AT ITS peak, the HIV rate in the District stood at approximately 3 percent — higher than in parts of West Africa. After nine consecutive years of decline between 2007 and 2016, the rate has fallen to 1.9 percent, a remarkable achievement for city health officials who deployed a multipronged strategy against the virus that causes AIDS. But a new public-health report from the D.C. Department of Health raises concerns that these efforts may be stalling.
According to the Annual Epidemiology & Surveillance Report, 368 District residents were diagnosed with HIV in 2017 — just one fewer than the number diagnosed the year before. This is a contrast to sharp drops in previous years, and the city’s infection rate still exceeds the World Health Organization’s threshold for what is considered a generalized epidemic. Troublingly, data shows that HIV rates among gay and bisexual men, Latinos, and young people between ages 13 and 29 have all increased in the past year. These trends highlight the challenges facing local officials as they strive to meet Mayor Muriel E. Bowser’s (D) goal of reducing annual HIV diagnoses in the city to 200 by 2020.
But the city’s HIV infection rates are not the only data point that should raise red flags: Rates of other sexually transmitted diseases have also risen significantly over the past few years. Chlamydia cases have increased by 35 percent since 2013, while gonorrhea cases have increased by a staggering 56 percent. Though local officials attribute these increases to better screenings, the trends mirror national rates, which have hit record highs as funding for STD clinics has been slashed.
The D.C. report comes amid growing concern that global efforts to combat HIV/AIDS and other STDs have also stalled. Last year, 1.8 million people were newly infected with HIV, and health experts noted the emergence of drug-resistant strains of the virus that are more difficult to combat. A recent report from UNAIDS, the U.N. program on HIV/AIDS, criticized the lack of urgency exhibited by many governments and suggested that there was a 20 percent shortfall in funding for effective interventions. It also found that HIV rates were rising among children and called on governments to do more.
Three decades into the global HIV/AIDS epidemic, the world has made impressive strides in tackling the virus. There is no excuse for dropping the ball now. Local and national governments need to redouble efforts to raise awareness about HIV and other STDs, curb risky practices and offer timely and affordable treatment to those infected. In the District, the D.C. Health report identified several areas for improvement, including expanding access to pre- and post-exposure prophylaxis medication that lowers the risk of contracting the virus; working with community partners and schools to increase access and information among youth populations; and raising awareness about risks and treatment among LGBTQ populations that are disproportionately affected. These measures are critical if the District is to have any hope of meeting its goal to end the HIV epidemic by 2020.