Last year, 282 people in the District of Columbia tested positive for HIV, a whopping 79% decrease from the 1,374 cases diagnosed in 2007 and a 61% decline from the total 721 new cases in 2011. In other good news, the district saw improvements in the HIV care continuum in 2019, meaning that more people are learning their HIV status, getting connected to care, starting treatment and maintaining an undetectable viral load.
The 2019 data were released last week by the District of Columbia’s Department of Health (DC Health) in its annual surveillance report on HIV, sexually transmitted infections (STIs) and tuberculosis.
“It’s the first time we had less than 300 new diagnoses in the city since 1984,” Michael Kharfen, the senior deputy director of the HIV/AIDS, Hepatitis, STD and TB Administration at DC Health, told The Washington Post. “However, I also see any new diagnosis as a failure of our entire system because we have the tools to prevent HIV. So we still have work ahead of us.”
The continued decline in new HIV cases can be attributed to several factors, including needle exchange programs, PrEP and U=U, according to the newspaper. PrEP stands for pre-exposure prophylaxis, a daily tablet that prevents HIV-negative people from contracting the virus. U=U, or Undetectable Equals Untransmittable, refers to the fact that when people living with HIV take meds daily and maintain an undetectable viral load, they can’t transmit the virus during sex, even when condoms are not used.
The city is on track to meet Mayor Muriel Bowser’s 90/90/90/50 Plan to End the HIV Epidemic by 2020. Launched in 2016, the plan aims to have 90% of the people in Washington, DC, living with HIV know their status, to have 90% of those people on treatment and to have 90% of those on treatment maintain an undetectable viral load. In addition, the plan aims to see a 50% reduction in the number of new cases from the plan’s launch, which translates to 196 HIV transmissions in 2020.
Of course, trends seen in the 2019 data do not reflect the challenges brought about by COVID-19. However, as the Post reports, DC Health officials have launched new strategies to address the current situation. For example, the city provides PrEP to people without requiring HIV blood tests first, and people who have HIV can now get 90-day supplies of their meds instead of the usual 30-day supply, which means fewer doctor visits and disruptions in treatment.
To ensure that people can get tested for HIV at a time when fewer people are seeing their doctors, the city will mail a free at-home HIV test kit to anyone who requests it. You can get a free test kit, info on connecting to care and even free condoms by visiting GetCheckedDC.org.
The 2019 surveillance report offers detailed breakdowns of the HIV and STI data. Below are several key takeaways:
- 12,408 current residents of the District of Columbia, or 1.8% of the population, are living with HIV.
- The number of newly diagnosed HIV cases in the district decreased to 282 cases in 2019, a decline of 61% from 721 cases in 2011 and 79% from 1,374 cases in 2007.
- Two babies were born with HIV in 2019.
- The number of newly diagnosed HIV cases attributable to injection drug use decreased by 99%, from 150 cases in 2007, prior to the scale-up of DC’s needle exchange program, to 2 cases in 2019.
- Blacks and Latinos with HIV exceeded 1% of their respective populations, with Blacks disproportionately impacted at 2.8%.
- More than half of people living with HIV in DC are 50 years old and older.
- Young people ages 13 to 24 represent nearly 20% of new HIV diagnoses between 2015 and 2019; the number of new HIV diagnoses among young people ages 20 to 24 remained level for the past three years.
- Sex between men and heterosexual contact are the two leading modes of transmission reported among newly diagnosed and identified HIV cases.
- Among people newly diagnosed with HIV, 62% were linked to medical care within seven days of diagnosis; 81% were linked to care within 30 days.
- Viral suppression among all people living with HIV in DC remained at 69% overall and 87% among people with an indication of engagement in care.
- Among people newly diagnosed with HIV, 59% were virally suppressed within 90 days, up from 45% in 2018. However, this indicates that not enough people are getting on HIV treatment in time to attain viral suppression.
- DC supported about 1,700 people to start pre-exposure prophylaxis (PrEP) in 2019.
- DC distributed more than 4.6 million male and female condoms in 2019.
- DC removed 478,038 needles from the street in 2019 through the DC needle exchange programs.
- DC distributed 43,034 Naloxone kits, saved nearly 1,000 people from opioid overdose death and supported 520 people onto medication-assisted treatment for opioid addiction in 2019.