With fiery epidemics like Zika and Ebola barging onto the scene, HIV may no longer be at the forefront of many minds. But a new report from the Centers for Disease Control and Prevention (CDC) serves as a punitive reminder that this virus is very much still an issue, and should not be swept to one side.
Despite the fact that, overall, the risk of acquiring HIV in the U.S. has fallen over the past decade, from 1 in 78 to 1 in 99, there are alarming disparities among populations, not just in terms of lifestyle but geography and race, too. For gay black men, for instance, almost half will be diagnosed with HIV in their lifetimes. That’s if current trends continue; HIV is preventable, so it doesn’t have to be this way, if governments and health workers step up their inadequate game.
“As alarming as these lifetime risk estimates are, they are not a foregone conclusion,” the CDC’s Dr. Jonathan Mermin said in a statement. “They are a call to action.”
Using diagnoses and death rates from 2009 to 2013, and assuming that current trends continue, the CDC was able to project the lifetime risk of individuals from different demographic groups in the U.S. becoming infected with HIV. Looking at different types of transmission, heterosexual men and women were at the lowest risk of diagnosis, with 1 in 473 and 1 in 241 facing infection at some point in their lives, respectively. For men who have sex with other men (MSM), the risk skyrocketed to 1 in 6.
But if race was taken into account for the latter group, the statistics were even more startling. While for white MSM the risk is 1 in 11, it’s a depressing 1 in 2 for African Americans. Even if we remove the route of transmission from the equation, black American men still draw the short straw, with 1 in 20 being diagnosed in their lifetime; for white men, it’s 1 in 132.
Pre-exposure prophylaxis (PrEP) pills are currently being investigated as a HIV prevention strategy. Marc Bruxelle/Shutterstock
These figures shouldn’t be taken to mean that black men are more risky than white males; rather, they likely reflect differing prevalence rates among communities. Access to healthcare and socioeconomic status are also probably significant players, something that clearly needs to be addressed.
The disparities aren’t limited to ethnicity, though. If we look state by state if trends continue, the South seems to be most at risk, with many states said to be "high risk". 1 in 13 residents of Washington, DC could become infected during their lifetime, followed by 1 in 49 in Maryland. Worryingly, that’s for all individuals, not individual groups. On the other end of the scale, if you’re in North Dakota, the risk is 1 in 670.
While we don’t have a vaccine or a cure, we do have the means to change this forecast. Condoms are effective at preventing transmission, as are antiviral drugs. Policymakers need to use this data as an excuse to act, by improving access to healthcare and raising awareness through educational campaigns. In the end, the cost of not acting will be greater than implementing such strategies.