The District of Columbia, which has historically had the highest rate of HIV/AIDS in the United States, has seen a 46 percent drop in the rate of infection between 2007 and 2011 from 3.2 percent to 2.4 percent, the Department of Health announced last week.
HIV cases in the District decreased from more than 1,300 in 2007 to 718 in 2011, and 80 percent of identified cases were treated within three months of diagnosis. Nevertheless, the 2.4 percent rate is still far above the national average of 0.4 percent.
In 2009, NPR reported that D.C.’s HIV/AIDS 2007 rate of 3.2 percent was higher than some West African countries. If the District were considered a country, it would have been placed on former President George W. Bush’s Emergency Plan for AIDS Relief list, which contained the 15 countries in the world with the worst HIV/AIDS rate.
On the list, D.C. would have ranked above four PEPFAR countries: Democratic Republic of Congo (1.3 percent), Ethiopia (1.4 percent), Sierra Leone (1.5 percent) and Rwanda (2.9 percent). On the higher end of the scale were South Africa (17.8 percent) and Zimbabwe (15 percent).
In particular, NPR found that black and Hispanic men in the District were especially at risk, and over 50 percent of HIV positive cases were fatal.
Michael Kharfen, interim senior director of the HIV/AIDS, Hepatitis, STD and Tuberculosis administration at the DOH, attributed the results to support from Mayor Vincent Gray since his 2010 election. Gray has supported a citywide recovery program that provides testing, education and medical resources.
“The DOH has benefitted from good community and political leadership, including from the mayor, city council and important health officials,” Kharfen said. “Together, we’ve made a push to talk about HIV prevention, promoting safe sexual behavior and effectively responding to this epidemic.”
Through this program, the DOH has focused on providing annual, convenient HIV/AIDS testing in an attempt to diagnose cases earlier.
“Our department has seen that after being diagnosed, people change their sexual behavior and are much less likely to transmit the disease to others,” Kharfen said. “Also, under the proper medication, the virus can be reduced to almost undetectable levels, which also reduces transmission rates.”
The DOH has also distributed 10 times more free condoms since 2007 and prioritized cooperation with local medical organizations and community awareness groups to provide prevention and treatment education.
Despite the District’s success with HIV/AIDS, more than 15,000 D.C. residents were still living with HIV in 2011. In addition, the DOH reported that rates of other sexually transmitted infections such as chlamydia, gonorrhea and syphilis have increased in the last few years, with over 9,300 total new cases between 2010 and 2011. According to Kharfen, not all of this increase reflects an actual increase in case numbers. Rather, because of the increase in testing, more cases are being found and reported.
“We’re simply testing more people here in the District than in most other places,” Kharfen said. “Our high schools have a system of STI testing, which is rare. This testing is vital, because these infections, and chlamydia especially, are prevalent in the adolescent community, and symptoms can at times be hard to spot. Syphilis is more an issue with gay and bisexual men, so we’ve ramped up our efforts of testing and prevention in that demographic.”
Kharfen added that the current political struggle on Capitol Hill could threaten the District’s HIV/AIDS prevention plan and other programs. According to Kharfen, more than 93 percent of District residents utilize expanded Medicaid services that would be provided under the Affordable Care Act.
“The District was one of the first places in the country to begin using the Affordable Care Act to give full medical coverage to residents, which is especially vital in ensuring that people get tested and can get treatment, no matter their socioeconomic status,” Kharfen said. “The possible repeal of the act would really strike a blow to our efforts for HIV/AIDS prevention in the city.”
Georgetown also participates heavily in dealing with the STI rate in the District through the Student Health Center, the Health Education Services Offices and Counseling and Psychiatric Services.
According to Assistant Vice President for Student Health Services James Welsh, the university focuses particularly on screening students and educating them about sexual health.
“STI screening, including for HIV, is offered regularly at the Student Health Center,” Welsh said. “Health Education Services, working with offices like the LGBTQ Resource Center and the Women’s Center, offer periodic free HIV screening opportunities here on campus.”
Georgetown played host to the 2012 International AIDS Conference, where university representatives highlighted the District’s battle against STIs.