Washington, D.C., Has Higher AIDS Incidence Rate Than Baltimore, San Francisco, New York

Washington, D.C., has a higher AIDS incidence rate than Baltimore, San Francisco and New York, according to research findings scheduled to be presented on July 28 at the National HIV Prevention Conference in Atlanta, the Washington Post reports (Vargas, Washington Post, 7/17). Guy-Oreido Weston, director of the data and research division of the District of Columbia Department of Health's HIV/AIDS Administration, and colleagues administered a questionnaire to AIDS surveillance coordinators for cities and incorporated places included in the Census Bureau's ranking by 2000 population size. The questionnaires requested data on annual AIDS incidence by year of diagnosis through June 30, 2000. Researchers determined 40 cities' incidence rates using Census Bureau data on population size for denominators and then ranked the cities by AIDS incidence rate. According to updated 2001 data, researchers found that Washington, D.C., had the highest AIDS incidence rate -- 119 AIDS cases for every 100,000 people -- among cities with more than 500,000 residents. Other cities with high AIDS incidence rates included Baltimore, with 117 cases per 100,000 people; San Francisco with 67 per 100,000; New York City with 64 per 100,000; and Philadelphia with 58 per 100,000. Researchers also found that the median AIDS incidence rate among the 27 largest U.S. cities was 22 cases for every 100,000 people (Weston et al., Study abstract, 7/17). The study is the first to compare the district to other cities rather than to states, Weston said.

Injection Drug Use, Access to Care
The district's high AIDS incidence rate is associated with the city's high rate of injection drug use and may point to problems with access to health care, according to national health officials. Weston said that his research shows that cities in the Northeast and the South had the highest AIDS incidence rates, which he said is highly correlated with injection drug use. A needle-exchange program is "severely needed" in the district to address the problem of injection drug use and HIV transmission, according to Michael Cover, a spokesperson for the Whitman-Walker Clinic, a Washington, D.C.-based health organization. The city ran its own needle-exchange program prior to 1998, when Congress prohibited the district from using locally raised tax money to support the program, an action that Cover called "simply shameful." In addition, Floyd Nelson, a spokesperson for the D.C. HIV/AIDS Administration, said that African Americans, who account for 61% of the city's population, represent almost 80% of all new AIDS cases. "Studies from national data show us that if you're African-American, you're less likely to be treated sooner," Tom Coates, director of the University of California-San Francisco AIDS Research Institute, said, adding that the findings suggest "that those infected with HIV in D.C. ... are not getting the medical care that they should be getting" (Washington Post, 7/17).


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