Metro Weekly

CDC: HIV diagnosis rates down, except among gay and bi men of color

CDC analysis shows Southern states lag behind in testing, and have higher death rates from HIV

An HIV-infected T-cell (Photo: NIH’s National Institute of Allergy and Infectious Diseases (NIAID), via Wikimedia Commons).

The Centers for Disease Control and Prevention (CDC) on Sunday announced that even though HIV diagnoses have declined by nearly 20 percent over the past decade, gay and bisexual men, particularly men of color, are not seeing similar success. In addition, Southern states are lagging behind the rest of the nation when it comes to testing and reducing the number of deaths related to complications arising from HIV.

The number of HIV diagnoses between 2005 and 2014 decreased by 19 percent over all, driven in part by dramatic declines among heterosexuals (a decrease of 35 percent), intravenous drugs users (a decrease of 63 percent), and African-Americans (a decrease of 22 percent, fueled by a marked decrease of 42 percent among black women).

For gay and bisexual men, the results varied by race and ethnicity. While white gay and bisexual men saw decreases drop by 18 percent, there was an increase of 24 percent among Latino gay and bisexual men, and by 22 percent among black gay and bisexual men.

However, the CDC also noted that the increase among black gay and bisexual men of all ages has leveled off since 2010. Similarly, young black gay and bisexual men ages 13-24 saw an 87 percent increase in new HIV diagnoses, but that has also leveled off since 2010.

“Although we are encouraged by the recent slowing of the epidemic among black gay and bisexual men — especially young men — they continue to face a disproportionately high HIV burden and we must address it,” Dr. Jonathan Mermin, the director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a statement. “Much more must be done to reduce new infections and reverse the increases among Latino men. There is hope that the National HIV/AIDS Strategy and other efforts are beginning to pay off, but we can’t rest until we see equal gains for all races and risk groups.”

In a separate analysis, the CDC also announced statistics from 2012 — the most recent data available — on state-by-state progress on HIV prevention and care, particularly in the areas of testing and reducing the number of deaths from complications arising from HIV. Seven of the top ten states with the highest death rate of people diagnosed with HIV were in the Southern region of the country, and all ten had rates that were above both the national rate of 19.2 deaths per every 1,000 people diagnosed with HIV, and the CDC’s ideal 2015 goal for all states of 21.7 deaths per 1,00o people with HIV.

The top 10 states in terms of death rate were, in descending order: Louisiana, with 30.8 deaths per 1,000 people with HIV; Delaware, with 28.6 deaths per 1,000 people with HIV; Alabama; Mississippi; South Carolina; Idaho; Kentucky; Michigan; Nevada; and Maryland, which rounded out the top 10 with 21.9 deaths per 1,000 people with HIV.

Among all Southern states or jurisdictions, only two — Georgia (16.9) and the District of Columbia (17.8) — had death rates below the national average. For those in the greater D.C. metropolitan area, Virginia (21.1) and West Virginia (20.8)  had the 14th and 16th highest death rates in the nation for people diagnosed with HIV.

“It is unacceptable that people with HIV living in many Southern states are more likely to die than those living in other parts of the country,” Mermin said. “Some state’s are making great strides toward getting people with HIV diagnosed and into care, but every state must do this if we are to reach our national goals for prevention and care.”

Complicating the matter of deaths and delay of treatment for those infected with the virus is the high number of people who do not know their HIV status. Nationally, 87 percent of Americans knew their HIV status in 2012, well below the CDC’s goal of 90 percent in all states. Only five states — New York and Hawaii at 93 percent, and Colorado, Connecticut and Delaware at 90 percent — met or exceeded that threshold. Louisiana had the lowest rate of people who knew their HIV status, at 77 percent, followed closely by Maryland, Iowa and Georgia, all at 81 percent. Of the 13 states with the lowest number of people who knew their HIV status, nine were in the American South.

“CDC is responding to the challenge of HIV in the South and nationwide by prioritizing the hardest-hit areas and populations and investing in the most effective strategies,” Dr. Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention, said in a plenary speech at the National HIV Prevention Conference in Atlanta on Sunday. “These strategies include expanded testing for HIV, helping people living with HIV obtain ongoing care and treatment, and increasing awareness of and access to all effective prevention tools, including condoms, pre-exposure prophylaxis, or PrEP, and interventions to decrease risky behavior.

“We have the tools to stop HIV right now,” McCray added. “We urgently need to accelerate access to testing, treatment, and new biomedical prevention strategies so that everyone can protect themselves and their partners.”

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