the disease that causes severe damage to the immune system.
In those days, a positive HIV test was considered a death sentence. It wasn't the disease that killed, but the damage to the immune system that left patients vulnerable to other illnesses – like the pneumonia that struck Luther's brother, Mark, in 1987. His brother was diagnosed in the hospital and died of AIDS-related complications within a year.
But today, people like Genzel have far more control over their condition. With the right combination of medication and care, many people diagnosed even 30 years ago are living with HIV without developing AIDS.
Today, Genzel is an advocate and educator. As a volunteer for Nashville CARES in Clarksville, he urges people to get tested for HIV and he performs those tests for free in just 20 minutes with a simple cheek swab – no blood draw required.
HIV testing in Cllarksville is easy and free. Stephanie Ingersoll
Testing everyone
Genzel doesn't limit his efforts to those at the highest risk for HIV, but instead he urges everyone to get tested once a year, regardless of whether they are even having sex.
Getting tested makes it easier for people to talk to others about whether they have been tested, he said. About one in six people with HIV in Tennessee don't know they have the virus. And the number of young people testing positive for HIV has grown significantly in recent years.
In 2013, young adults between the ages of 15 and 34 represented 58 percent of new HIV infections in Middle Tennessee. One in five of those were women. Minorities were at a higher risk than whites.
The disease does not discriminate. Those living with HIV in Tennessee include people of all ages and races, straight and gay. Some, like a married grandmother who tested positive in Clarksville, had none of the usual risk factors.
Testing is now so easy, Genzel said there is no excuse to not get tested. To those who say they know they are HIV-negative, he simply says, "prove it."
“The Health Department was testing in a bar one night. I was tossing a few back, just like everyone else, and thought 'Sure, why not get tested?'”
Claude Genzel
A test in a bar
Genzel's attitude today is far different from what it was in 1997 when health care workers came into a bar and offered him and others a free test.
"I never went out to get tested. I wasn't sick," he said. "The Health Department was testing in a bar one night. I was tossing a few back, just like everyone else, and thought 'Sure, why not get tested?'"
He was told to call for his results a week later. When he did, he was told to come to the office in person.
He arrived before the office opened the next day, waiting to learn his fate.
"I was sitting in the parking lot waiting for someone to open the door," Genzel said. "They escorted me to a nice, quiet room in the back and informed me I was HIV-positive."
At first, Genzel numbed his feelings with alcohol and cocaine.
"It didn't feel like a death sentence but it felt like an isolation – the shame, the fear and the stigma and not really wanting to tell anybody," he said.
"I knew there was treatment, but I didn't know what all was involved because, frankly, I didn't bother educating myself. 'Bury your head in the sand, and if you ignore it, it won't affect you.'"
But then Genzel got serious about his health. He set out to learn about his disease, get medical help and address his alcohol and drug addiction.
Pill overload going away
By the late 1990s, there were drugs that could help keep HIV under control. But it wasn't easy.
"I was taking 18 or 19 pills a day depending on what day of the week it was," he said. "One prescription was Monday, Wednesday and Friday. Another prescription was two capsules, three times daily, one hour before, two hours after food – which means I needed to take them at 6 a.m., 2 p.m. and 10 p.m. to stay compliant with the way they were prescribed.
"Half the pills I was taking were to counteract the side effects of the other pills I was taking – the nausea, the acid reflux, the diabetes."
There has been a lot of progress in the years since.
“We can't get rid of the virus HIV, but we can make sure that everyone who has the virus doesn't progress to the disease state called AIDS.”
Patrick Luther, Chief Program Officer, Nashville CARES
Thanks to Truvada, which is one pill with two drugs, and other new medications, many people with HIV can take far fewer pills. But, more importantly, it now appears possible to keep the virus from replicating and keep the immune system healthy, Luther said.
The drug can also be used as a preventative by people at high risk of getting HIV. If they take it as prescribed, they are unlikely to become infected, Luther said.
"We can't get rid of the virus HIV, but we can make sure that everyone who has the virus doesn't progress to the disease state called AIDS," Luther said. "Our new strategic goal is to end the AIDS epidemic."
That is no small task.
Since the AIDS epidemic emerged in the early 1980s, more than 9,300 Tennesseans with HIV or AIDS diagnoses have died, and more than 16,000 people in the state are living with HIV today.
Even with help available, hundreds die each year. There were more than 250 deaths across the state in 2013.
Anyone diagnosed with HIV can get medication, regardless of their ability to pay, Luther said. There is support available for people from all walks of life. Medicine and care have changed the landscape, and those who want to live, can live, he said.
"Now, for the first time in the epidemic, we can say we can end AIDS," he said. "Now it's a realistic goal."
Buy PhotoA quick, free HIV test is available and takes only 20 minutes. Free condoms are also available and can help prevent the spread of HIV and AIDS.(Photo: THE LEAF-CHRONICLE/STEPHANIE INGERSOLL)Prevention still best option
Montgomery County Health Department Public Health Director Joey Smith said preventing the spread of HIV is still imperative.
"One thing we stress at the Health Department is prevention," he said. "You'll see a lot of times folks are talking about treatment. We always lean toward prevention."
He noted the spike of new cases in Montgomery County last year. According to his records, there were 27 new reported cases, which is two more than state records show. In both 2012 and 2011, there were 17 new cases.
He doesn't know if more cases are being spread or more testing is leading to the higher numbers.
With the opening of the Nashville CARES office in Clarksville in June 2013, testing has been more accessible and promoted more heavily.
The previous record had been 20 new cases, set in 2008, and Montgomery County had reached that number by early November with several weeks still left in the year. It can be difficult to track cases, because some who test positive here may move away, or HIV-positive people may move into the area.
"What we look at at the local level is, is it getting better or worse?" Smith said.
The department stresses the importance of protected sex or abstinence.
"The vast majority of deaths we see every year from AIDS could have been prevented," Smith said. "HIV is spread primarily through unprotected sex and injection drug use, both of which are avoidable behaviors."
He also said that while there have been advancements in treatment, there is still no cure.
"The reality is a large number of those who become infected with HIV will endure suffering and a premature death," Smith said. "There is still no cure for AIDS and no vaccine to prevent HIV infection, but it is possible to protect yourself and others from HIV. Everyone who is sexually active should know his or her HIV status. Learn about HIV and avoid any behavior that can transmit HIV."
Anyone who wants condoms can pick them up at the Health Department in Veterans Plaza, free of charge.
"When people come in and ask for condoms, we don't ask their name," Smith said. "We just hand them a bag."
“Everyone who is sexually active should know his or her HIV status. ”
Joey Smith, Montgomery County Public Health Director
Where to go
Free testing is available at the Health Department. Mouth swabs can be taken to test for HIV antibodies or blood can be drawn.
Testing is also available at Nashville CARES in Clarksville at its office inside Trinity Episcopal Church on Franklin Street. The organization also provides support for those who test positive, including counseling, support groups and nutritional supplements for those in need.
Luther said that under the Affordable Care Act, most insurance companies also offer HIV testing as part of routine screening, without a co-pay. That could lead to an increase in testing and HIV diagnoses this year and in the near future.
Testing and treatment for HIV can and will save lives, he said. In fact, many of the people who have been living with HIV for three decades are now facing a whole new host of health problems, like everyone else – issues related simply to aging. Some would call it a good problem to have.
"Ending AIDS means overcoming the emotional barriers to HIV testing and accessing all of the life-giving resources available to assure people living with HIV are thriving and healthy for their foreseeable futures," Luther said. "This was once merely an aspiration. Today, it is a reality."
Stephanie Ingersoll, 245-0267
City government and crime
singersoll@theleafchronicle.com
Twitter: @StephLeaf
FREE HIV TESTING
•Nashville CARES in Clarksville
Trinity Episcopal Church, 317 Franklin St.
Wednesday and Friday, 10 a.m.-3 p.m.
•Montgomery County Health Department
Veterans Plaza
Monday-Friday, 8 a.m.-4:30 p.m.
•Matthew Walker Clinic
210 Dover Road
Saturdays, 9 a.m.-noon
STATEWIDE STATS
Race, gender, sexual orientation
•17 percent of Tennessee's population are black or African American, however, this demographic represented 63.4 percent of new HIV diagnoses in Tennessee in 2013.
•4.4 percent of new HIV diagnosis in Tennessee were among Hispanic people.
•Last year, 20 percent of new HIV diagnoses were women. Black women represented 75 percent of new HIV diagnoses among women in Tennessee.
•In 2013, men who have sex with men represented only 58 percent of new HIV diagnoses in Tennessee.
Age
•25 percent of new diagnoses were 15-24.
•56 percent were 34 and younger.
•26 percent were over 44.
•10 percent were 55 or older.
Deaths
Although people are living longer and fewer people die each year as a result of HIV/AIDS:
•In 2013, there were 250 deaths among persons with an HIV diagnosis in Tennessee.
•Since the beginning of the epidemic, there have been over 9,300 deaths among persons with an HIV diagnosis in Tennessee.
Source: Nashville CARES. For information, call the Nashville CARES Heartline 1-800-845-4266
Read or Share this story: http://leafne.ws/1rFSn39
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