Is the HIV Epidemic Over?

If the United States achieves a reduction to 12,000 new HIV infections by 2025, it could mark an important turning point in the HIV epidemic: a decline in the total number of people living with HIV in the U.S., and the beginning of the end of the nation’s AIDS epidemic. Is the end possible? The numbers tell a riveting story, and the epidemic leaves a despicable and indelible scar in southern and black communities. 

The region:

The South made up more than 50% of all new HIV diagnosis in the United States. Southern states also have the largest population of people living with HIV who don’t know they have been infected. This means they are not receiving potentially lifesaving treatment and care — and they are at risk of infecting others. An indefensible number of people in the South are dying, when treatment is extending life in other regions. In 2014, according to Duke University, 2,952 people in the Deep South died with HIV as an underlying cause, with the highest death rates in Mississippi and Louisiana. Among black men in this region, the HIV-related death rate was seven times as high as that of the United States population at large. Blacks accounted for close to half (44%) of deaths among people with an HIV diagnosis in 2015.

The people:

Young people were the most likely to be unaware of their infection. Among people aged 13-24 with HIV, an estimated 51% didn’t know when surveyed by the Centers for Disease Control and Prevention. In 2015, among all adults and adolescents with HIV,37% received no medical care. 

In 2017 the CDC predicted that if current rates continue, one in two Black gay and bisexual men will be infected with HIV. That’s half, fifty percent. Compare this estimate with a lifetime risk of one in 99 for all Americans and one in 11 for white gay and bisexual men. The number of men who have sex with men without a condom is increasing and more than one-third of young male high school students who had sex with men had also engaged in condom-less anal sex and other higher risk behaviors.

In 2014, nearly one in five black gay men who had received a diagnosis of HIV. had progressed to AIDS by the time they learned of their infection — indicating they were already quite ill when they began treatment. HIV also disproportionately affects the Hispanic/Latino community. HIV was the 4th leading cause of death for Black women ages 35-44 in 2015. In the same year, Hispanic/Latino people accounted for 24% of new diagnoses of HIV in the USA, despite only representing around 18% of the population.

The other issues:

Increasing levels of injecting drug use, linked to the epidemic of opioid misuse, threaten the gains made on reducing HIV among people who use drugs. Elevated viral loads (higher levels of HIV genetic material in a blood sample) in smaller sexual networks (people still tend to have sex with people of the same race), amplified by social issues such as joblessness, lack of education, and transportation contribute to the disproportionately high rates of infection in the black community. 

One thing has remained unchanged for 30 years: HIV disproportionally affects the most vulnerable, marginalized, and stigmatized populations. New HIV infections and deaths are seen in places where higher-risk groups remain unaware, underserved or neglected. 

Protecting yourself:

Get tested and treated for sexually transmitted infections. Use condoms correctly every time you have oral, vaginal, and anal sex. If you inject drugs, make sure to use a new, sterilized needle that hasn’t been used by anyone else. If you think you’ve been exposed, a series of emergency antiretroviral drugs referred to as Post-exposure prophylaxis (PEP) can be used as an emergency prevention method. PEP must be started within 72 hours of exposure, but should be started as close to the time of exposure as possible. If you’re sexually active and have multiple partners, get tested for HIV regularly and know your partner’s status before you have sex.

Stay safe and let’s end the epidemic together.