HHD’s Jorge Hernandez counsels those with HIV knowing exactly what they’re going through

Jorge Hernandez knew exactly what to do when he received the news that his HIV test results had come back positive. What would have been a devastating diagnosis for many actually triggered a calling to help others that started with a TV commercial 18 years ago and turned into a career path that also helped him understand and manage his own life with HIV.

“I still remember the date,” Hernandez said. On Oct. 19, 2014, while he was working doing outreach and HIV testing for The Houston Area Community Services — what is now Avenue 360 Health and Wellness — he administered a rapid test on himself at the office. After waiting 20 minutes, the result from the rapid test came back positive. Hernandez was skeptical. Thinking it could be a false positive, he took a second rapid test, but the results were no different. 

Hernandez remembers digesting the news with calm.

“I felt fine. I didn’t feel scared because I’ve been in the field for years and I knew so much about it that it just doesn't faze me,” he said.

After the second result, he walked across the hall to the clinic side of the facility to discuss his result with colleagues and start the more accurate lab testing process that would involve a blood sample. Three days later the result confirmed Hernandez was positive for HIV. 

There are three types of HIV tests: one looks for antibodies, another looks for antibodies and antigens, and a third — the Nucleic Acid Test — that looks for the actual virus in the blood. The NAT is a lab test requiring blood from a vein. Results usually take three days to a week, depending on the lab.Rapid result tests are usually antibody or antigen/antibody tests that sample blood from a finger stick or oral fluids. They have a false positive rate of 0.09% and an accuracy ranging from 91.1% to 99% depending on the test manufacturer and other conditions that may include the time frame of the date of exposure. These types of tests are reliable, resourceful and easy to use. Home kits for self-testing are also available at pharmacies.

The step after receiving a positive result from a rapid test is to take the NAT not only to confirm the presence of the virus in the blood but also to know the HIV viral load, which will help determine the most appropriate treatment for each patient.

The calling 

Hernandez has been a disease and prevention specialist for the Houston Health Department’s Bureau of HIV/STD and Viral Hepatitis Prevention for five years now, but he said his true calling started “by accident” with a medical assistant program TV commercial from the Texas School of Business almost two decades ago. 

02 The callingIn 2006 Hernandez enrolled in the medical assistant program that led him to an internship with Legacy Community Health. He established connections with both the medical/provider side and health education portion of the clinic. When his internship concluded, he applied for a job was hired to work with the health education section.

A few years after launching his career at Legacy Community Health Services, Hernandez moved to Avenue 360 Health and Wellness to continue his journey of providing health education through community outreach, HIV testing, and protocol counseling to newly diagnosed HIV patients on how treatments and adherence work.

“There was a very different aspect,” he said. 

Hernandez remembers when medications such as pre-exposure prophylaxis, or PrEP, that prevent and treat HIV did not exist, before smartphones were used for outreach to offer information, and distributing rapid tests was done at bars and clubs.

“We still did it the old fashion way.” he said.

One of the most important and delicate tasks Hernandez handles now is delivering the news to newly diagnosed patients.

“In all my years diagnosing, not everybody’s reaction is the same,” he said. In some cases people may react with denial and aggressiveness, while others will diminish the results and act like they don’t care, or may have an emotional outburst and break down in tears. 

Uncertainty can be devastating when receiving a positive diagnosis, especially when a person is not aware of available options and the latest medical advances. Consequently, Hernandez sees the benefits of effective and accurate rapid at-home tests, but his primary concerns are for the emotional and psychological aspects.

Learning the other side of the coin

For Hernandez early detection was a priority. He had no symptoms, other than a recent weight loss that may have been unrelated to HIV. As a health educator, he believes it is his responsibility to set an example and stay on top of his health status by getting tested periodically. 

When Hernandez’s results came back positive, he knew exactly how to start his treatment, what insurance would cover, and what additional resources he could benefit from. But Hernandez viewed his diagnosis as an opportunity to see firsthand the other side of the coin and understand what those he had counseled went through. He followed the process he advised for his patients: “I decided to go through the same thing that everybody else went through. Even though I had insurance, I wanted to see myself,” he said. 

03 Hernandez s advocacyAssisting patients from all walks of life, Hernandez wanted to know exactly how everything worked, especially to be resourceful for migrants and those who may not have a job or health insurance but can still get treatment through grants.

Hernandez tells newly diagnosed patients, “I’m in the same boat as you!” That connection makes them feel more comfortable, accepted, and optimistic about the outcomes of following their treatment. He wants to make sure they walk out of his office feeling calm and knowing they are protected.

“When I tell them that I am (HIV positive) as well, their demeanor changes because now they are talking with someone in the same shoes as them,” he said.

Hernandez has lived with HIV for nine years and became undetectable within a few months of his diagnosis. When he started his treatment, he learned how other health conditions and lifestyle choices — such as diet or being a morning person vs. a night owl — can determine the type of treatment and when during the day to take the medication. Current viral suppression treatment medication is consolidated into one pill that is more powerful and less toxic.

As a City of Houston Employee, Hernandez makes good use of his resources, especially when it comes to his health benefits. He follows the same recommendations he suggests to his patients: “In all my jobs I’ve always got the PPO because it will cover more as far as for medications and services, and you can go anywhere without having to wait for a referral,” he said.

Preferred Provider Organization or PPO health insurance plans may seem more costly at first glance, but for a person living with HIV — no matter If they are undetectable — it is very important to stay on top of their health, including dental and vision, and to be alert for any arising chronic disease such as diabetes or other conditions. It is best to have coverage for the unexpected, Hernandez said.

Hernandez's advocacy for health literacy is not limited to a 9-to-5 job or something that he separates from other aspects of his life. Apart from his work as a senior public health investigator for Houston Health, he is a renowned and people's favorite DJ, having been named "Favorite Drag Queen DJ” more than once. Hernandez has more than 24 years of experience in the DJ industry and has toured across the country. Also known by the stage name DJ Aracely Manterola, Hernandez is frequently approached by members of the LGBTQIA+ community whom he has helped with treatment and professional counseling, and by others in need of assistance for grants and medication.

“The word gets out and people approach me when I’m doing my DJ thing,” he said.

Being transparent with his patients by sharing his story and having a bubbly personality makes him approachable and relatable, which allows him to help more people.

U=U

When people are first infected with HIV, they may not feel sick or have symptoms until two to six weeks after the infection. In some cases, there may not be symptoms for years. Once the virus is installed it will attack the immune system making the person more vulnerable to other infections and diseases. Something as small as a dental cavity may turn into a dangerous infection for a person living with HIV.

Once a patient is diagnosed with HIV, it is important to draw blood to determine the viral load and assign a treatment. HIV has different stages and the viral load will continue to grow as the virus keeps making copies of itself. A high viral load is considered above 100,000 copies per milliliter of blood, while the lower viral load is below 10,000 copies per milliliter.

While there is no cure for HIV, thanks to medical advances viral suppression treatments have proven to be effective by reducing the viral load to as low as less than 200 copies of HIV per milliliter of blood, a number so low that even tests cannot detect it. When this happens, patients are defined has undetectable. And undetectable also means zero risk of transmitting HIV during sex.

When following treatment correctly, an undetectable person can live a healthy, regular, and long life, just like an HIV negative person. Current HIV viral suppression treatments are as simple as one pill a day.

“Undetectable equals Untransmittable” is a slogan that many worldwide HIV campaigns use, Including ones from the Centers for Disease Control and Prevention and the Human Rights Campaign.  These efforts aim to end the epidemic while fighting the stigma and misinformation surrounding HIV and AIDS. They also work to ensure a life of dignity to those living with HIV by bringing awareness to the effectiveness and safety of the viral suppression treatments, providing resources about HIV prevention treatments such as PrEP, and promote and normalize HIV testing.