HACKENSACK, N.J. — A 20-year-old diagnosed with HIV or AIDS today can expect to live 50 years, due to groundbreaking advances in treatment since the discovery of the virus 30 years ago.
Despite the progress, troubling trends remain: 47,500 new cases of HIV infection are diagnosed each year in the U.S.
And in the African-American community, the statistics are even more grim: The virus continues to strike a disproportionate number of blacks, and their death rates are higher than other ethnic groups.
Even when there’s good news — a 21 percent decline in the number of new cases nationally among black women in a recent three-year period — it is muted by other statistics — the rate of infection is still 20 times higher for African-American women than white women.
Meanwhile, new infections among gay and bisexual men between the ages of 13 and 24 were up 22 percent in 2010 compared with 2008. More than half of these were among young black gay and bisexual men, who now account for more new infections than any other subgroup, according to an HIV surveillance report from 2007-10 released by the federal Centers for Disease Control and Prevention in December.
“The general feeling is that this fear of HIV has gone away for young people,” said Dr. Michael Lange.
“Many young people consider it just another STD,” and aren’t as likely to practice “safe sex” and get tested, said Lange, chief of the division of infectious diseases at St. Joseph’s Regional Medical Center in Paterson, N.J. That’s because they know if they get sick, there “is medication that provides patients with an almost normal life like diabetes or hypertension,” he said. Lange and colleagues treat about 1,200 patients at one of the state’s largest HIV clinics, which St. Joseph’s operates on Market Street in Paterson.
Experts cite a number of reasons why HIV/AIDS disproportionately affects African-Americans.
Socioeconomic factors play a role — higher rates of poverty among African-Americans may hamper access to prevention education and testing, said Dr. Sindy M. Paul, medical director of the Division of HIV, TB and STD in the state Health Department.
“If you have a greater number of people with HIV, you face a greater risk of becoming infected in your community,” Paul said.
Claudia, a 33-year-old Hackensack, N.J., woman who was diagnosed with HIV in 2004, said she understands why people don’t get tested.
“A lot of people think, ‘This will never happen to me,’” she said, declining to give her last name. Claudia was diagnosed when she sought treatment for swollen glands. She said she was “shocked” to learn she was positive for HIV and insisted on a second test.
“I went into a deep depression, I didn’t want to get out of bed,” she said. “I thought I was going to die.”
Today, the model and musician is healthy — she takes no daily HIV treatment regimens, never misses her regular checkups and volunteers at Buddies of New Jersey, an HIV/AIDS support group based in Hackensack that’s “my second family.”
Claudia said she still hears from wives who have become infected by their husbands or people insisting they won’t use condoms.
“People trust too much,” she said. “They say, ‘He looks great’ or ‘She looks good.’ You cannot look at someone and judge their HIV status. Everybody needs to get tested.”
The CDC recommends getting an HIV test as part of routine health prevention for people age 13 to 64. Yet, of the more than 1 million Americans estimated to be living with HIV, more than 20 percent are unaware of their infection, according to the CDC.
“What drives HIV transmission is how much virus is around,” Paul said. “With treatment for people who are infected, the treatment lowers the viral load. The lower the viral load, the less risk of transmission.”
One research group found even higher incidence of the disease than what’s estimated by the CDC in Newark, N.J., and five other cities. In some areas, it was six times the rate the CDC has reported, according to work by a study team and Dr. Sally Hodder, an HIV/AIDS expert at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School.
“The HIV epidemic is not a generalized epidemic, it’s a series of micro-epidemics in hot spots,” with some rates of infection surpassing some sub-Saharan African countries, said Hodder, professor and vice chairwoman of the Department of Medicine. She also treats patients with HIV, AIDS and other infectious diseases at UMDNJ-University Hospital in Newark.
In the nation’s capital, for instance, 1 in 30 adults are HIV-infected — a prevalence higher than that reported in Ethiopia, Nigeria or Rwanda, Hodder and colleagues reported in “AIDS in America — Forgotten but Not Gone.” The article was published in the New England Journal of Medicine in 2010.
“We have known that black women in the U.S. are disproportionately impacted by HIV, however, the magnitude of this disparity in areas hardest hit by the HIV epidemic underscores the gravity of the problem,” Hodder said.
Women make up about one-quarter of new HIV infections, with 66 percent of these infections occurring in black women. The age-adjusted death rate of black women with HIV is about 15 times higher than it is for white women, Hodder noted.
For all the strides, Hodder notes that prevention efforts are still thwarted by a lingering problem, one that keeps countless people from getting tested.
“There is still an enormous stigma,” Hodder said. “Some people don’t get tested because they would just rather not know. You have folks that say, ‘I don’t want to know because I’m going to die anyway,’ which is not the case today.
“The reality is that we still have ongoing HIV transmission that requires focusing prevention efforts,” she said.