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DCNOW Endorses 14th International Workshop on HIV & Women

By: Miriam Edelman

DCNOW is pleased to announce its endorsement of the Academic Medical Education’s 14th International Workshop on HIV & Women. This conference will occur at the Mayflower Hotel (1127 Connecticut Avenue, N.W., Washington D.C., 20036) and online on Friday, April 12, 2024, and Saturday, April 13, 2024. At this event, health care providers, researchers, government, industry, and community representatives can learn about HIV and women. This workshop will feature lectures from international experts, roundtables, and discussions. Registration fees vary between $715.00 and $1,075 depending on type of registration (virtual and face-to-face) and type of attendee (regular and industry).

 

HIV/AIDS is important to the National Organization for Women (NOW). On December 1, 2023 (the last World AIDS Day), NOW’s President Christian F. Nunes released a statement. She said:

Since 1988, the global health community has marked December 1 as World AIDS Day to bring attention and raise awareness around the ongoing HIV/AIDs epidemic. Medical research has made great strides to better understand and treat the virus. Still, today, we remember that more than 1,800 women around the world every day get infected with HIV, and the virus still disproportionately affects women and girls.

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In 2022, approximately 39 million people across the globe live with HIV: 37.5 million adults and 1.5 million under 15. Notably, 53 percent of this group are women and girls. Women – especially young women – face increased biological susceptibility to HIV but also encounter sexual violence, gender inequalities, restricted access to prevention, or the inability to protect themselves against infection that men often do not.

She also said, “NOW’s goals to end violence against women, create better access to health care, and continue the fight for overall equality extend to finding a cure for AIDS and preventing more women from infection.”

 

HIV in the District of Columbia

HIV has long been a major problem in Washington, D.C. However, in recent years, D.C.’s HIV/AIDS situation has improved, although more remains to be done.

 

In 2007, D.C. had the highest HIV/AIDS rate of cities in the U.S. That year, according to a report that D.C. health officials released, more than 12,400 D.C. residents (the equivalent of approximately one in 50 people) lived with HIV or AIDS. Based on the first study of HIV and AIDS statistics in D.C., the report said, “H.I.V./AIDS in the district has become a modern epidemic with complexities and challenges that continue to threaten the lives and well-being of far too many residents.” It also found that most of the 56 children aged 13 years or younger who had HIV/AIDS were born with HIV. D.C.’s AIDS office reportedly had trouble maintaining data to track and combat HIV. In addition, it had at least 13 directors in a little more than two decades. At that time, D.C. was the only U.S. city that federal law banned from utilizing local tax dollars to pay for needle exchange programs.

 

In 2009, D.C. had the highest HIV/AIDS rate in the United States. D.C.’s then-almost three percent HIV/AIDS rate (equaling 2,984 residents per 100,000 people older than 12 years old) was higher than the rate in West Africa. HIV/AIDS affected every race and gender and was at an epidemic level in every ward but one.

 

D.C. had many people at highest risk of AIDS: African-Americans and homosexual men. Ron Simmons, an HIV-positive homosexual African-American, was not surprised, saying, “You have a high incidence of HIV among African Americans, and a lot of African Americans live in the city” and “D.C. also has a high number of gay men, and HIV is high among gay black men.”

 

Meanwhile, people identified non-demographics issues as contributing factors to D.C.’s high HIV/AIDS rate. Health officials blamed D.C.’s high rate on individual behaviors and D.C.’s response to HIV/AIDS. D.C.’s AIDS office had not had a completely staffed surveillance unit to collect, analyze, and provide data. That office no longer had credibility. Critics also cited Congressional control over D.C.’s AIDS office to handle HIV among drug injection users by prohibiting local tax money to be used for a needle exchange program. In 2008, that ban ended.

 

As of July 2015, D.C.’s HIV rate had decreased to 2.5 percent, equaling an epidemic level. D.C. still had a higher HIV rate than many comparable cities. This 40-percent decrease seemed to result from at least federal, local, and nonprofit policies. Examples of local policies were more testing and condom distribution.

 

Ending HIV in D.C. is important to D.C.’s Mayor Muriel Bowser. On World AIDS Day on December 1, 2015, (her first World AIDS Day as Mayor), she discussed her 90/90/90/50 HIV-related plan and signed a Fast-Track Cities declaration. The declaration is based on UNAID goals. On World AIDS Day on December 1, 2016, D.C.’s Mayor Bowser released her “90/90/90/50 Plan: Ending the HIV Epidemic in the District of Columbia by 2020,” a result of a public-private partnership. This plan’s goals were “90 percent of DC residents with HIV will know their status;” “90 percent of DC residents diagnosed with HIV will be in treatment;” “90 percent of DC residents in treatment will achieve viral load suppression;” and “the District will see an overall 50 percent decrease in new HIV cases.” In 2019, D.C. had met or almost met the three 90-percent goals.

 

Being tested for HIV is crucial as it would help protect one’s health and prevent transmission, assuming people get treated after getting diagnosed. According to the Centers for Disease Control and Prevention, 153,500 people (13 percent of people with HIV in the U.S.) do not know they have HIV. Some people do not get tested because of stigma, lack of access to testing, fear of testing positive, having tested in the past, inability to afford a test, and trust in their sexual partner. Less testing causes more HIV cases.

 

According to Clover Barnes, Senior Deputy Director for D.C. Health’s HIV/AIDS, Hepatitis, and TB Administration,

A lot of people won’t even come out and try [to get tested], they’d rather not know. If we can show you people who are living and thriving with HIV, who are happy and healthy and not afraid to talk about it on a podcast that’s broadcast around the world, then maybe we can reduce some of the stigma.

It is crucial to decrease the stigma of HIV. Los Angeles Laker legend Magic Johnson, diagnosed with HIV in 1991, has not let HIV stand in his way of being successful with sports, business, and HIV. After his diagnosis, Johnson won a gold medal as part of the “Dream Team” in the 1992 summer Olympics. Johnson said, “people who were living with not just HIV and AIDS, but with any disease, that you can live on, you can be — live a productive life.”

 

On December 4, 2020, Bowser released D.C.’s updated HIV plan and the DCEndsHIV.org website. Under this plan, there can be fewer than 130 new HIV cases by 2030, meaning that D.C. maximized every way to end the epidemic. Other goals include “a minimum of 95% of people with HIV knowing their status by new testing options (including GetCheckedDC.org),” “95% of people with HIV on treatment by starting medication same day as diagnoses,” “95% of people on treatment achieving viral suppression by promoting Undetectable equals Untransmittable or U=U and wellness supports,” and “more people on Pre-Exposure Prophylaxis or PrEP, a HIV medication that prevents people from getting HIV.”

 

D.C. continues to strive to end HIV. Now, D.C. tries to have fewer than 21 new cases of HIV each year. The three 95 percent goals remain. The following graph shows D.C.’s status with the plan’s three 95 percent goals (with 2022 data) (Note – The 2022 goal #1’s percent was not available when the new February 2024 report was released.).


 



As of 2022, 11,747 District of Columbia residents (equaling 1.7 percent of D.C.’s population) have HIV, decades after the HIV and AIDS outbreak in the U.S. and around the world. In D.C., men who have sex with men, heterosexual African-American women, transgender people, and people between 20 and 29 years old are at risk of acquiring HIV. Of the 11,747 D.C. residents with HIV in 2022, 3,016 were female, and 2,061 of those 3,016 women (68.3 percent) were virally suppressed (fewer than 200 copies of HIV per milliliter of blood) in 2022. Most people with HIV in D.C. are at least 50 years old. The proportion of D.C. residents with HIV varied substantially by race/ethnicity and gender from a high of 4.0 percent of African-American men to a low of 0.1 percent of Caucasian women. While 1.7 percent of African-American women in D.C. had HIV, 23 percent of people with HIV in D.C. were African-American women. The main cause of death of 62 (18.4 percent) of the 337 people with HIV who died in 2021 was HIV-related.

 

New cases of HIV appear to be substantially more prevalent in D.C. than in the United States. The estimated numbers of new HIV cases per 100,000 people between 2018 and 2021 were 27.0 in D.C. and 10.8 in the United States.

 

In 2022, there were 210 new HIV cases in D.C., marking a decline from the peak of 1,374 cases in 2007. 48 of the 210 new HIV cases in 2021 were among women; nine in ten of these females newly diagnosed with HIV were African-Americans, and six in ten of females newly diagnosed with HIV were at least 50 years old. Between ten and 30 people were diagnosed with HIV each month in 2022 in D.C. Between 2007 and 2019, 13 babies were born with HIV in D.C. Since then, no babies were born with HIV in D.C. The most common form of HIV transmission in new cases was sexual contact. Women of color were 20 percent of the new HIV individuals from 2018-2022. One in four foreign-born people diagnosed with HIV in D.C. in 2022 was a woman.

 

Preventing HIV

HIV/AIDS can end without a cure. Through treatment as prevention, people with HIV can take medication, which lowers their viral load, usually within six months, so that it is undetectable (meaning a standard lab will not see it).  A person with an undetectable viral load cannot transmit HIV to others via sex. An undetectable viral load also decreases the chances of giving HIV to offspring during pregnancy, labor, and delivery and reduces the risk of HIV transmission via breastfeeding. It might decrease HIV transmission for individuals who inject drugs.

 

Another highly effective drug for preventing HIV is Pre-exposure Prophylaxis (PrEP), which decreases the likelihood of getting HIV from sex by approximately 99 percent and from drug use by at least 74 percent. PrEp is for HIV-negative people who are at high risk of getting HIV through sex or injection drug use. Doctors could recommend people to go on PrEP if they have a sexual partner with HIV, have sex without condoms, have been diagnosed with a sexually transmitted disease (STD) during the past six months, inject drugs with a person with HIV, inject drugs by sharing needles or syringes, and/or have been exposed to HIV and engage in risky behavior. The three types of PrEP are Truvada, Descovy, and Apretude. PrEP begins to work in one to three weeks. People must take PrEP as directed. Common side effects of PrEP are nausea, diarrhea, headache, fatigue, and stomach pain. As PrEP does not prevent STDs, PrEP users should also utilize condoms.

 

Conclusion

DCNOW encourages its community to attend the 14th International Workshop on HIV & Women. It will be great way to learn about HIV and AIDS. We hope to see you there.

 

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