New HIV infections in Georgia – long a leader in HIV diagnoses – dropped by nearly twice the national average, though gay men did not see the same decline that other populations did.
That's the takeaway from new numbers released this week by the Centers for Disease Control & Prevention. The estimates from the federal health agency showed that across the U.S., new infections dropped by 3.6% in 2014 and by 18% from 2008 to 2014.
In Georgia, new HIV infections dropped by 6.1% in 2014, a decline among the highest seen in states cited in the new CDC estimates. In 2014, there were 37,600 new HIV infections across the country with 1,900 of those in Georgia.
"We have the tools, and we are using them to bring us closer to a future free of HIV,” Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention, said in a prepared statement. “These data reflect the success of collective prevention and treatment efforts at national, state and local levels. We must ensure the interventions that work reach those who need them most.”
HIV infections didn't drop as much among gay and bisexual men overall as they did in other populations across the country. HIV infections dropped 36% among heterosexuals from 2008-2014 and 56% among people who inject drugs. But among gay and bisexual men ages 25 to 34, HIV infections jumped 35 percent, while infections increased 20 percent among Latino gay and bisexual men.
For both white gay and bisexual men, and gay and bisexual men ages 13 to 24, HIV infections dropped 18%.
“Unfortunately, progress remains uneven across communities and populations,” said Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention. “High-impact prevention strategies must continue to be developed and implemented at the state and local levels to accelerate progress. That means more testing to diagnose infections, increasing the proportion of people with HIV who are taking HIV treatment effectively and maximizing the impact of all available prevention tools.”
The CDC attributed the decline to efforts to increase the number of HIV-positive people who know their status and are virally suppressed, early treatment and, to a lesser extent, the increase in the use of the preventative treatment PrEP.
But Georgia – particularly metro Atlanta – is facing an HIV crisis among gay men. Across the state, 1 in 51 people will be diagnosed with HIV in their lifetime – the third-highest in the U.S. The rate of people living with HIV/AIDS in Atlanta and Fulton is nearly six times the national rate.
AID Atlanta on its HIV fight, PrEP clinic
The local crisis was highlighted Tuesday by AID Atlanta officials during a briefing about their efforts to combat HIV.
Last year, the agency provided more than 11,000 HIV tests – doubling its total from 2015 – and provided primary care to nearly 1,500 people, an increase of nearly 300% from a year earlier.
"We really should have this issue under control by now but we don't," said Nicole Roebuck (top photo), AID Atlanta's executive director. "There still is a demand for agencies like AID Atlanta, like AIDS Healthcare Foundation."
AID Atlanta also provided housing services to more than 800 people last year.
"If you don't have a place to live – a safe, affordable place to live, the last thing you're kind of thinking of is your HIV and taking your medicines," Roebuck said.
"If you are worried about eating, where's your next meal going to be, where you are going to stay, the last thing you are going to worry about is going to your doctor's appointment," she added.
In 2017, the agency plans to "expand and increase" efforts for HIV testing and linkage to care so people can see a doctor and start their care within 72 hours of being diagnosed with HIV.
AID Atlanta is also planning to build on its small PrEP clinic and provide "full access to PrEP service" for people at highest risk for HIV. The agency's parent, AIDS Healthcare Foundation, has been criticized for opposing the use and expansion of PrEP.
"It is one of the tools in the toolkit that is available to people who are not living with HIV who might be at highest risk," Roebuck said.
In its PrEP program, AID Atlanta provides medical care at no charge and a small grant program helps patients with the cost of lab tests needed to enroll in the program. The drugs – a daily dose of anti-HIV medication – can often be provided at no cost from pharmaceutical companies, Roebuck said.
In 2016, the clinic counseled more than 100 people about PrEP, Roebuck said. But nearly half of the people who started PrEP later stopped. Currently, the clinic has about 45 people on PrEP.
"We have been seeing a drop off in terms of folks who thought they were ready, who wanted to get on PrEP but then life happened and they never came back for medications, never came back for ongoing care because, again, it is a commitment. It is a daily commitment to taking your medication," Roebuck said.
Also Tuesday, officials with AID Atlanta and AIDS Healthcare Foundation unveiled an art sculpture to raise awareness of the disease and its impact in metro Atlanta. The HIV clock (second photo) tracks the number of HIV diagnoses in five metro Atlanta counties and will be updated each Friday by Matthew Terrell, the gay artist and writer who created the 8-foot pyramid.
[infographic via CDC]