The Paid Leave Podcast

How to Live a Healthy Life with HIV

• The Connecticut Paid Leave Authority • Season 3 • Episode 9

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December is HIV/Aids Awareness Month.   While the treatments for HIV have prolonged life expectancy, there is no cure yet. HIV it is considered a chronic illness or a chronic health condition. Since the first cases of HIV were reported more than 40 years ago, 78 million people have become infected with HIV and 35 million have died from AIDS-related illnesses.

Kayce Harding is the director of the Center for Key Populations, which is part of Community Health Center inc. Kasey says that people can live healthy full lives after an HIV diagnosis. Treatments have also changed with daily medications that can keep the HIV detection in your blood very low. The new medications have less side effects and new research is being done on a monthly injection that will be easier than taking pills every day. Kasey says CT Paid Leave can help ease the burden for people with HIV. Being able to use paid leave for your continuing care gives peace of mind to patients, and it's important people know this service is available to them.

CT Paid Leave can help patients take time off from work who qualify, with up to 12 weeks of income replacement for their own serious health condition or that of a loved one. HIV is considered a chronic health condition and CT Paid Leave can help with being flexible with the time off when you need it. If you need more time you can use block leave and take all 12 weeks at once , or there is intermittent leave and reduced schedule leave.

To get in touch with Kasey Harding: Our Locations (chc1.com)
or call 860-347-6971

For home HIV test kits: 5 best at-home HIV tests: A comparison guide (medicalnewstoday.com)

FREE HIV Self-Tests! - Greater Than HIV

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Nancy Barrow:

Hello, Connecticut and welcome to the paid leave podcast. The title basically says it all. I'm Nancy Barrow and I will be delving into this new state program and how it can help you and your family. This podcast will give you information you should know about Connecticut paid leave, and maybe just a little bit more. Connecticut paid leave brings peace of mind to your home, family and workplace. Welcome to the paid leave podcast. December is HIV AIDS Awareness month while the treatments for HIV have prolonged life expectancy. There is no cure yet, and HIV is considered a chronic illness or a chronic health condition. Since the first cases of HIV reported more than 40 years ago, 78 million people have become infected with HIV and 35 million have died from AIDS related illnesses. Connecticut paid leave lets you take time away from work to deal with your own or a loved one's serious health condition or family issues. You can take up to 12 weeks of income replacement if you qualify. And there are several types of leave, one is a block leave, you can take the 12 weeks all at once. There's intermittent leave and reduce schedule leave. For people with HIV, they will need to have continued medical care and medications to control the disease. Kasey Harding is my guest and Kasey is the Director for the Center of Key Populations that is part of Community Health Center Inc. and Kasey began as the director of the HIV ryan white center. Now Kasey took on the role of Director of Community Health Center New Horizons domestic violence services, including oversight of the New Horizons shelter, you are a very busy woman Kasey.

Kasey Harding:

I am I love being busy, though.

Nancy Barrow:

well I'm amazed that you even have time. But thank you for coming on the podcast.

Kasey Harding:

Oh, thank you for having me.

Nancy Barrow:

As I said, December is HIV AIDS Awareness Month, and how many people are diagnosed each year with HIV in Connecticut.

Kasey Harding:

So as much as we work on prevention mechanisms, we still have people diagnosed each year, in 2002. There are around 235 new diagnoses, and there's an estimated 10,000 people living in Connecticut living with HIV.

Nancy Barrow:

So does HIV always progressing to AIDS? Or

Kasey Harding:

no and you know, we're at a really critical time in health care right now, where we have lots of treatments and treatments that are much less burdensome than they used to be. And so people are much healthier. One of our goals at Community Health Center and across the state working with our Department of Public Health is to diagnose people as early as possible. Because the earlier you diagnose someone with HIV, the easier it is to control the amount of HIV that's in their blood and to you know, hopefully make them as healthy as possible and also make the HIV not transmittable.

Nancy Barrow:

So how long after a person is infected, do symptoms appear? Is it it does vary for per person? Or is there an average?

Kasey Harding:

It varies from person to person. And I'll be honest with you, one of the things we really advocate for is routine HIV testing. So we really believe that regardless of your risk factors, doing routine testing, when you come for your doctor's appointments is really important. And I will tell you that last year at the health center, we diagnosed 13 new cases and people who had app or who believed they had no risk factors. Wow. It's really important that people get those routine tests.

Nancy Barrow:

there's been talk of a cure for HIV and AIDS by 2030. What do you think about that? Do you think there is a cure on the horizon?

Kasey Harding:

You know, I don't know, I would love to say a resounding yes. Because obviously that's the goal. What I do know is that if you have HIV and you're living with HIV, and your viral load is undetectable, you can't transmit it to anyone else. And so even in the absence of that vaccine, or that cure, I think it's really important for people to know that if they get medical care immediately, and they take their medication as they're supposed to, the risk really goes down and the quality of life for that person goes up. If you treat HIV and you and your adherence to medications, there is a way to stay safe and to keep your community and your partners safe.

Nancy Barrow:

That's great news. Are some people scared to get treatment because they're fearful that their employer may find out? Is there still that worry?

Kasey Harding:

Yeah, I think unfortunately, with HIV, the stigma has never gone away. So you know, if you know there's probably a lot of young people listening who don't remember, but back in the 80s When HIV and AIDS were really prominent, you can you know, Freddie Mercury and Rock Hudson and those kind of things. First of all, it was debilitating and people died pretty quickly from it. But there was also a lot of stigma Because of who, who was getting HIV and how it was, you know, transmitted and things like that. And I think that's just carried on, into into today. And so it's really unfortunate because I think people are, you know, when you hear you're gonna get an HIV test, I have a 21 year old daughter, who was like, why are they what did they think about me? Why am I getting tested for HIV, and I've been doing this since she was born. So, you know, I think there's still just that little bit that people can't let go of, and there's really no reason for it. And, you know, obviously working for a healthcare organization, the HIPAA laws are so they're, they're designed to protect people. But so are the employment laws. You know, it's designed so that your employer has certain people who have access to certain information that absolutely need it. But other than that, they don't. But I also believe on the other side, we have a really good system that that protects them. And, and that's important, too,

Nancy Barrow:

it is working at the HIV ryan white center, what did you learn about the disparities in the stigma and the discrimination, as you said, there still is that present?

Kasey Harding:

Yeah. So I have been really fortunate in my life to have these amazing jobs. And before I came to community health center, I ran an organization Tabor House that provided residential help for people living with HIV. And so that was a little bit more because it was so long ago, that was a little bit more really helping people to treat their illness, but also in some ways to kind of transition into perhaps being sicker and dying and things like that, and working with families. Whereas now, you know, we're really looking at a different a whole different population. And we're looking at an older population who lives longer, we're looking at a lot of comorbidity. So again, when we talk about the family leave, it might not be HIV, that is that that is make someone sick, or need to take a leave, it might be that comorbidity of, you know, a cancer or diabetes, which we didn't really see in people with HIV, because they didn't live long enough. And now, you know, the life expectancy is so much greater, and but I think around the stigma, it really is opening safe spaces for people. And, you know, it's the same with a lot of things. It's a same with LGBTQ rights. And, you know, we need to be a society that accepts people for who they are and meets them where they are. And until that happens, people are going to feel fear, and they're going to feel discriminated against. So it's kind of on us who run these systems to make them more more accessible.

Nancy Barrow:

When someone is newly diagnosed. What does your center do?

Kasey Harding:

Well, I mean, one of the biggest things in HIV care specifically is that linkage to care. So how quickly can we get them to a provider, a medical provider who can offer them treatment and offer them some explanations and things like that. So the first thing that we do when someone's diagnosed is obviously run a confirmatory test to make sure it's accurate, and then link them with a provider. And at chc. We have these phenomenal providers, all of our providers can do HIV care, which is an exceptional thing. Because a primary care usually when you would go to a private primary care, they would refer you somewhere else for your HIV care. In our case, we have most of our providers are proficient in HIV care. And so you don't have to go anywhere else you go, you stay right with it within your own medical center. We offer counseling, we offer education. And the great thing about the HIV services that we can offer is that there's a wraparound support system. So it's not just an chc. In general, we have a wraparound support system of behavioral health and oral health care, and substance use treatment and things like that. And again, it's all in one place. And even our even our quest labs are in our build most of our buildings. So I think that creates a scenario that's really great for patients who are struggling to kind of comprehend what's happening to them. But it also initiates treatment really quickly. And that's one of the most important things. Yeah, and I think one of the most important things and this goes back to the discrimination and fear is having people who are knowledgeable about HIV, who know what the risks are, who can walk you through and that's not just you know, your your doctor or your APRN. That's the case managers and the the medical assistants and everybody involved in your care when they have that knowledge than it does create that safe space for care.

Nancy Barrow:

it's comprehensive. Yeah. You mentioned mental health and behavioral health. How important is that when someone is diagnosed with HIV?

Kasey Harding:

Well, I'm a big proponent of it being important for everyone. So Oh, you know, I definitely think that that and right now after COVID, I particularly think we're seeing a lot of untreated mental health issues. That, you know, part of it is we need more providers to respond. But part of it is again, that that discriminate not discrimination, but the stigma of knowing and acknowledging that you need mental health care. And I think for people with HIV, there's some very specific things that you know, they have to deal with and some specific challenges. One of the biggest is, is telling your family and acknowledging with your family and talking about, you know, a trauma that may have occurred that created, you know, the the diagnosis, those are all really heavy subjects. And we need to make sure that mental health is accessible to people with HIV, really, from the get go. At Community Health Center, we do something called a warm handoff, which is, you know, where you basically can go from your medical provider, right to a behavioral health specialist, and just get an assessment on where you are and what your needs might be. And it's a really great way to just kind of get that first in into mental health and see where you're at and what your needs might be. It's

Nancy Barrow:

interesting that you said, telling the family I hadn't even thought of that aspect of it. And it must be really difficult to do that, is that the biggest challenge,

Kasey Harding:

that's probably one of the biggest challenges is, you know, and not just telling your family, but living with your family, and, you know, and acknowledging it, and then making it part of your existence with your family, your friends, figuring out how to operate your life in a different way, you know, now you're going to take medications, and you're going to have to make different accommodations for yourself and kind of putting that into your own, you know, your own world and your family's world. And as you can imagine, you know, I'm a mom, I have five kids. And you can hear my landline, I'm the only one in the world who still has a landline. I apologize. But I'm a mom with five kids. And I always think if something were, you know, if one of my children had to come to me and told me, that's a, that's hard, because I want them to have the easiest life possible. And so it's not that I wouldn't love them anymore, or that the challenge wouldn't be accepted. It's just you know, it's heartbreaking when someone has a challenge, and you wish they didn't. So I think that's, that's what people deal with a lot.

Nancy Barrow:

Do you encourage people to do like family therapy, so they can all understand it better together?

Kasey Harding:

Yeah, we actually do a lot of that. But we also do support groups. So we have support groups for people living with HIV, but we also have support groups for their families or friends or just a caregiver. Sometimes Sometimes it's not even someone related, but it's a caregiver. And that's really important.

Nancy Barrow:

Yeah, you've touched on a lot of what Connecticut paid leave covers, like the mental health, behavioral health aspect, addiction services and treatments, we, we cover that as well. And caregiver leave is really a big one for us. And of course, we have that extended definition of family. So it doesn't have to be a relative a blood relative, it can be a best friend or a co worker or your neighbor. That is like family to you. So I love that about Connecticut paid leave. And do you think that that's something that can really help the people that that you are dealing with?

Kasey Harding:

absolutely. And I too, I love the idea that, again, when we look at creating safe spaces, it means you, you have to meet people where they're at. And it's not always a parent, or a sibling who's taking care of you, it's sometimes other people. And I do think that that's a huge, a huge bonus to the family paid leave. And I also think that making people aware of that, that it's there and that it's there for a purpose. And, you know, you and I have talked a little bit already about, you know, people are going to be healthier when they have someone to take care of them. And you're going to be a better employee, when you're not worried about your parent or your best friend who's struggling through something when you can just go and take that week or two. And, you know, my mom had hip replacement surgery. And I would have loved to just feed her every meal and sit with her and and I think she would have been healthier, and I would have been a better employee at that point. And so it's the same thing with people living with HIV or you know, hepatitis going through hepatitis C treatment. You know, you just need that time and our bodies are not designed to go 24 hours a day. And I think this makes it possible.

Nancy Barrow:

Is it a lifelong treatment. So this is something they have to go to see their doctor once a month or is it more than that?

Kasey Harding:

No, it's great. So, again, HIV care has changed so much. And we are at a point now where we see people, we'd like to see them once every six months to check in, but we don't need to. So it can be longer. And, you know, we get routine lab work to see where their viral load is to see how much HIV is in their in their bloodstream. And you know, it is a lifetime of medication to stay virally suppressed, which means there's under 200 copies of the HIV virus in your blood. But again, that just points to if, if you're virally suppressed, generally, people are pretty healthy, they're able to do kind of what they want. And there, they don't transmit it to others, despite any any kind of risk behavior. So it really puts them in a good position. And that's why we work so hard. We have care coordination and case management and, you know, adherence counseling, and all of the mental health stuff, the support, and all of that is really designed to keep people in care, keep them taking their medications, and to eliminate any barriers, like, you know, I had a patient the other day who just got COVID and couldn't get to the pharmacy. Well, that's an easy fix, we'll we'll have the pharmacy will I'll get the pharmacy to deliver it to you, or I'll bring it to you. And, you know, those are the kinds of things that seems small. But if you go off your medication, you risk not being able to use that medication anymore. And so we want to keep people as adherent as possible so that they stay as healthy as possible.

Nancy Barrow:

Are there different? You know, if someone is on one medication, and it's not working anymore? Are there other medications that are available to them?

Kasey Harding:

Yes, absolutely. And again, we're looking at things like injectable HIV medication, where you would come in once a month, like we do for some of the birth controls. And so there's lots of options that are really getting cutting edge. And one of the reasons is because we want to eliminate that pill fatigue of people having to take a medication every day. And of course, we all as we get older, you know, everybody's maybe started to have to take blood pressure medicine or whatever. So it's not, it's not awful. But if we can make it easier on people, especially because we do see such high risk populations with HIV. So people who are living in poverty, people who are, you know, who experienced other social determinants of health, and we want to make it as easy as possible to stay healthy.

Nancy Barrow:

Can you explain to me what prep is and how prep works

Kasey Harding:

Yeah, Prep is wonderful. Prep is a miracle. Prep is called pre exposure prophylaxis. And it is a medication that was originally designed for HIV, but that through research was found to prevent the transmission of HIV. So if you take one pill, every single day, and you're adherent to it, you will not get HIV despite risk factors, it's 99%. Effective. And what that means is if you're someone who lives a lifestyle, that maybe you're you're introducing risk periodically or regularly, you can take this medication and you can stay safe despite what your risk factors are. The other thing is, there's zero discordant couples. So one, one person in a partnership has HIV and one doesn't. The one who doesn't can be on PrEP and protect themselves and still have a healthy sexual lifestyle. You know, it prep is amazing. The one thing is that you have to be adherent for it to work. And that's really hard. And the other interesting thing about PrEP is as great as the research is, and as wonderful as it is. People still don't want to do it, because it's an HIV medication. And so, and sometimes where you have to access that medication feels like you're, you know, like someone said, Well, I don't want to go to an HIV clinic. And I said, Well, we're not an HIV clinic. We're a clinic who serves everyone. Yeah. And but people still get that little, that little bit of fear of the stigma or fear of someone seeing a medication and knowing it's an HIV medication and thinking they have HIV. So there's a lot of things we're looking at to try to change that.

Nancy Barrow:

maybe change the name. So I say, change, change the name of that. So it doesn't make people think like, oh, I'm healthy, but I'm taking an HIV medication.

Kasey Harding:

Right. And there's still also that kind of throwback to what we used to call, you know, when the 80s and 90s the HIV cocktails

Nancy Barrow:

the cocktails. Yeah, there's not around anymore. Right?

Kasey Harding:

They and that was just horrendous on your body and in the side effects were almost worse than the actual disease. But that's not true anymore. The HIV medications are amazing. Today and the research has been phenomenal. So

Nancy Barrow:

Wow, that's wonderful. Is there home testing for HIV?

Kasey Harding:

options is, if you come to us for rapid HIV testing, which we do right there, it takes about 20 minutes. If you came and said, You know what, I'm just not comfortable doing this, we can also give you an at home kit. And with that, we would also give you a phone number to call so that if you want to take the test, and in the 15 minutes, while you're waiting for the result, you want to call us and talk to us about your risks, or just to have a friendly person on the other end, while you're waiting. We can offer that you can also believe it or not get them sent to you. So there are websites, which I'll give you after this. There are websites where you can just have two kids sent to your home. And I actually did it because I wanted to make sure before I gave it as a referral. And it's it's beautiful, it works perfectly. And you can give your phone number and they'll text you and say did you take your test? Is there anything we can do for you. But you can also do it anonymously, you just have to be able to give them an address to send it to

Nancy Barrow:

what about pregnant women? Kasey do moms give the virus to the baby and our babies being born with HIV?

Kasey Harding:

Yeah, so absolutely, moms can give it to to their baby. And they can do it a couple of ways. One is through the birth, and the other is through breastfeeding. And so we want to be that's another reason we really want to be careful about making sure everybody gets tested. And one of the interesting things is that we did have babies born in Connecticut, with HIV years and years ago, and then we started testing pregnant, all pregnant women, for HIV. And because of that, when you're pregnant, if you do have HIV, you can take medication that will protect the baby and make sure the baby's born isn't born with HIV. If you don't know you have HIV, that's where the risk is. And so we test pregnant women and we treat them if they have HIV. And there were no for the for about 10 years, there were no babies born with HIV in Connecticut. Wow. The The one issue is if someone doesn't get prenatal care, and we aren't able to test, then they could potentially still give birth without knowing that they're HIV positive. But there's also treatment for the baby afterwards. And there's a chance that they won't be positive with treatment. And so, you know, we want to watch pregnant women really carefully for all sorts of things. But this is in particular, the state of Connecticut did a great job of instituting that testing, getting getting the treatments that needed and making sure that kids are born healthy.

Nancy Barrow:

its wonderful to Connecticut paid leave, does bonding leave. So you can have 12 weeks of bonding leave. But prior to that you can take an extra two weeks for pregnancy leave and do prenatal. So you can actually take time away from work and get income replacement. If you have a risky pregnancy. You know, if you're doing if you have HIV, that would be definitely something that would help.

Kasey Harding:

yeah that's amazing and really important. And I think that prenatal phase people, you know, underestimate how important especially the the two weeks before you give birth and what might be happening. And so I think that's really important.

Nancy Barrow:

I know that you said, moms are getting tested for HIV. Do people still have to get tested when they get a marriage license? Listen, that's something that was happening. Really, it was something that was done a few years ago, right, like years ago that to me is really interesting. What group

Kasey Harding:

It was Yeah. And I don't honestly know when we stopped doing it. And I don't know why I think it probably was right now, is it the highest risk or is getting infected more something to do with privacy and that kind of thing. But yeah, no, you don't have to get an HIV test now. And I can tell you that I have many patients at the health center, who were infected by a partner that they didn't know was positive when they when they got married. Oh, wow. So yeah, so it does create a little bit of, you know, an issue quickly, Connecticut is a little bit different than the United States. So in the United States, young black males who have sex with men who have sex with men are the highest risk. They're the getting the newest HIV infections, that's the highest rate. In Connecticut, we see a little bit of everything we see young black males, we see heterosexual Latina women, we see, you know, heterosexual white women. And so we really have to kind of make sure that we're reaching all of these populations. There's also a significant injection drug user population that gets HIV and so always really being careful about those risk factors. And again, that's where the routine testing comes in. Because you don't have to target a specific population. If everybody's getting their HIV test when they come in.

Nancy Barrow:

We know how to stop the spread of HIV. So why are we still dealing with it? Why aren't people taking precautions Is it as simple as Education. Kasey,

Kasey Harding:

I think it's education, I think there's a little bit of, in all of us human beings who, you know, we don't think about our mortality as much as we should. And so HIV, as greatest as it is that it has become an illness that's very manageable and treatable, and people are living longer. That also sort of gives a sense of freedom that, oh, it's not so bad if I were to get HIV or, or things like that, some of it is education. A lot of it is I still believe, you know, that stigma around not wanting to ask someone to put a condom on and, or not wanting to, you know, go to the syringe exchange program and get clean needles, and, you know, just being afraid or fearful of what the implications are, and, and really getting a message out there a positive message, I think sometimes our HIV messaging is, is not as as person positive as it could be. You know, we want people to have healthy sexual lives, we want people to enjoy life. So, you know, it doesn't have to be punitive, or, or so our messaging needs to be this is how you have the best life, this is how you protect yourself, your family, your community. And, and that's what we kind of work on. Now.

Nancy Barrow:

What final thoughts do you have about Connecticut paid leave with the HIV population and and your other programs and how they can benefit from this program?

Kasey Harding:

Yeah, I think one of the things that's amazing about this is, again, as you said, it gives people a tool in their tool belt, and, and it doesn't necessarily mean everybody needs to use it, you know, but when you do, I think it makes a healthful individual. And, you know, I'm pretty healthy. But I know that when my mom was struggling, the stress on me to keep going to work, and then take care of her needs and things like that. And, and if you can do it in a different way, I think it creates a safety net for people and, and, you know, and I've, I've perused the website to make sure that I had all of the information for this. And it's easy, you can find out if you're eligible, you can find out who to contact at your, where you work, you can find out an approximation of how much you you know, you could you could get, it's really, you know, we just need people to know it's there and to make use of it in a positive way.

Nancy Barrow:

Usually people don't know about it until they need it.

Kasey Harding:

Thank you so much for highlighting specifically the HIV population. Because again, I think sometimes we forget 10,000 people living in Connecticut with HIV, and important people who are doing really, really cool things and and deserve that acknowledgement and, and the education that we can provide them with the family paid leave. And I really appreciate you taking the time, especially December is World AIDS, awareness. And so this is a perfect time for this conversation.

Nancy Barrow:

Kasey is there a way to get in touch with the Center for key populations? Or if someone needs a little more information?

Kasey Harding:

yeah www dot center for key populations.com. And you can also go to the CHC website, www dot chc one.com. And that will actually link you directly to me, and I'm happy to answer questions or provide more information. And as I said, I'll also send you some links that you can post if you want.

Nancy Barrow:

that would be great They'll they'll be in the notes in the podcast, that's for sure. Casey Harding, Director for the Center of key population with the community health centers. Thank you so much for joining me today on this podcast. Oh, thank you, there was a pleasure. Again, to get in touch with the Center for key populations, you can go to the website at Center for key populations.com. To find out more or to apply for benefits go to CT paid leave.org. This has been another edition of the paid leave podcast. Please like and subscribe so you'll be notified about new podcasts that become available. Connecticut paid leave is a public act with a personal purpose. I'm Nancy Barrow and thanks for listening

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