District of Columbia HIV/AIDS Prevalence at 3%, Report Says
March 16, 2009
At least 3% of District of Columbia residents are living with HIV/AIDS, greater than the 1% level that constitutes a "generalized and severe" epidemic, according to a 2008 report to be released Monday by the city's HIV/AIDS Administration, the Washington Post reports. The 2008 study, which updates 2007 data, is the most accurate count to date of the district's HIV/AIDS prevalence, the authors said. Tracking for the report occurred as the district made the switch from a code-based system to a name-based system. Surveillance teams interviewed medical workers to identify unreported HIV cases, questioned providers who did not provide consistent reports and searched databases for unreported cases. According to the Post, about 2,984 district residents per every 100,000 people older than age 12 -- or about 15,120 people total -- are HIV-positive. The report found a 22% increase in HIV/AIDS cases from the end of 2006, when the district reported 12,438 HIV cases. The report suggests that HIV/AIDS has reached an epidemic level in all but one of the city's wards and that the increase in prevalence has affected all genders and racial groups. The report also cautioned that "the true number of residents" living with HIV could be higher than official data indicate, according to the Post.
Shannon Hader, director of the district's HIV/AIDS administration and former head of CDC's work in Zimbabwe, said the city's HIV prevalence is "higher than West Africa" and "on par with Uganda and some parts of Kenya." Hader added that all modes of transmission are "on the rise, and we have to deal with them." Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, called the report's findings "very, very depressing news, especially considering HIV's profound impact on minority communities." Fauci added that the report is "just based on people who've gotten tested," the Post reports. Walter Smith, executive director of the DC Appleseed Center for Law and Justice, praised the study but also expressed disappointment that it did not include more data on new HIV cases. The report did not include this information because it could take five years to discern accurate data from the transition to the name-based tracking system from the code-based one, according to the CDC. Smith said that he is "not criticizing" officials for not including information about new cases but added that the city has "had more testing, more needle exchange programs." Smith said, "We don't have, at this moment, any understanding about what impact the new programs have had."
David Catania, chair of the D.C. Council's Committee on Health, said that the city has improved testing and monitoring efforts in the past two years but added that the HIV/AIDS administration still faces several difficulties arising from past challenges. Catania said, "For years prior to 2005, mayors and previous individuals allowed things to exist in an unacceptable way." He added that he does "blame this government for part of the epidemic we're confronting." District Mayor Adrian Fenty praised the city's recent efforts to address HIV/AIDS but also acknowledged that more action is needed to control the spread of the disease. "In order to solve an issue as complex as HIV and AIDS, you have to step up," he said, adding, "It's the mayor and certainly other elected officials. But it's also the community. You have this problem affecting us, and you tell people how serious it is and it literally goes in one ear and out the other." Some people also have questioned whether congressional control over the district has hindered the city's ability to address HIV among injection drug users. According to the Post, a nearly 10-year ban Congress imposed on the use of tax dollars to fund needle-exchange programs in the district was lifted last year.
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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
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