But things only got harder. They couldn’t seem to carve out a place for themselves in orthopedic implant sales in Denver, and soon they’d gone through all their savings. They lost their apartment and had to stay with friends. Then, around four years ago, Hayden got a letter through FedEx that changed his life forever.
“Right after we had lost our apartment in Denver, we started selling plasma for extra money,” says Hayden. “I had donated plasma three times [already] and one morning I got a knock on the door and it was a letter from the Colorado Department of Health and Human Services telling me I needed to contact them immediately. So I called and they were like, ‘You tested positive.’ And I was like, ‘Wait. They ran all these tests before I even started donating.’”
But the virus hadn’t shown up then, and now the antibodies were there in numbers large enough to count. At 36 years old, Hayden had been diagnosed with HIV.
Hayden is one of approximately 600 HIV positive people living in Boulder County. In addition to those 600 people, the Colorado Department of Public Health and Environment estimates that there are about 126 people in the county who are unaware they are infected. Those 700-odd people account for 6 percent of the total number of people (11,750) living with HIV in the state of Colorado.
“A lot of people who were around in the early days [of the HIV/AIDS epidemic] will say, ‘HIV — is that still an issue?’ Yes indeed, it is still an issue,” says Ana Hopperstad, executive director of the Boulder County AIDS Project. “I think it’s not as visible anymore. You can’t go into a grocery store and see someone in the line next to you who has wasting syndrome. People with HIV aren’t as easy to identify in the public venue anymore. I think even though that’s true, I think the people I know who are HIV positive are very careful about who they reveal their status to. There’s still subtle discrimination.”
But the Boulder County AIDS Project, or BCAP, has been a safe haven for those living with HIV since 1985, when the world was just awakening to the threat of a scarcely understood virus — just four years after AIDS was recognized as an epidemic in the United States.
In those first days, BCAP consisted of two volunteers working two afternoons a week on a borrowed phone line. They served 49 clients. The nonprofit organization now services more than 230 people in Boulder, Broomfield, Gilpin and Clear Creek counties, providing assistance with everything from transportation to and from doctor’s appointments to navigating the complexities of insurance to making sure clients stay nourished through one of BCAP’s two food pantries.
And a new study shows that BCAP’s efforts over nearly three decades have truly changed lives for the better. In March, BCAP finished an analysis of five years of data, from 2008 to 2013, and found that HIV positive clients using their medical case management services were three times more likely to have an undetectable amount of HIV in their blood — referred to as a viral load — than other HIV positive individuals receiving medical care across the country.
According to AIDS.gov, viral load testing looks for the number of virus particles, or “copies,” in a milliliter of blood. The goal of HIV treatment is to help patients achieve an undetectable level of HIV, generally less than 40 to 75 copies of the virus, but the exact number depends on the lab doing the testing.
“Research has shown that people with an undetectable viral load are dramatically less likely to transmit HIV to others,” the recent BCAP study reads. “The path to an undetectable viral load requires continuous, uninterrupted treatment that starts with early diagnosis through HIV testing and continues throughout a person’s lifetime.”
And according to Hopperstad, this is exactly what BCAP aims to provide.
“I’m pretty excited about this study,” she says. “It’s grounded in statements made in the national HIV/AIDS strategy that came out in April of 2010: getting people quickly in care and retaining that care so people can have positive health outcomes.”
Research from around the world shows that consistent treatment is key to limiting the transmission of HIV. The PARTNER study, a multinational European study, enrolls couples where one partner is HIV positive and the other is not and looks at the risks of HIV transmission when the positive partner is engaged in effective HIV treatment. In March, researchers from the PARTNER study announced that no one with an undetectable viral load, gay or heterosexual, transmitted HIV during the first two years of the study. Ultimately, the study shows that antiretroviral therapy has played an undeniable role in limiting the transmission of HIV.
However, the BCAP study looked at more than just medical treatment. Case management at BCAP does make sure clients get the treatment they need, refill prescriptions on time and maintain their commitment to treatment, but they also offer housing assistance, financial aid, therapeutic services like massage and acupuncture, and access to pro bono professional services. Taking all of this into account, the BCAP study showed that their services helped 75 percent of clients reach or maintain an undetectable viral load, compared to 59 percent of people receiving medical care for HIV, but not BCAP services. Nationally, only 28 percent of HIV positive people who are receiving care reach or maintain an undetectable viral load, according to the Centers for Disease Control.
Granted, Hopperstad says, BCAP has pretty high standards.
“Our definition of undetectable is less than the current standard used by state,” she admits, adding that the state defines undetectable as 200 copies of HIV or less, while BCAP says 40 or less copies of the virus.
“What excites me about this study is I think organizations like BCAP can have a positive impact on communities, and community level intervention can have a positive impact on the HIV community,” says Hopperstad. “One of the greatest indicators of success in case management is the establishment of relationships. Ask clients questions in a space [where] they know they will get accurate medical support and resources and information that will help them, and people succeed.”
Hayden seems to be a clear example of BCAP’s ability to help HIV positive individuals succeed — but it took time and more heartache. After Hayden found out he was HIV positive, he pushed his partner to get tested. When Gouthro got tested the result was irrefutable — he too had HIV, and his disease had progressed further than Hayden’s.
There they were, homeless and both newly diagnosed as HIV positive. Hayden sums the situation up as best anyone could: “It was just devastating.”
The couple eventually made their way from Denver to Boulder, where they found BCAP to be a source of positivity and consistent assistance in their difficult situation. Over the course of a year, Hayden and Gouthro were in and out of the hospital as Gouthro’s health declined — he suffered three strokes, and while Hayden says that Gouthro had his mind, he simply wasn’t able to take care of himself, making Hayden’s ability to secure a job that much harder. Hayden freely admits he dealt with alcohol addiction. And then in December of last year, Gouthro passed away.
“We were together for 18 years and I think the only thing that saved him for as long as it did, and saved me, was that we had each other to balance off of,” says Hayden.
Hayden made the push to get sober, and it’s been three months since he had a drink.
“BCAP has been amazing. Celeste [LaBlanc] was my partner’s case manager, and Christina Lopez is my case manager. They both have done whatever they could. I mean, after my partner had his second stroke they were able to get him a walker so he could get around easier. A little over three months ago I got out of alcohol treatment and they’ve been there for me. Anything I’ve needed, they’ve been there.”
Hayden’s working now, helping other homeless men and women in Boulder change their situation through paid work with Bridge House’s Ready to Work program. And BCAP is still there for him.
“Not only do they track my medical doctor appointments, now that I’m on Medicaid they helped set up vision care and dental care, and when there were added costs they were able to get funding for things that weren’t covered, like my eye exam was covered, but my glasses weren’t” says Hayden. “It takes worry off of myself. One month’s worth of prescriptions is around $5,000. If I didn’t have help from BCAP, I couldn’t dream of paying for it.
“I’ve been through a lot in the last six months, losing [my partner] and getting sober,” says Hayden, but through state funding, he’s going to school to be a certified addiction counselor. “Hopefully in the next couple of years I’ll be able to jump in and help out.
“I’ve been given so many opportunities through BCAP, and now I’m getting back on my feet,” Hayden says. “I’m actually starting to volunteer with BCAP. It’s my way of trying to repay what they’ve given me. Without them who knows where I’d be.”