An estimated 1.7% (n=12,161) of the resident population in the District of Columbia is living with HIV based on case report and laboratory data collected as part of routine disease surveillance activities. In 2020, 217 individuals were newly diagnosed with HIV in the District, marking an 83% decrease from the number of newly diagnosed HIV cases documented in 2007 (n=1,374). Unfortunately, such declines have not been consistent across all populations, contributing to persistent demographic disparities in the risk and burden of HIV infection within the District. While a 46% decline in the number of newly diagnosed cases was observed within the Black population over the past five years, only a 37% decline was observed within the Latino population compared to a 41.5% decline within the White population over the same time period. Overall, Black men who have sex with men (MSM)/Black MSM who also engaged in injection drug use (IDU) and Black heterosexual women accounted for 34% and 15.5%, respectively, of newly diagnosed HIV cases in the District from 2016 through 2020 (n=1,586), followed by Black heterosexual men (9%), and White (9%) and Latino (8%) MSM/IDU. While likely underestimated due to the limitations of surveillance data, approximately 3% of newly diagnosed HIV cases in the District from 2016 through 2020 occurred within the transgender community. Slightly over 50% of all individuals living in the District diagnosed with HIV are 50 years of age or older; however, newly diagnosed HIV cases tend to occur within younger age cohorts. From 2016 through 2020, approximately 34% of newly diagnosed HIV cases in the District occurred among those aged 20 to 29, with individuals aged 30 to 39 accounting for the second largest proportion (28%) of newly diagnosed HIV cases. Geographically, the highest HIV burden and rates of new infection are observed in the southeast region of the District, comprised of Wards 5,6, 7, and 8.
The HIV/AIDS, Hepatitis, STD, & TB Administration (HAHSTA) within the District of Columbia Department of Health (DC Health) recently initiated the DC Ends HIV Plan outlining HIV prevention and treatment strategies targeted towards ensuring that 95% of HIV positive District residents are aware of their status; 95% of District residents diagnosed with HIV are in treatment; 95% of District residents living with HIV who are in treatment are virally suppressed; and over 13,000 District residents at high-risk for HIV infection are engaged in pre-exposure prophylaxis (PrEP) utilization. By the end of 2030, the District has a target of fewer than 130 new HIV diagnoses per year.
The National HIV Behavioral Surveillance (NHBS) system has been an integral tool for identifying HIV-related risk behaviors among specific populations. Since 2006, the DC Health HAHSTA has successfully conducted NHBS through its Public Health-Academic Partnership with The George Washington University Milken Institute School of Public Health (GW). This progress report describes the implementation of PWID2022, MSM2023, PWID2024, HET2025, and MSM2026, as specified in the funding announcement. Implementation and data use will be based on past successful practices, as well as adding new capacity within the Partnership. Funding of this proposal will enable HAHSTA to collect data for the development, monitoring and evaluation of innovative prevention strategies in DC.