Ending the HIV Epidemic in DC: 2017 Progress Report


A year ago on World AIDS Day, DC Appleseed stood at a press conference with the Washington AIDS Partnership, Mayor Muriel Bowser and Dr. LaQuandra Nesbitt of the DC Department of Health (DOH) to release the 90/90/90/50 Plan – the blueprint to end the HIV epidemic in DC.

We set ambitious goals: By 2020…

  • 90% of District residents who are HIV-positive will know their status,
  • 90% of those diagnosed will be in treatment,
  • 90% of those in treatment will achieve “viral suppression,” meaning they will not transmit the virus, and
  • New infections will be cut by 50%.

We believed these aims were attainable with strong leadership, dedicated resources, robust prevention activities, and adoption of the most current science – the same tools that took the District from the worst HIV epidemic in the country in 2005 through a decade of steady declines in the infection rate.

The Plan was bolstered further by two clinical advances. First, research has shown that people living with HIV who are adherent to anti-retroviral treatment have effectively zero risk of passing on the virus. Second, a daily prescription of Pre-Exposure Prophylaxis (“PrEP”) can prevent HIV-negative individuals from becoming infected.

On this World AIDS Day, we are assessing the status of the 90/90/90/50 goals and the work on each of the 42 tasks laid out in the Plan. Our assessment, “Ending the HIV Epidemic in DC: 2017 Progress Report” is available online now.

The bottom line is that the District is making good progress toward meeting the 90/90/90/50 goals: 86% of people infected with HIV know their status, 76% of those diagnosed are in care, 82% of those in treatment are virally suppressed, and there has been a 33% reduction in new infections since 2013. All of this is good news.

Four Goal Chart

 

But the bad news is that in 2016 there were still 347 new HIV infections in the District. Those new infections disproportionately affect black residents. And alarmingly, the greatest number of new infections is occurring among young people. As a result, going forward more must be done to reach those most at risk.

For example, one of the factors that most influences health is stable, safe and affordable housing. People who are in treatment for HIV but who have housing problems are likely to fall out of treatment. The 90/90/90/50 Plan dedicated five tasks to access to housing for people living with HIV in DC, but these efforts must move faster to have an impact by 2020.

It is also urgent to renew commitments to HIV education in schools, since new HIV infections are trending younger. DC Appleseed is concerned that sexual health education is not uniformly implemented across all schools, particularly charter schools.

Lastly, it is critical to redouble efforts to tackle stigma, discrimination and myths about HIV – in the general population and among medical providers – in order to achieve our goals.

The District has come a long way in the last decade and, as our report today shows, in the last year. But the truth is, the more progress we make, the harder future gains will be. The District must sustain current investments while leveraging new medical advances. And to keep moving the needle, we must also address all the conditions and factors that contribute to, or interfere with, a person’s health. This will require an unprecedented effort at cross-sector and cross-agency work.

DC Appleseed is proud to be part of this collaborative work and will continue to report on the District’s progress toward ending the HIV epidemic.

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