Nearly 50,000 Americans were newly diagnosed with HIV in 2011, and Philadelphia ranked 24th among metropolitan areas in terms of new diagnoses — the vast majority of which were classified as AIDS.
Approximately 960 Philadelphians were newly diagnosed with the disease in 2011, according to the Centers for Disease Control’s HIV Surveillance Report, released every three years. The rate of infection per 100,000 people was 23.8 percent.
Of the new Philadelphia diagnoses, 726 cases — or more than 75 percent — were Stage 3 AIDS, and about 12,000 people are living with AIDS in the city. The Philadelphia region ranked 16th among metropolitan areas for new AIDS diagnoses.
The classification into disease stages is a new introduction to the report. Stage 3 AIDS is described when a person’s CD4 count falls below a certain level and/or the person becomes infected with an AIDS-defining condition.
“The fact that 700 of the new diagnoses in Philadelphia were Stage 3 is horrible,” said Action AIDS executive director Kevin Burns. “We should’ve known they were positive much sooner.”
The CDC estimates it generally takes eight-10 years for untreated HIV to progress to AIDS.
Previous CDC reports found nearly 70 percent of Philadelphia men who have sex with men who tested positive for HIV were unaware of their status.
“It’s not surprising when you think about the difficulty we’ve had in getting people to be tested,” Burns said. “But 700 out of 900 in Stage 3 is very significant and supports what we’ve known: that people who don’t know their status early miss out on the advantage of getting into treatment earlier, before they tend to get sicker. Most of these 700 folks likely became diagnosed as positive when they had some sort of AIDS-defining illness. That’s way too late. We should be catching people in Stage 1.”
Elicia Gonzales, executive director of Gay and Lesbian Latino AIDS Education Initiative, noted that 34 percent of Latinos who are diagnosed with HIV receive a subsequent AIDS diagnosis within a year, higher than in other populations.
“This suggests that folks are waiting to show signs of an illness or infection before they go and get tested,” she said. “This notion that you can tell if you’re HIV-positive is still pervasive in some communities.”
Gonzales said GALAEI has been reaching out to community partners like Congreso and Prevention Point Philadelphia “to ensure that we have a clear outreach strategy and messages that are particular to our community around integrating HIV testing with other services we have, so that it’s a normalized part of overall health care versus something you do when you get sick.”
Statewide, there were about 1,600 new HIV diagnoses in 2011, about 1,200 of which were classified as Stage 3 AIDS. Pennsylvania was ranked 10th in the nation for number of new HIV diagnoses in 2011.
The Philadelphia metropolitan area, which also includes Camden, N.J., and Wilmington, Del., reported 1,234 new HIV diagnoses, or 20.6 percent per 100,000 people.
As of the end of 2010, about 20,450 Philadelphians had been diagnosed with the disease. There were 25,757 people in the entire region living with the disease and nearly 873,000 people in the United States.
Demographic information was available for state statistics on the prevalence of HIV, but not for metropolitan areas or for new diagnoses.
At the end of 2010, there were nearly 31,500 people living with HIV/AIDS in Pennsylvania.
Of those cases, nearly 49 percent were among African-Americans, 32 percent among whites, 15 percent among Latinos, 3.5 percent among multi-racial people, .5 percent among Asians, .1 percent among American Indians and .07 percent of Native Hawaiians.
Approximately 18,475 Pennsylvanians are living with Stage 3 AIDS, the demographic distribution of which was similar to that of the HIV prevalence.
Nationwide, African-Americans accounted for the majority of new HIV diagnoses, and men who have sex with men accounted for 62 percent of all diagnoses. Transmission information was not broken down by areas of residence.
Gonzales said the study emphasizes that the “test and treat model” should not be the only reaction to the disease.
“That model is incredibly important for folks who are HIV-positive and is one measure of preventing the spread of HIV but it’s not the only approach,” she said. “Prevention is still incredibly important, especially in vulnerable, marginalized communities. We have to continue to fund prevention efforts to prevent folks from contracting HIV to begin with. We have to ensure access to accurate, factual prevention messages and ideally couch testing and treatment in a broader, comprehensive and holistic strategy that involves health promotion and disease prevention.”
Burns said the report makes the case for routine HIV testing.
“We need to do better at identifying people who are HIV-positive who aren’t yet symptomatic and providing psycho-social support. People need to stay connected before they become sick, so they have good care and know their viral load and T-cell count. They need to be starting treatment at the appropriate time.”