HIV/AIDS rate in Washington, D.C. highest among U.S. cities

Public health officials launch programs to address racial disparity, infant HIV and late diagnosis in wake of grim report on HIV.

Washington, D.C. has the highest HIV/AIDS rate in the nation at 128.4 cases per 100,000 people. The average rate for the rest of the United States is about 14 cases per 100,000 people.

The rates for newly-reported AIDS cases in Washington, D.C. are higher than Baltimore, Chicago, Detroit, New York and Philadelphia.

Statistical data compiled by the Washington, D.C.’s Department of Health’s HIV/AIDS Administration were released in a report on Nov. 26 concurrent with the launch of several new city initiatives aimed at decreasing HIV/AIDS prevalence.

Findings included trends of racial disparity in HIV/AIDS, a growing trend in women affected by HIV/AIDS and a greater population of infants born with HIV than in most U.S. regions.

At the end of 2006, the number of people with HIV/AIDS in Washington, D.C. increased 43% since 2001. The report is the first to include statistical HIV/AIDS data for Washington, D.C. and provides updates to statistics that were last reported five years ago.

“The report gives us critical statistics on HIV and AIDS in our city and we must take advantage of this information with a sense of urgency that the epidemic deserves,” Adrian M. Fenty, mayor of Washington, D.C., said in a press release.

CDC officials applauded the report as an important tool to enhance targeted programs to fight the city’s epidemic.

“This report provides important data on the state of the HIV/AIDS epidemic in D.C.,” said Irene Hall, PhD, chief of the HIV Incidence and Case Surveillance Branch at the CDC. “Additionally, these data indicate the severity of the epidemic, especially in the marked racial disparities and the disproportionate number of late-testers.”

Blacks, women most affected

Washington D.C. began HIV surveillance in 2000 using code-based reporting for new HIV cases. Statistics in the report represent data collected between Jan. 1, 2001 and Nov. 16, 2006.

In 2006, there were 12,428 people with HIV or AIDS in Washington, D.C. Of those, 80.7% were black and 70% men. More than two-thirds of newly-reported HIV and AIDS patients were aged 30 to 49 years.

Between 1997 and 2006, nearly 70% of all HIV cases progressed from HIV to AIDS in less than one year after initial diagnosis, compared with 39% nationally. Late diagnosis was attributed to late testing.

Nine percent of pediatric AIDS cases in the United States during 2005 were reported from Washington, D.C. Fifty-six children aged 13 years and younger were diagnosed with HIV or AIDS in Washington, D.C. between 2001 and 2006. Many states reported no new cases among children during the same time.

Racial disparity was reported in the statistics. Black residents accounted for 57% of the population but accounted for 81% of the newly-reported HIV cases. Black women comprised 58% of all women in the city, but accounted for 90% of all new HIV cases in women. Black children were predominantly affected by HIV (97.3%) and AIDS (95.3%).

The leading mode of HIV transmission in Washington, D.C. is heterosexual contact, which was reported in 37% of cases. Nationally, men who have sex with men represent the highest transmission mode for new HIV cases. Most new cases were reported among those aged 30 years to 49 years.

Reduction plans made

The Washington, D.C. Department of Health’s HIV/AIDS Administration announced several initiatives to address the report findings.

“The report is not meant to sit on the shelf; it is a critical tool for every government official, community provider and District resident to fight this disease,” said Shannon L. Hader, MD, MPH, senior director of the Washington, D.C. Department of Health HIV/AIDS Administration. “We in the District have a modern, large and diverse HIV/AIDS epidemic that requires modern and innovative strategies to save lives, which will be achieved under Mayor Fenty’s leadership.”

In 2008, Washington, D.C. officials said they will launch more effective public awareness for increased testing and access to treatment while reducing high risk behavior.

Washington, D.C. officials also hope to eliminate all mother-to-child transmissions by 2009 through working with city hospitals to implement routine HIV testing, add third trimester repeat testing and to provide rapid testing at delivery. Administering appropriate antiretroviral treatment to pregnant women is also included in the planned initiatives. – by Kirsten H. Ellis

Washington, D.C. has the highest HIV/AIDS rate in the nation at 128.4 cases per 100,000 people. The average rate for the rest of the United States is about 14 cases per 100,000 people.

The rates for newly-reported AIDS cases in Washington, D.C. are higher than Baltimore, Chicago, Detroit, New York and Philadelphia.

Statistical data compiled by the Washington, D.C.’s Department of Health’s HIV/AIDS Administration were released in a report on Nov. 26 concurrent with the launch of several new city initiatives aimed at decreasing HIV/AIDS prevalence.

Findings included trends of racial disparity in HIV/AIDS, a growing trend in women affected by HIV/AIDS and a greater population of infants born with HIV than in most U.S. regions.

At the end of 2006, the number of people with HIV/AIDS in Washington, D.C. increased 43% since 2001. The report is the first to include statistical HIV/AIDS data for Washington, D.C. and provides updates to statistics that were last reported five years ago.

“The report gives us critical statistics on HIV and AIDS in our city and we must take advantage of this information with a sense of urgency that the epidemic deserves,” Adrian M. Fenty, mayor of Washington, D.C., said in a press release.

CDC officials applauded the report as an important tool to enhance targeted programs to fight the city’s epidemic.

“This report provides important data on the state of the HIV/AIDS epidemic in D.C.,” said Irene Hall, PhD, chief of the HIV Incidence and Case Surveillance Branch at the CDC. “Additionally, these data indicate the severity of the epidemic, especially in the marked racial disparities and the disproportionate number of late-testers.”

Blacks, women most affected

Washington D.C. began HIV surveillance in 2000 using code-based reporting for new HIV cases. Statistics in the report represent data collected between Jan. 1, 2001 and Nov. 16, 2006.

In 2006, there were 12,428 people with HIV or AIDS in Washington, D.C. Of those, 80.7% were black and 70% men. More than two-thirds of newly-reported HIV and AIDS patients were aged 30 to 49 years.

Between 1997 and 2006, nearly 70% of all HIV cases progressed from HIV to AIDS in less than one year after initial diagnosis, compared with 39% nationally. Late diagnosis was attributed to late testing.

Nine percent of pediatric AIDS cases in the United States during 2005 were reported from Washington, D.C. Fifty-six children aged 13 years and younger were diagnosed with HIV or AIDS in Washington, D.C. between 2001 and 2006. Many states reported no new cases among children during the same time.

Racial disparity was reported in the statistics. Black residents accounted for 57% of the population but accounted for 81% of the newly-reported HIV cases. Black women comprised 58% of all women in the city, but accounted for 90% of all new HIV cases in women. Black children were predominantly affected by HIV (97.3%) and AIDS (95.3%).

The leading mode of HIV transmission in Washington, D.C. is heterosexual contact, which was reported in 37% of cases. Nationally, men who have sex with men represent the highest transmission mode for new HIV cases. Most new cases were reported among those aged 30 years to 49 years.

Reduction plans made

The Washington, D.C. Department of Health’s HIV/AIDS Administration announced several initiatives to address the report findings.

“The report is not meant to sit on the shelf; it is a critical tool for every government official, community provider and District resident to fight this disease,” said Shannon L. Hader, MD, MPH, senior director of the Washington, D.C. Department of Health HIV/AIDS Administration. “We in the District have a modern, large and diverse HIV/AIDS epidemic that requires modern and innovative strategies to save lives, which will be achieved under Mayor Fenty’s leadership.”

In 2008, Washington, D.C. officials said they will launch more effective public awareness for increased testing and access to treatment while reducing high risk behavior.

Washington, D.C. officials also hope to eliminate all mother-to-child transmissions by 2009 through working with city hospitals to implement routine HIV testing, add third trimester repeat testing and to provide rapid testing at delivery. Administering appropriate antiretroviral treatment to pregnant women is also included in the planned initiatives. – by Kirsten H. Ellis