- The Washington Times - Monday, June 26, 2017

D.C. officials are aiming to focus public attention on the ongoing HIV crisis with events around the city on Tuesday, which is National HIV Testing Day.

According to the federal Centers for Disease Control and Prevention, the District leads the nation in the rate of HIV infection, with the chance of a person ever being infected with HIV in their lifetime at 1-in-13 in the District, compared to Maryland, where 1-in-49 residents have a chance of being diagnosed HIV-positive.

The CDC estimates that 1-in-7 people nationwide don’t know they are HIV positive.

“It’s important to get an HIV test at least once a year and more often than that every three or six months, depending on your behavior and how much risk you may be for coming in contact with HIV or contracting HIV,” said Josh Riley, director of community commitment at the District’s nonprofit community health center Whitman-Walker.

Tuesday events in the District marking National HIV Testing Day include free screening centers or mobile units, and giveaways at the D.C. Health and Wellness Center on 77 P St. NE. Tuesday evening, the Brave Soul Collective will put on a theatrical performance at The Fridge venue at 516 1/2 Eighth St. SE.

Mayor Muriel Bowser is expected to announce new data from the annual report on HIV/AIDS, Hepatitis, STD and TB Administration, and to speak at the Whitman-Walker Health clinic at 14th Street NW on Tuesday afternoon.

Similar events and initiatives are planned across the country to encourage people to get tested for HIV. Early intervention is the best way to control the virus and decrease the chances of spreading it, health experts say.

Currently, 1.1 million people in the U.S. have the human immunodeficiency virus, which can cause AIDS, despite strides in raising awareness, early intervention and treatment. HIV infections exploded across the country in the 1980s, disproportionately affecting gay men and minority populations. There is no cure for HIV or AIDS.

Following the District and Maryland, the states with highest rates of HIV infection are Georgia, Florida, Louisiana, New York, Texas, New Jersey, Mississippi, South Carolina, North Carolina, Delaware and Alabama, according to the CDC.

The rates of new HIV cases fell about 18 percent between 2008 and 2014 but are increasing among young people, said Patrick Sullivan, a professor of epidemiology at the Rollins School for Public Health at Emory University and the lead researcher for AIDSVu — an interactive map based on CDC data on HIV infection rates.

The map allows users to zoom in on statistics in their neighborhoods, as well as find nearby testing and medical centers.

“We have to really catch youth with the right education and messages and resources, whether that be condom provision or for those who are 18 and over, can use Preexposure prophylaxis [preventive medication for people who are HIV negative but at a high risk for infection],” Mr. Sullivan said.

“The idea that HIV testing become normative, especially for young people who may need testing more than just one time, but may need testing every year, it’s important for that to become a normative behavior,” he added.

The CDC encourages everyone between 13 and 64 years old be tested for HIV at least once.

Advances in antiretroviral therapy since the mid-1990s have allowed people who are HIV-positive to live longer, protect against infecting others, and prevent the virus from devolving into AIDS, which leaves a person with a severely suppressed immune system and vulnerable to infection by opportunistic diseases.

Promising research has shown that HIV-positive patients on a strict medication regimen can reduce the detectable amount of the virus in their systems and that reduces the risk of infecting someone else.

Mr. Sullivan said that scientists are working on improving antiretrovirals by making the medications easier to take and simplifying dosing regimens. He added that the research community is still focused on a cure for HIV.

“I think it’s really important that we have both,” he said. “In the short term that we continue to try and make medication for people living with HIV to be as simple, as tolerable and as effective as possible while there’s also a sustained effort to look towards a cure.”

Additionally, HIV and AIDS disproportionately affect the black and Hispanic communities. In the District, black men are 2.8 times more likely to be living with HIV compared to white men, and Hispanic men are 1.5 times more likely to be living with HIV compared to white men.

Meanwhile, the rate for black women living with HIV is 27.5 times higher compared to white females, and the rate of Hispanic women is 5.8 times higher than white females, according to federal data compiled by AIDSVu.

In 2015, Miss Bowser launched the 90/90/90/50 by 2020 initiative to combat HIV. Its goals are to increase to 90 percent the number of residents aware of their status, increase access to treatment for people who are HIV positive, increase the number of those in treatment to reach viral load suppression — keeping HIV at an undetectable level which in turn reduces the risk of transmission — and finally, reducing new HIV infections by 50 percent.

According to the 2016 annual report, there were 13,391 HIV-positive residents the District in 2015. In that year, 371 new HIV cases were reported, compared to 1,333 new cases in 2007.

Notable improvements came in the area of reducing transmission, particularly among intravenous drug users. The city accounts for a 95 percent decline in transmission by needs — from 149 cases in 2007 to eight cases in 2015 — to a scaling up of a syringe exchange program.

Transmission of HIV from mother to child during birth in the District is virtually non-existent since 2012.

However, the two leading transmission modes among newly diagnosed HIV cases continue to be men who have sex with men and heterosexual contact.

According to AIDSVu, the District’s efforts have succeeded above national goals in some areas, while making just falling short in reaching national goals in others. The District has improved access to HIV testing, surpassing the national goal by over a third, and is slightly ahead of the rest of the nation in increasing HIV status awareness.

However, it still falls behind national averages in increasing HIV Viral Suppression (at 74.7 percent compared to the national goal of 80 percent), increase HIV linkages to care (79.6 percent compared to 85.2) and increasing HIV retention in care (53.3 percent compared to 56 percent).


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