Data released by the Centers for Disease Control and Prevention this month revealed that 1.1 million people in the United States are currently living with HIV, with the number of new infections remaining steady at approximately 50,000 infections per year since the mid-1990s. D.C. still suffers from the highest HIV/AIDS rates in the country, according to the latest data from the D.C. Department of Health.
“Big picture, we know that there’s approximately 50,000 new HIV infections annually and currently 1.1 million people living with HIV. However, we also know that certain communities are disproportionately affected (e.g., gay and bisexual men, African Americans, Latinos, etc.),” CDC spokesperson Donnica Smalls wrote in an email to The Hoya.
According to the CDC data, HIV is primarily still an urban disease. Over 600,000 people have died from AIDS since the epidemic started, and 15,000 people die of AIDS in the U.S. each year. Of the more than one million Americans with HIV, only 25 percent successful keep their virus under control.
Additionally, the CDC reported that the 63 percent of HIV infections are transmitted through male-to-male sex. The CDC estimated that MSM accounted for 78 percent of new infections in men and almost two-thirds of all new infections in 2010.
The latest D.C. DOH data available, from 2012, says that 2.5 percent of the D.C. population is living with HIV. Gay and bisexual men of all races have consistently had the highest rates of infection nationally.
White House AIDS Coordinator Jeffrey Crowley, a senior scholar at the Georgetown University Law Center’s O’Neill Institute for National and Global Health Law, said that the District, which has the highest HIV/AIDS diagnosis rate in the country, needs to balance the needs of this particular population with other populations disproportionately affected by the disease.
“In the District of Columbia, gay men are highly impacted, but black women and people who inject drugs are also highly impacted,” Crowley said. “A challenge for policy makers and the public is to appropriately place high infection rates among gay men in context, and to appropriately target resources for gay men and other populations while demonstrating a strong commitment to all highly impacted communities. Nonetheless, gay men are very disproportionately impacted by HIV in D.C.”
Melody Wilkinson, an instructor of nursing in the department of nursing at the School of Nursing and Health Studies and certified HIV specialist with the American Academic of HIV Physicians, concurred, noting that the racial breakdown of those affected by the disease has changed. According to data released by the CDC this month, African-Americans make up 14 percent of the population nationwide, but 44 percent of HIV infections.
“HIV disease has always disproportionally impacted [gay] men,” Wilkinson said. “Unlike the early days of the epidemic when HIV disproportionately impacted gay white men, we have seen a shift, and now African American [gay] men represent more than any other subgroup of gay/bisexual men. …African Americans bear a heavy burden related to HIV.”
Latinos have also faced disproportionate HIV rates. At 17 percent of the national population, Latinos make up 21 percent of new HIV infection, according to the recent CDC data.
The World Health Organization classifies a severe epidemic as a disease affecting more than 1 percent of the population. The rates for whites, Hispanics and blacks all exceed this classification, with 1.2 percent of whites, 1.6 percent of Hispanics and 3.9 percent of blacks affected by the disease in D.C. in 2012.
In all wards except Ward 3, more than 1 percent of adult residents are living with HIV. Ward 8 has the highest percentage of HIV-infected people. Wilkinson related the prevalence of the disease to poverty throughout the wards.
“I believe that the two greatest barriers to improved HIV care are related poverty and stigma,” Wilkinson said. “Poor patients may have fewer health care resources.
They may not see a primary care provider for health screening and they may wait until they’re sicker before seeing a health care provider.”
According to the Kaiser Family Foundation, D.C. residents ranked HIV/AIDS as the top health issue facing the area, whereas nationally it is ranked seventh. Crowley noted that increased focus on the disease has improved the District’s response to the disease.
“It is important to acknowledge that D.C. has made major strides in recent years in strengthening its response to HIV,” he said. “In fact, some of the most innovative and evidence-based approaches to preventing and treating HIV are being tested in D.C.”
Wilkinson urged, however, for more accessible testing to prevent the spread of the disease, which still kills more than 15,000 people per year in the United States.
“A change in practice — with more routine HIV testing — would identify those who are HIV-positive and enable those patients to engage in care and decrease the spread of HIV,” Wilkinson said. “In addition to improving testing efforts, we must do a better job linking patients to care, engaging them in care and medically managing those patients.”