By George Kevin Jordan, AFRO Staff Writer
Here is the science.
The CDC confirmed the study and world view from HIV advocates and professionals that “people with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load (or stay virally suppressed) have effectively no risk of transmitting HIV to their HIV-negative partners.”
Suppression for HIV+ people can mean taking a prescribed regimen of Antiviral drugs. For HIV-negative people it can mean taking PrEP or Pre-exposure prophylaxis, which is also scientifically effective in stopping the transmission of HIV.
With the science firmly in place however D.C. still faces a problem with HIV rates and STI infections. Last week the AFRO spoke to Activist and Ruby House Executive Director Ruby Corado about opening a wellness center in the Southeast. She unpacked the need for HIV services in D.C. “The D.C. HIV epidemic continues to be worst in the country of a major city,” Corado told the AFRO. “It has become totally accepted that today a young Black or Brown gay or trans kid become HIV positive with no local outcry.”
The D.C. Health Department’s 2018 Annual Epidemiology and Surveillance Report seemed to confirm Corado’s fears. But not for everyone.
According to Michael Kharfen, Deputy Director of HIV/AIDS, Hepatitis, STD & TB Administration at the D.C. Department of Health the number of HIV infection rates overall over time decreased dramatically.
“We say 73 percent decrease in HIV infections from 2007 to 2017,” Kharfen said, referring to the report. “That’s a greater decrease than San Francisco, New York and other cities.”
He urged the people to not just look at a year by year analysis, adding, “When you look at public health data and HIV data you tend to look at a span of years because one year to the next is not defining a trend. When you look at the report we’re showing you a perspective.”
However for certain pockets of the population, particularly Black Same Gender Loving (SGL) men who have sex with other men (MSM), and African American woman, the picture is different.
According to the report:
- There were increases in new HIV diagnoses among young people ages 13-29 from 134 in 2016 to 150 in 2017
- Black men through sex with men and Black women through heterosexual contact have the highest proportion of newly diagnosed HIV.
About 13,000 people are currently living with HIV, according to the report. This compared to 38,739 new infections in the U.S. in total. The most impacted Wards are 5, 6,7 and 8 according to the data. One in five cases were Black women, and one and three cases were Black men who had sex with men of color.
Woman account for 1 in 4 of the new HIV diagnosis, Kharfen said, but of those women diagnosed, 90% are African American women.
To compound the issue of HIV, STI’s are on the rise in D.C. The data showed that:
- There were record numbers and increases among reported STDs with 10,157 cases of chlamydia, a 35% increase from 2013 to 2017; 5,070 cases of gonorrhea, a 56% increase from 2013 to 2017; and 318 cases of primary and secondary syphilis, a 13% increase from 2013 to 2017.
The good news is we now know treatment for both HIV negative and HIV positive people is the most effective way to reign in HIV rates.
The Mayor’s office along with the Department of Health came out with their 90/90/90/50 Plan in 2016 which is a bold step in eradicating the spread of the virus.
In the executive summary the document states that: “Despite years of progress in the understanding and treatment of HIV/AIDS, the District of Columbia still is in the midst of an HIV epidemic. In fact, more than 13,000 people in D.C. are living with HIV, which is equal to 2 percent of the District population. This percentage far surpasses the generally accepted definition of an epidemic, which is 1 percent of the population. For some groups in D.C. the situation is even more severe: 4.6 percent of African-American men, 2.1 percent of Hispanic men, and 1.9 percent of African-American women are living with HIV.2 A recent survey by the DC Trans Coalition suggests that as many as 20 percent of transgender people in D.C. may be HIV-positive.”
To combat the high infection rates the Mayor’s office pushed for 6 goals by 2020:
- 90 percent of Residents know their HIV status.
- 90 percent of HIV positive residents are in treatment
- 90 percent of residents in treatment reach viral suppression. This coincides with the goal of undetectable means no chance of passing on the virus.
- 50 percent reduction in new infection rates.
But despite the plan’s initiatives the numbers are still disproportionate for people of color.
However Kharfen pointed out to some positive outcomes for the city’s overall goals.
“Overall I would say we’re making progress,” Kharfen said. “We have multiple goals. We are closer to our three 90 goals.”
“Eighty seven percent of persons with HIV know their status,” he said. “Eighty percent of those diagnosed are on treatment. We’re around 84% on treatment achieving viral suppression.”
“We know we need to ramp up reducing HIV diagnoses.”
The biggest key to that plan is PrEP and also PEP (Pre Exposure Prophylaxis) which occurs after exposure to the virus. The city set a goal to provide the two drugs to 8000 people by 2020. So far it since 2018 they have reached about 2000.
“We need a lot more people to consider this as an option,” Kharfen said. “It doesn’t have to be a lifetime option. But an option.”
Kharfen said that the cities DC Health and Wellness Center at 77 P Street will be providing PreP and PEP.
On Jan. 14 Mayor Bowser will lay out her vision for the city, and the issues that need to be addressed. She is reported to talk about health outcomes for the city as part of her agenda. The AFRO will follow this story.