80% of U.S. cases occur in just 20% of counties, report finds
MONDAY, June 22 (HealthDay News) -- Your chances of getting infected with HIV may largely depend on where in America you live, a new report finds.
The HIV/AIDS Atlas found that 80 percent of U.S. cases are clustered in 20 percent of counties -- typically comprised heavily of gay, black, Latino and other minority populations.
The new data doesn't mean that anyone should relax their guard in protecting themselves against the AIDS-causing virus, experts said, but it may alert people and policymakers to the level of danger closest to home.
"If we think of the AIDS pandemic as a global wildfire, the way that you fight wildfires is to identify the hot spots," said Michael Weinstein, president of the AIDS Healthcare Foundation. "The reality right now is that we have not focused on geographies in this country and we know that you can't fight the disease if you don't know who has it. And we know that in every disease early detection is the key."
The report, put together by the National Minority Quality Forum with support from drug company Gilead Sciences, is the first ground-level look at the HIV/AIDS epidemic in the United States.
"We wanted to make sure that organizations had the information they needed to organize interventions in their communities, as well as talk intelligently to legislators," Gary Puckrein, president and chief executive officer of the forum, said at a Monday teleconference.
"We also think a lot about policymaking. We're trying to create a more mature conversation in the 21st century of, 'Where are the communities that have the burden?' The question is, do communities have the resources they need? We want to improve the quality of care that patients get but we can also manage health-care resources a lot better" with these facts, he added.
The release of the Atlas also helps sets the stage for National HIV Testing day on June 27.
According to the federal Centers for Disease Control and Prevention, more than 1.1 million people in the United States now live with HIV, with 56,000 more infected each year -- a number about 40 percent higher than previously estimated. Some 20 percent of people with HIV -- 220,000 individuals -- do not know they are infected and are thought to be responsible for up to 70 percent of new infections.
In a way, the new level of reporting on HIV incidence is simply catching up with monitoring routinely done for other diseases.
"We have been mapping chronic disease now for about three to four years. We've mapped diabetes to the zip code level, cardiovascular disease and end-stage renal [kidney] disease," Puckrein noted. "After the CDC announced that everyone should know their HIV status in their guidelines, we thought that communities also needed to know their status."
TheAtlas draws on 2005-07 data from health departments in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and New York City. It found that, of 3,027 counties that provided data for the report, 556 counties bear the lion's share of the nation's HIV/AIDS burden.
Furthermore, the epidemic has hit hardest in the two-thirds of the 556 counties that are predominantly minority populations, including blacks, Hispanics, Asians and Pacific Islanders.
A random sampling of the 20 percent of counties with the highest HIV rates include: Marin and San Francisco counties, Calif; Miami-Dade county, Fla; Bronx, Queens and New York (Manhattan) counties, New York City; Richland (Columbia), S.C.; Orleans (New Orleans), La; Butts, Clayton and Dekalb counties (Atlanta), Ga; New Haven and Hartford counties, Conn; Multnomah (Portland) Ore; and Denver (Denver) Colo.
In New York City, data on HIV prevalence has now been pinpointed to the zip-code level, although other locales were "more comfortable" providing data at the wider, county level, Puckrein said.
Puckrein emphasized that the Atlas does not count the actual number of people in the community living with HIV/AIDS. Instead, it looks at a ratio of what percent of the population in those communities are living with the disease.
The map is also broken down by age, gender and race/ethnicity, as well as by congressional and state legislative districts.
To view the atlas, visit the National Minority Quality Forum.
SOURCES: June 22, 2009, press conference with Gary Puckrein, Ph.D., president and chief executive officer, National Minority Quality Forum; Michael Weinstein, president, AIDS Healthcare Foundation
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