551 new HIV cases diagnosed 2000-03; sharp increase in long-term AIDS survivors
A new five-year plan to tackle HIV and AIDS in Rhode Island will pay special attention to the two most at-risk groups, intravenous drug users and men having unprotected sex, but also black and Latino youths and women, whose infection rates are disproportionately high.
Concern about HIV and AIDS has risen across the country in recent weeks due to the appearance of a new, highly virulent, drug-resistant strain of HIV found in New York City. New York Health Commissioner Thomas R. Frieden has called the case, which involves a 40-year-old male drug user with multiple sex partners, “a wake-up call” to the public health community, doctors, and those who continue to engage in high-risk behavior.
The ravages of AIDS in the 1980s changed many people’s behavior across the country, especially among at-risk groups. But as drug treatment has improved, allowing people to live with HIV and even AIDS for many years, the sense of urgency faded.
Rhode Island’s own statistics show that as of 2003, 1,325 people had died from AIDS here, but the number of deaths has dropped sharply since the early 1990s, from well over 100 per year, to a handful. The incidence of AIDS has also declined, from 317 new cases in 1993, to 98 in 2003. While only 213 Rhode Islanders were living with AIDS in 1993, however, by 2003 it was 1,155.
Guided by those figures, and by a detailed analysis of who’s contracting HIV and developing AIDS, a public-private partnership called the Rhode Island Community Planning Group for HIV Prevention unveiled a plan on Monday to ensure that the deadly disease isn’t forgotten, especially among the populations that are most vulnerable to it.
The group, which includes state officials, AIDS Care Ocean State, and several community groups, outlined its vision at a day-long conference at the Providence Marriott that included an update from an HIV/AIDS expert at the U.S. Centers for Disease Control and Prevention, a look at how Massachusetts has tackled the disease, and discussions about individual “priority populations” that Rhode Island needs to target.
The five-year plan shows, for example, that men having unprotected sex with other men – or with men and women – made up 30 percent of the people diagnosed with HIV between 2000 and 2003, the single biggest category. A key goal of the plan is to get more people from within that demographic involved in HIV/AIDS prevention, and to reach out more to men of color.
In dealing with women, who accounted for 27 percent of HIV infections between 2000 and 2003, the plan zeroes in on Latina and African-American women in particular, who make up 14 percent of Rhode Island’s female population but account for 75 percent of HIV cases among women. The plan recommends fostering greater cultural sensitivity, making it easier for women to access free HIV tests, especially if they work and/or have children, collecting better data, and creating a women’s HIV/AIDS resource guide.
Intravenous drug users, while still a priority population, are getting infected far less than just years ago, the plan notes. Thanks to Rhode Island’s needle exchange program and a law that allows anyone to buy a needle and syringe at a pharmacy, it says, HIV infections due to intravenous drug use dropped from 50 percent of all cases in 1989, to 10 percent in 2003.
For youths, the fourth target group, the plan recommends reaching out to kids who are recovering from substance abuse, networking through existing youth organizations, and creating a youth advisory group with a peer facilitator. Again, minorities were identified as being at particular risk: Of 60 HIV infections among people aged 14 to 24 between 2000 and 2003, 44 (73 percent) involved black or Latino youths.
A preface to the plan, which is posted in PDF form on the Department of Health Web site (www.health.ri.gov), says one of the main goals is to bring about “a broader community response” to HIV/AIDS prevention.
“The HIV Prevention Plan is based on a wealth of input from a diverse group of people committed to stopping the spread of HIV,” said Elisa DelBonis, community co-chair of the group and prevention supervisor at AIDS Care Ocean State.
“The plan will go a long way toward guiding the state’s funding decisions and the work of community-based providers of prevention services,” DelBonis added, “ensuring that funds are distributed and programs developed in a way that has the greatest impact on those most at-risk.”
HIV Infections in R.I. 2000-03
Between Jan. 1, 2000, and Dec. 31, 2003, 551 Rhode Islanders were diagnosed with HIV. Below is a breakdown of who they were:
Gender:
Male: 403 (73.1%)
Female: 148 (26.9%)
Age group:
0-19 17 (3.1%)
20-29 121 (22.0%)
30-39 225 (40.8%)
40-49 144 (26.1%)
50+ 44 (8.0%)
Race/ethnicity:
White: 202 (36.7%)
Black: 187 (33.9%)
Hispanic: 153 (27.8%)
Asian: 8 (1.5%)
Native American: NA
Risk factor:
Male unprotected sex: 164 (29.8%)
Intravenous drug user: 89 (16.2%)
Both of above: 9 (1.6%)
Heterosexual contact: 97 (17.6%)
Blood transfusion: NA
No risk specified: 187 (33.9%)
Source: RICPG Comprehensive HIV Prevention Plan, 2005-09
Note: In the same time period covered by this chart, 384 AIDS cases were diagnosed. Intravenous drug users and people infected through heterosexual contact are far more heavily represented in AIDS cases, accounting for 33.1% and 37.0%, respectively.
