Examining HIV/AIDS Situation In Philadelphia

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The Philadelphia Inquirer on Tuesday examined how estimates indicate that new HIV infections in Philadelphia are occurring at a rate more than five times the national average. According to the Inquirer, the estimates, which are based on CDC data released in August, are part of a broader government strategy to slow the spread of the virus.

According to the Inquirer, approximately 1,400 Philadelphians contract HIV each year, and those who are not aware of their HIV-positive status are believed to be responsible for transmitting the majority of new infections. There currently are more than 16,000 people living with HIV/AIDS in the city. More than half of new cases in Philadelphia are transmitted through heterosexual contact, a third among men who have sex with men and 13% from injection drug use. John Cella, director of the city's AIDS Activities Coordinating Office, said that the high number of new cases is "a wake-up call that we've got to do better."

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According to experts, "the local picture is of a disease that is transmitted largely by people who do not think of themselves as being at high risk and have not until recently been primary targets for prevention efforts," according to the Inquirer. For example, rates of HIV nationwide are highest in black communities, and Philadelphia has the second-highest percentage of black residents of the 10 most populous U.S. cities at 43.2%, according to the 2000 census. Consequently, the Inquirer reports that public health workers are "trying to get past cultural barriers that contribute" to high HIV/AIDS rates among minority communities with initiatives such as needle-exchange programs and efforts by the city's Department of Public Health to offer HIV testing in emergency departments, city prison intakes, homeless shelters and mobile units that travel to neighborhoods and social gatherings. According to Cella, the number of HIV tests performed in Philadelphia is expected to double by the end of 2008 from the 30,000 tests typical of previous years.

Nevertheless, research suggests that more than one-fifth of HIV-positive people are not aware of their status, and CDC believes this demographic is responsible for the majority of new cases. Cella added that although advocates in MSM communities, who primarily are white, have been educating themselves about HIV/AIDS for decades, there is "a lot of hidden homosexuality in black and Latino communities." Karam Mounzer, medical director of the Jonathan Lax Center, said, "There is no question in my mind that we are seeing a younger population of African-American kids with the virus," adding, "We are also seeing more young African-American females."

David Metzger, director of the HIV prevention research division at the University of Pennsylvania School of Medicine, said that the structure of Philadelphia and its neighborhoods also help explain the city's high rates of the virus, adding that old Northeast cities tend to have fixed boundaries while other cities periodically "annex" surrounding suburbs. Although this does not affect who contracts HIV, it could lower a city's rate, according to Metzger. In addition, neighborhood structures might cause HIV to spread faster, Metzger said, adding that in some poor black and Hispanic communities, there is a greater chance of coming in contact with HIV "even if you are not doing practices that are considered particularly risky" (Sapatkin, Philadelphia Inquirer, 10/28).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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