July 23, 2012
This year, as Washington, D.C., prepared to host the 2012 International AIDS Conference, residents in the nation's capital continued to battle epidemic levels of HIV/AIDS.
According to a report released by the Washington, D.C. Department of Health (DOH), the prevalence rate -- or the proportion of cases within a given population -- of HIV among adults and children living in Washington is 3.2 percent. The World Health Organization states that a 1 percent prevalence rate in the general population meets the criteria for an HIV/AIDS epidemic.
In 2009 President Obama lifted the 22-year-old order that banned people living with HIV/AIDS from traveling to the United States, paving the way for the conference.
"If we want to be the global leader in combating HIV/AIDS, we need to act like it," Obama announced then.
Leadership was sorely needed in the District back in 2005 when DC Appleseed, a non-profit organization that examines public policy in the Washington metro area, gave the city government failing grades for their HIV/AIDS initiatives. Following the stinging report, then-Mayor Adrian Fenty announced that fighting the HIV/AIDS epidemic in the city was his top public health priority.
Since the announcement the District has made strides in reducing the number of people living with AIDS and toward getting more residents living with HIV/AIDS in treatment programs. DOH reported that the number of AIDS cases declined by 30 percent from 2005 to 2009 and now more than 75 percent of D.C. residents get treatment within three months of their diagnosis compared to just 58 percent in 2005. In 2011 the District government earned A's in several programs, including surveillance, testing, condom distribution and programs for inmates; a C in public education in its charter schools; and no D's or F's.
When it comes to HIV/AIDS, Blacks are overrepresented in the population of Washingtonians living with the disease. The nation's capital is 52 percent Black and 35 percent White, but 75 percent of the HIV/AIDS cases occur among Blacks and 17 percent among Whites.
Black women in D.C. are 14 times more likely to be living with HIV/AIDS than White women. Fifty-four percent of women living in Washington are Black, yet Black women accounted for 91 percent of HIV/AIDS cases. White women, who represent 33 percent of the female population in the District, accounted for just 3 percent of the HIV/AIDS cases.
"As a citizen of the United States and knowing that this is my nation's capital and knowing that this is something that I can do something about, we decided to embark on a program that really tried to change the paradigm in Washington," said Carl Dieffenbach, Ph.D., director of the Division of AIDS at the National Institute of Allergies and Infectious Diseases.
Dr. Dieffenbach hopes that getting tested becomes a badge of honor in the Black community, as it has become in the gay community in San Francisco. The researcher also said that educating Blacks about the role that clinical trials play in fighting HIV/AIDS is an important factor in stemming the tide of HIV infections. He announced that the National Institutes of Health will be bringing a series of PrEP (pre-exposure prophylaxis) demonstration projects and clinical trials on new PrEP agents to Washington, D.C. Clinical trials involving new PrEP agents for MSM who live in D.C. will begin in August and another for women will begin later this year, he said. According to the Centers for Disease Control and Prevention, when used as prescribed, PrEP has been shown to be effective in reducing the transmission of HIV in men who have sex with men (MSM).
Although most HIV transmission for Whites (75 percent) occurs among MSM, a majority of Blacks (34 percent) contracted HIV through heterosexual contact followed by MSM (24 percent).
African-American women in the city's communities most at-risk for health and income disparities can use all the help that they can get. Their HIV infection rates soared in the last two years, climbing from 6 percent to 12 percent according to the DOH study.
DOH officials said that the increase is likely due to increased testing of residents who didn't know their HIV status.
As the District struggles to find answers to its own unique HIV/AIDS epidemic, this week city leaders will be talking more about recent successes and less about past failures.
City council member David Catania (I At Large) touted Washington's success at stemming the tide of new HIV/AIDS infections and treating those infected with HIV sooner in a recent op-ed for The Washington Post. Catania, who also chairs the council's Committee on Health said:
"More specifically, though, our city has moved from the systemic failures of yesterday -- characterized by waste, fraud and dysfunction -- to today's reality, in which we are cementing our reputation as the model of an aggressive and effective response to this deadly disease."
Catania looks at AIDS 2012 as an opportunity for D.C. residents and the international community to share lessons learned and diverse perspectives in a "spirit of collaboration."
Adam Tenner looks forward to those collaborations as well. Tenner, the executive director of Metro TeenAIDS, a non-profit group based in Washington, D.C., that supports young people in their fight against HIV/AIDS, said that the support and additional resources that come with increased visibility of local organizations is even more important. The Kaiser Family Foundation reported that Black teens (ages 13-19) make up 17 percent of the U.S. teen population, but accounted for 68 percent of new AIDS cases in their age group in 2009.
"From Metro TeenAIDS perspective, at the end of the day, we're still going to be here next Sunday night and we have a lot of work to do and we need support in doing that," Tenner said.
Freddie Allen is a Washington, D.C.-based journalist and a correspondent for the NNPA.