The HIV Blame Game: Let the Debate Begin
Blogger Black Informant, with whom I disagree.
Yesterday, I wrote a post calling out Black Informant, a blogger who called out homosexuals for the striking new HIV/AIDS numbers in the District. The blogger then proceeded to call me out, in a post titled “Calling Amanda Hess of the Washington City Paper.” Black Informant wanted to debate. Well, here we go!
I take issue with two main assertions in Black Informant's response to the new AIDS numbers. First, that the "leading cause for this HIV/AIDS jump" in D.C. was due to high-risk homosexual activity. And second, that stepping up HIV/AIDS education efforts in the District would be both fruitless and condescending, because "folks know EXACTLY how this is caused, yet they consistently choose to do the wrong thing." That "wrong thing" goes back to Black Informant's number one—gay sex.
From 2006 to 2008, the number of known HIV/AIDS cases in D.C. increased by 22 percent. Three percent of the District's population is now known to be infected with HIV. But the "jump" can't be attributed to D.C.'s gay community, as Black Informant states. The study notes that "Heterosexual sexual contact is quickly becoming the leading mode of transmission among all HIV/AIDS cases, already surpassing MSM among newly diagnosed AIDS cases."
That means that over the past two years, the majority of HIV/AIDS diagnoses in D.C.—the "jump" we're referring to—were a result of heterosexual contact. Not. Gay. Sex. (Check page 57 of this PDF for those figures).
If it's not the gays, then what's responsible for the jump? Another foe of Black Informant—education. HIV/AIDS infections haven't increased 22 percent in two years—infections we know about have increased. That means:
a. People are getting tested more. Three-fifths of D.C. residents knew their HIV status in 2008. Testing efforts have significantly increased since 2006, the first time the District released a full report on its HIV status. "In mid-2006, the District became the first city in the country to implement a policy of routine HIV testing, and implemented a series of measures to encourage residents to get tested and providers to normalize HIV testing as part of routine care," the study states.
b. People are getting tested earlier. A person's CD4 count is a good indicator of how far along a patient's immunodeficiency has progressed—the more CD4 you have, the better. Only 18 months after D.C. stepped up its HIV testing program in 2005, the study found that "the median first CD4 count had risen to 332, a 50 percent increase in CD4 counts since 2005." That means that more people are getting tested for HIV/AIDS while they're still healthy, before they have signs of a secondary illness indicating an immunodeficiency (a CD4 count below 200 indicates a patient has full-blown AIDS).
c. Patients are living longer. The earlier a person tests positive for HIV, the less likely they are to spread the virus to another person. But early testing helps out the positive person, too: early testing and diagnosis gives those infected with HIV a much higher chance of survival. That's why 40 to 49-year-olds make up the largest HIV/AIDS population in the District, at 7.2 percent. The longer an HIV-positive patient lives, the higher the rate of HIV will be in the District of Columbia.
The 22 percent jump in HIV/AIDS cases is due to increased testing initiatives and medical advancements in fighting the virus. Not. Gay. Sex.
But the District of Columbia can't make people get tested for HIV. To what can we attribute the increase in testing? First of all, making HIV tests easy, accessible, and free, as they are at D.C.'s Whitman Walker Clinics. Second, normalizing the testing process through education. If D.C. residents think—like Black Informant does—that AIDS is a disease for homosexuals and sexual deviants, they're less likely to be tested, and they're more likely to pass the virus on to their partners. Continuing to spread the falsehood that HIV is a gay disease is dangerous to all residents of Washington who may be at risk.
There's an advantage to the high visibility of HIV/AIDS in the gay community—gay activists have been mobilizing since the 1980's for gay men to be tested regularly for HIV. But the visibility has also hurt other at-risk populations who think that their own behavior is "normal" enough not to subject them to the "gay" disease. Now that the rest of Washington D.C. has been proven to be as at-risk as the gay community, hiding behind homophobia will only impede our efforts to make everyone—gay and straight—healthy and safe.
Okay, Black Informant. It's your turn.