WASHINGTON, DC – The nation’s capital, which has the highest rates of HIV in the country, has released more information about its epidemic – and it’s a mixed picture.
The District reported Wednesday that 14,465 people were infected with HIV in 2010, a steady increase of nearly 3,000 people since 2006.
“That means more people are living with HIV,” said Dr. George Pappas, the city’s AIDS director.
DC's overall prevalence decreased to 2.7 percent from 3.2 percent in 2009, a drop partly attributable to the city’s growing population, changes in racial composition of its residents, and a new name-based reporting system. The name-based reporting system was the biggest reason for the drop in the prevalence estimate because it eliminated some 2,041 former HIV cases that were reported as duplicates or deceased.
In addition, according to the report, HIV-related deaths are down, new infections are down, and no child has been born HIV positive in more than two years.
But the story is more complicated than just those indicators. Major challenges remain in trying to reduce numbers of infections in high-risk populations, including African American men and women.
A small behavioral study released along with the report revealed that 12.1 percent of the 482 people surveyed were infected. A similar study in 2007 demonstrated that only 6.3 percent of African American women were infected.
So is DC making progress in its AIDS fight?
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Dr. Alan Greenberg, the chair of Biostatistics and Epidemiology at George Washington University, who played a key role in the city’s report, said two statistical indicators were most important when passing judgment on the city’s efforts.
“The two outcomes you want to see are the reduction in incidence and the maximizing of effective therapy – that people infected are getting excellent healthcare,” he said.
Incidence — the rate of new infections — is going down. There were 835 newly reported cases in 2010, a 24 percent reduction from 2006, which had 1,103 reported cases.
The picture is not as good for making sure HIV-positive people stay on therapy.
Some 76 percent of infected individuals were connected to care within three months of their diagnosis. But in economically depressed areas of Washington, including the predominately African American areas east of Anacostia River, many drop off medication.
“In the communities that we are dealing with — people with low income, low education, low employment — people are generally more concerned with, ‘How am I going to keep the lights on? How am I going to get food in my stomach? How am I going to feed my family?’” said Terrence Young, who runs field operations for a community-based organization in southeast DC. “We find that once we’ve been able to address somebody’s supportive issues then it’s a lot easier to have that conversation around HIV.”
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