District Reports Seventh Consecutive Year of HIV Cases Decline

The Washington, D.C., Department of Health announced a decrease in new HIV cases among District residents for the seventh consecutive year in a report published Feb. 2.

The DOH’s interim HIV/AIDS surveillance report used preliminary data from recorded patients in 2014 to form its assessment. Under current law, doctors and hospitals must report to the DOH when they have a patient with a confirmed case of HIV.

According to the report, there was a 29 percent decrease in new HIV cases between 2013 and 2014, with 396 new cases reported in 2014 and 553 cases reported in 2013. The number of new HIV cases in 2014 is also down 70 percent from the 1,333 new cases reported in 2007, the year with the highest number of new HIV cases in Washington.

Mayor Muriel Bowser celebrated the decline in new HIV cases in a press release on Feb. 2.

“Last year, I announced the bold goal to cut in half new HIV cases in the District by the year 2020,” Bowser said. “Today, we continue to make progress toward that goal and take new approaches that will enable us to ultimately end the epidemic in our city.”

DOH Senior Deputy Director for the HIV/AIDS, Hepatitis, Sexually Transmitted Diseases and Tuberculosis Administration Michael Kharfen said this decline can be attributed to a comprehensive combination of approaches that the DOH uses in treating HIV. Kharfen emphasized the District’s timeliness in linking HIV-positive patients with the healthcare they need as critical in reducing HIV rates.

“The standard that the federal government has set is within three months,” Kharfen said. “We have a protocol here in the District called red carpet entry. This protocol is that if you are newly diagnosed with HIV or you have been wanting to return into care, we can get you an appointment with one of our HIV medical providers within 72 hours.”

Kharfen also cited other methods used by District healthcare providers to reduce the rate of new HIV cases, including providing free condoms and clean intravenous needles as well as ensuring HIV-positive residents remain in care.

Kharfen stressed the need to understand the intersections of social and economic factors when considering healthcare policy.

“You have to understand that health doesn’t occur in a vacuum, that there are other factors that can have impacts on people’s health choices and conditions,” Kharfen said. “That can be their economic opportunity, it can be whether or not they have a stable place to live, it can be whether or not they can have transportation and access to health services and it can be education.”

This year’s report also marks the implementation of two new changes to the DOH’s method of compiling data on HIV cases: the addition of a separate gender category for transgender residents suffering with HIV and AIDS and a change to the methodology of tracking cases. The report cited the new gender category as a way to ensure transgender residents are not underrepresented as they have been in past reports.

Kharfen emphasized the importance of this new category in developing patient comfort in healthcare.

“It’s also a way to destigmatize sex, because for a lot of people their sexuality is fluid and their gender identity can be fluid,” Kharfen said. “Therefore, we’re missing the opportunity to have people feel comfortable about health, their sexual health, and that may put them at risk for HIV in a way because we’ve categorized them in a way that they don’t see themselves as.”

For the first time, the DOH will also change its methodology to define the transmission of HIV in all new cases by either injection, drug use or sexual contact, aiming to enhance the quality of reported data and reduce stigmatization.

DOH Director LaQuandra Nesbitt highlighted inclusivity as the basis for both of these changes in a press release Feb. 2,

“We are promoting an inclusive approach to the HIV epidemic as part of our strategy to reduce barriers and develop effective and scientific-based strategies to achieve a HIV-free generation in the District,” Nesbitt said.

Kharfen lauded Bowser’s administration in the work it has done to reduce the spread of AIDS and HIV in the District, especially through measures that account for marginalized people.

“We’re fortunate in that in the District of Columbia we’ve got a mayor who really has set out a new way of talking about health. The way that she’s describing it is really about looking at health equity,” Kharfen said. “What we’ve got in the District is leadership that says, ‘We’ve got to think about all of these factors and how they relate.’”

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