Chicago recorded the lowest number of new HIV diagnoses in 26 years in 2016, public health officials say.
In 2001, the city reported 1,850 HIV diagnoses, the highest number of cases recorded since 1990, when the city began keeping records on the virus. That number fell nearly 55 percent by 2016, to 839 new diagnoses, according to data set to be publicly released Friday — World AIDS Day — by the Chicago Department of Public Health.
Chicago has been seeing an overall decline in new HIV diagnoses for more than a decade, city officials said. But more needs to be done.
“It is very bittersweet,” said Hector Torres, chief program officer at the Center on Halsted, an LGBT community center. “It’s great to celebrate a decrease that is significant, but those who’ve had challenges seeking services and solutions still lack access.”
Local public health experts and practitioners who focus on sexual health attribute Chicago’s success to the Affordable Care Act and the availability of new treatment.
Signed in 2010, the health care law has enabled thousands living with HIV in the city to access care many often went to emergency rooms for — or skipped altogether — because of the high cost of frequent doctor visits or lab work, officials said. And just after the ACA became law, the FDA approved a critical drug — pre-exposure prophylaxis, or PrEP.
The highly effective medication, approved by the FDA in 2012, can be taken daily by those at high risk for contracting HIV, lowering their chances of getting infected with the virus. Combined, the changes in health care policy and the availability of anti-viral medicine have dealt HIV a crippling blow across the country, experts said. New HIV diagnoses have fallen overall in the U.S. for the past few years, according to CDC data. Now, local public health practitioners said, HIV is not the harbinger of death it once was.
“When I had to diagnose someone, say a 19- or 20-year-old, with HIV, when I would give them that news — I couldn’t say with confidence that they would have the quality of life that they have now,” said Kristin Baker, chief operating officer and a physician’s assistant at the Howard Brown Health center in Uptown. “More people are hearing that they have control over this.”
Baker’s colleague, Chad Hendry, has been both a patient and an employee at Howard Brown and credits the organization for saving his life after he was diagnosed with HIV.
“The key is that you know,” said Hendry, director of sexual and reproductive health at Howard Brown. “And you know you’re not gonna die.”
While there is plenty of reason to celebrate the decline in new diagnoses, experts agree, disparity is still a pervasive part of the HIV epidemic.
In the past five years, black Chicagoans have made up more than half of those diagnosed with HIV. Young men ages 20 to 29, especially black and Latino men who have sexual contact with men, also continue to make up the majority of new diagnoses. So do transgender women, particularly those of color. The city said these populations, as well as Chicagoans in some southern, western and northern community areas, continue to be “priority populations” for HIV prevention efforts.
This pattern is seen nationally as well. According to data released Tuesday by the CDC, blacks in the U.S. made up almost half — 44 percent — of all new HIV diagnoses from 2011 through 2016. Of the 39,782 new HIV diagnoses reported by the CDC in 2016, 67 percent of cases fell under the public health body’s “male-to-male sexual contact” transmission category.
Progress against HIV lags for some primarily because many members of these high-risk groups consistently engage in sexual activity with one another, said Cynthia Tucker, vice president of prevention and community partnerships at the AIDS Foundation of Chicago.
Disparity also has persisted for low-income populations. Before the ACA was adopted, said David Ernesto Munar, president and CEO of Howard Brown Health, many low-income patients living with HIV, considered a pre-existing condition by insurers, would grow increasingly ill, unable to keep up with typical medical costs of $20,000 to $30,000 a year. Many would die.
“Life happens,” said Munar, who is HIV-positive. “And people say, do I pay the rent, or do I pick up my medications? People start making choices.”
Thanks to the ACA, Munar said, that question is being asked less frequently. An estimated 12,000 people living with HIV in the state were able to get insured through the health care law, he said. Without it, they’d likely be experiencing “enormous crisis and fear for their lives — without hyperbole.”
Although people are still dying of complications from HIV and AIDS, the number living with the disease rose to nearly 24,000 in 2015, city health department data show, a steady rise from 1990, when that figure was less than 6,000.
“The overall trends are fabulous,” said Dr. Julia Morita, commissioner of the city’s health department. “It really is dramatic.”
The department has set a goal of reducing the number of new HIV diagnoses each year to “functional zero” — a figure so low that the epidemic can’t support or sustain itself — by 2027, Morita said. It is also close to meeting a U.S. Department of Health and Human Services goal: having 85 percent of newly diagnosed patients connected with medical care within a month of their HIV diagnoses. Officials said 80 percent of those diagnosed were linked to care in 2016.
City officials will also announce Friday that Chicago will join 14 other U.S. cities participating in a 2014 global initiative that aims to end the AIDS epidemic by 2030. New York, Atlanta, San Francisco and Miami are among the more than 200 international cities already partnering with U.N. AIDS. The initiative has set “90-90-90” targets in each of these metros, aiming to have 90 percent of those living with HIV know their status, 90 percent of that population on anti-viral treatment and 90 percent of that group achieving viral suppression.
“90-90-90 is a starting point. It gets us to HIV epidemic control — and that’s important,” said Dr. Jose M. Zuniga, U.N. special adviser on the initiative. “But the Chicago goal of getting to zero new HIV infections is where we need to be.”
Established by the World Health Organization in 1988, World AIDS Day takes place on Dec. 1 each year. The global observance promotes awareness and action around AIDS and HIV.
Since the early 1980s, when the first AIDS cases were reported, 76 million people have become infected with the disease globally, the United Nations notes. Just under half of them have died from AIDS-related illnesses since. Close to 37 million were living with HIV in 2016, according to the U.N., and almost 2 million new HIV infections were recorded last year.
In connection with World AIDS Day, a bevy of local organizations are hosting programs, including the AIDS Foundation of Chicago’s “World of Chocolate” Festival on Friday, workshops, performances and other events.