Increase of HIV Close To Home
There is a serious crisis taking place in our community — close to us, right at our doorstep or within our household. Chicago has had an increase of HIV/AIDS related cases within the African-American community, according to a new site, AIDSVu.org , which monitors 40 cities breaking down geographical areas with the disease.
In the U.S., there have been 2,680,484 people reported living with the virus. Globally, an estimated number of 35 million people were reported living with HIV.
In recent reports, Atlanta and other Southern cities have some of the highest numbers for most the HIV/AIDS cases within the Black community. The concern is not too far from our state and within the city of Chicago.
The Chicago Department of Public Health released a comprehensive HIV/STI Surveillance Report in 2015. An increase of young Black male-to-male sexual contact in the age group 20-29 is the group most affected by HIV in Chicago and accounted for more than 1 in 4 new HIV infections in 2014.
Among women, Black heterosexual women make up a disproportionate share of new and prevalent HIV infections, though not nearly as many as gay/bisexual and other male-to-male sexual transmission.
Broke Out in Late ‘70s
Since the virus first became a public health epidemic in the mid to late 1970s, it has gone through gradual stages from the misconception of the “Gay Cancer” first named GRID (Gay-related immune deficiency) to beyond just centering on the LGBTQ community. As medical research prevailed with more awareness and education, the stigma of the disease helped ease public stereotypes and fear over the last three decades.
AIDS stands for acquired immune deficiency syndrome, and HIV (human immune deficiency virus) which causes AIDS was appropriately named by researchers and acknowledged in 1984 by the U.S. Department of Health and Human Services.
Unfortunately, we’ve witnessed Third World countries such as in Africa hit hard with limited medical resources and preventive care, spring boarding a fatal epidemic. Often, women and children are hardest hit by the disease. Closer to our U.S. mainland, a similar rise in numbers has hit the Caribbean islands of Puerto Rico, Dominican Republic and Haiti in recent years.
Over time, billions of dollars have been raised to find ways to extend the quality of life to those diagnosed early with HIV before it escalates to AIDS.
Life-saving drug treatments such as CAPRISA 004 microbicide have been found successful in reducing the risk of HIV infection in women by 40 percent. Among other trials decreasing pre-exposure and also making trial drugs approved by the FDA such as HPTN 052 and Complera, expanding the treatment options for people living with HIV.
But as the state has seen an overall decrease across the board, the number of HIV-related cases is steadily rising among Blacks in Chicago. Out of our community, women are the hardest hit — although among Blacks 83 percent of people
newly diagnosed with HIV between 2010 and 2014 were men, and 17 percent were women. The new diagnoses of people re- ported having HIV during this period included 54 percent Black, 20 percent Hispanic/ Latino and 19 percent white.
Why are Blacks are at the top of the list?
The importance of developing AIDSVu.org was a realistic viewpoint of not only helping medical professionals and HIV/ AIDS advocacy agencies be aware of the locations hardest affected, but also to assist in providing an accurate assessment based on ZIP code analysis.
The Chicago Defender used the map to find out which Black communities in Chicago were most affected, and discovered some statistics of concern.
In the study, estimated rates of people living with an HIV diagnosis were calculated per 100,000 populations to permit data standardization and comparison. Denominators used to calculate rates for all ZIP Code, census tract, and neighborhood/ community/ward populations were obtained from the U.S. Census Bureau’s census for each respective year. Population denominators are restricted to people aged 13 and older.
The City of Chicago Deputy Commissioner of HIV/STI Bureau David Kern goes further into the causes of why African-Americans are higher on the list for HIV infections.
He said, “African-Americans tend to have sex with partners with the same race ethnicities leads to greater risks of infection with each new sexual encounter. Secondly, the higher rate of infection in the community, lower rates of HIV viral suppression, and use of pre-exposure prophylaxis. This means it’s a greater chance of transmission in the community even if behaviors are less risky than behaviors in other racial and ethnic groups.”
The drug PrEP is a way for people who don’t have HIV but are at high risk of getting it. By taking the pill daily, Truvada can prevent the infection and also treat it.
He explains. “We believe this is big drivers increasing rates of infection among African-Americans.” In addition, Kern discusses socioeconomic issues, which includes limited access to high-quality health care and housing. So, HIV prevention, education, employment both directly and indirectly increase risk of HIV infection — affecting the overall health of people in communities.
A contributing factor in the community is the stigma and fear of discrimination, homophobia as well as negative perceptions about HIV and health care in general. “This behavior puts more Blacks with higher risk — at times discourage HIV testing and HIV care and treatment,” says Kern.
In the most recent account on AIDSVu. org, new diagnosis has found 78 percent of Black males who have contracted HIV are involved in male-to-male sexual contact through transmission, yet 58.7 percent of Black females contract the virus through heterosexual contact.
In addition, Chicago has risen in other types of sexually transmitted diseases compared to the national average.
The data that we have shown that in comparison to white and Hispanic populations in Chicago overall, Blacks are less likely to be linked to HIV care after they are diagnosed with HIV, less likely to be retained or engaged in medical care overtime and less likely to achieve viral suppression.
How the Map Works and Why
With the cooperation of the 40 cities listed on the AIDSVu.org map, like other states — Illinois is broken down in color coded grids to show the levels of high concentrated areas that are most affected by reported HIV/AIDS cases.
In order to narrow down the communities, they have provided filter options to help visitors narrow down the search from ages ranging 13 to 24, 25 to 44, 45 to 59 and 60+. Race and gender are included with primary groups including Asian, Black, Hispanic and White ethnicities.
When you view the map, there the color ranging down the scale from yellow (0-100 cases) being the lowest diagnosed areas, warming up to different hues through orange, reds (1,201 -1,950 cases) and the highest number of cases with purple (1,951+). It is most chilling when the neighborhoods such as Bronzeville, Washington Park, Greater Grand Crossing, South Shore, Austin, Lawndale, Garfield Park, Calumet City and West Englewood are a part of the dominating communities with HIV/AIDS cases.
Patrick Sullivan, PhD, Professor of Epidemiology at Emory University and AIDSVu’s lead researcher at Emory University explains the importance of the geographical breakdown of the map.
Dr. Sullivan says the breakdown is not designed to alarm the public, but allow them to have access to the information that the medical community receives through annual reports released by local agencies.
“In the case of Chicago, we worked with the Chicago Health Department and with the Centers for Disease Control. We also worked with 40 cities and state health departments to get this data down to a level of geography that would be meaningful to people,” he said. “It can be easy to think about HIV as the problem. People know that it’s a problem somewhere, but it’s not that clear to them that it is an important problem right where the live.”
This has become a mission for organizations such as the Englewood Neighborhood Health Center to continue funding, driving preventive care and awareness in Black communities.
It is no secret that the Illinois state budget stalemate has hurt programs to educate the community in continuous testing and prevention measures. Illinois State Rep. La Shawn Ford (D-Chicago) works with various groups to make sure their voice is heard on the Illinois General Assembly floor. His district is one of the hardest hit, but his mission is to serve different parts of the city in low-disparity areas.
His push to pass legislation through the General Assembly made changes in the AIDS Confidentiality Act to remove the barriers in testing for HIV in Illinois and in the hopes to extend the quality of life of African-American HIV/ AIDS Response Act. House Bill 1004 requires medical providers who want to conduct routine HIV screenings.
“We’ve raised the awareness to make sure that people are aware of the dangers of being able to track HIV/AIDS. We work with the community providers in the Austin community and organizations such as the AIDS Foundation of Chicago. I work with many other South Side HIV/AIDS organizations to continue to sound the alarm that we need to prioritize when it comes to testing people,” he said.
The past 18 months have presented a head-on collision between Gov. Bruce Rauner and House Democrats in passing a solid state budget. The temporary relief has helped, but the long delay has caused irreparable damage to HIV/AIDS organizations throughout the state, cutting budgets by 60 percent.
Ford said with the rise of HIV cases in young Black males between 13-29, community outreach is imperative. “In our community we still need to have a lot of outreach to young people in our community and to schools. We just don’t have it. I think that the budget crisis has hurt. The good thing is that we have the red ribbon. “The West Side state representative said that all communities should recognize the red ribbon lottery scratch-off ticket’s purpose. “It helps to generate money for HIV/ AIDS education in the Black communities and giving the money to small HIV organizations.”
According to AIDSVu.org, the data accumulated also omits homeless cases or those cases that had no address. The area rate of infection data was calculated per 100,000 people in each Chicago neighborhood that was reported with the HIV infection and restricted to people aged 13 and older. These approximate statistics are based on reported cases.
In 2014, the Austin community’s area rate of infection was 1,173 overall with Black males at 684 and 347 female cases. On the same side of town, the East Garfield Park community area rate of infection is 1,778 overall with Black males at 215 and Black females at 96 cases. The highest age group affected: 45-59 and 25- 44 at a close second. Other West Side communities showing high rates include Douglas Park, North and South Lawndale along with Near West Side areas.
On the South Side, the numbers are just as troubling with Washington Park showing a 1,993 rate of infection with 126 reported Black males affected, 59 Black females. In the Grand Boulevard community, the infection area rate is 1,734; Woodlawn and South Shore show
the rate of infection both at 1,671. Other areas: Kenwood, Chatham and Pullman reflect high numbers for infection cases. Although, most of the neighborhoods have predominantly Black residents, one of the highest HIV/AIDS reported cases in the Chicago area is the Edgewater and Uptown community on the far North Side of Chicago.
Both Edgewater and Uptown are very diverse in the make-up of Chicago residents. In Edgewater, the overall infection rate is high at 2,675 with African-American reported cases at 351 out of 1,370 cases for the area. The Uptown community reflects an infection rate of 2,908 with Black individual reported 452 HIV cases out of 1,474 per 100,000 residents overall.
Efforts made by the Chicago
Department of Public Health has re-doubled their support to six HIV/STI organizations two additional programs — providing $3 million to fund HIV PREP, testing and awareness.
The decrease in AIDS-related deaths has created lack of urgency to the needs of HIV/STI prevention in our communities, but the fight is not over. Rep. Ford says communities that seek the urgency of funding forces their public officials to fight even harder on their behalf.
“What we have is a case of communities that decide that they’re going to fight the hardest — those are the communities that are going to get the most. Things just don’t happen ‘because’; it’s because these communities fight. They fight hard to demand a bigger cut of the pie.”