Key trends 'lost amid alarm' over District of Columbia HIV/AIDS report

A recent report that showed an HIV/AIDS prevalence rate of about 3% in the District of Columbia "brought new attention to AIDS" in the city, but several "key trends shown in the report got lost amid the alarm," Washington Post reporter Craig Timberg writes in a recent article.

The report showed the epidemic is "serious" and "more extensive than most suspected;" however, it "also suggests that the situation is in some way improving, and has been for years," Timberg writes. He adds that the increase in HIV/AIDS prevalence, although "troubling," is "largely a product" of antiretroviral drugs that allow HIV-positive people to live longer. Timberg writes that there is not much in the data to suggest that the district is "experiencing a burgeoning, African-style epidemic," adding that there has been "nothing like [Africa's] scale of devastation since antiretroviral drugs arrived" in the city.

The incidence of AIDS in the district has been declining since 1993, with 648 new cases reported in 2008, Timberg writes, adding that AIDS-related deaths have also declined since 1994. "What's clearly rising here is the number of people surviving with AIDS because of medicine not easily available in most African countries," Timberg writes. He adds that improving medical services for people living with HIV/AIDS will improve their quality of life and that increased access to HIV testing will get people into treatment earlier. A "main target" of these efforts should be injection drug users -- who make up 25% of the district's new cases -- through increased access to needle-exchange programs, according to Timberg.

In addition, "[a]ny effort to finish off a declining epidemic would make sexual behavior priority No. 1," Timberg continues, adding that most sex education programs in the U.S. typically emphasize abstinence or condom use but have "shied away from discussing the risks of several concurrent sexual relationships." Many African countries are "making that shift" and including sexual behavior in their HIV/AIDS prevention campaigns, Timberg writes. "We'll know that a similar seriousness has arrived in Washington when the rhetoric cools and the billboards that I've seen in Botswana and Swaziland start appearing here, too," Timberg writes (Timberg, Washington Post, 3/22).

Related Opinion Piece

District Mayor Adrian Fenty's recent 2009 State of the District address "did not contain a word about the dramatic event with which Fenty started the week" -- the release of the HIV/AIDS report -- columnist Colbert King writes in a Post opinion piece. Fenty "wasted an opportunity to level with the city," King writes, adding that the district's HIV/AIDS epidemic is "scandalous." The district was among the first U.S. cities to appoint an HIV/AIDS director, as well as an office to oversee the epidemic and care for those living with the disease, but "things have gone downhill fast," King continues. Almost $500 million in federal and local funding was distributed between 1998 and 2006 for HIV/AIDS-related services in the local community, King writes, adding, "What do we have to show for it? An astonishing" 3% of residents who" are living with HIV/AIDS. "More than $500 million in taxpayer money down the drain, we're left with the highest HIV/AIDS rates," King writes, adding there was "not so much as a peep of concern from" Fenty in his address (King, Washington Post, 3/21).