Washington Blade - August 8, 2008
Lou Chibbaro Jr.

Clinic officials said the new findings are especially troubling because the total number of people it tested for HIV so far in 2008, about 6,500, is roughly the same number it tested during the first half of 2007, meaning the spike in cases was not a result of testing of more people.

"These are troubling statistics that warrant more aggressive education, prevention, and testing initiatives," said Dr. Raymond Martins, Whitman-Walker's chief medical officer.

Martins said the clinic is reviewing demographic and other background information of the clients that were diagnosed this year with HIV to determine a possible cause for the increase in positive cases.

He also said one-third of the clinic's clients diagnosed with HIV this year were found to have AIDS. Many had no obvious symptoms of illness but a measurement of their body's immune system was found to be past the benchmark for an AIDS diagnosis, Martins said.

Martins said that similar to findings in recent years, gay men and African Americans comprised most of the clients diagnosed with HIV during the first half of 2008.

News of the increase in HIV diagnoses for Whitman-Walker's clients comes less than a week after the CDC released new data showing that the number of new HIV cases in the U.S. each year has been about 56,500 since the early 2000s. The CDC had previously estimated the number of new cases each year to be about 40,000.

CDC officials have said the increase stems from better techniques for counting and identifying new infections rather than an actual increase in new infections.

Whitman-Walker's new data, however, appear to show a clear increase in the actual number of new HIV infections among its client base, according to Martins.

He and Justin Goforth, director of Whitman-Walker's Medical Adherence Unit, said young males make up a large percentage of the new cases in the D.C. area.

"At each of our testing sites, we are seeing an increasing number of young gay men, particularly African American men, coming to us newly infected," Goforth said. "These are young men who don't remember the first wave of the HIV/AIDS epidemic and came of age when effective treatments were available. As a result, they have never seen HIV as a major problem."

In an effort to determine why the infection rate is rising among certain groups, Whitman-Walker recently conducted a series of "focus group" interviews with people in the D.C. area who are considered at risk to contract HIV. According to a clinic statement, among the groups represented in the focus groups were African American heterosexual men and women, young gay men and gay men of color.

"One surprising theme emerged-even though everyone recognized HIV was a serious issue, every group identified HIV as really being a problem for another demographic group," the statement says. "This is of great concern because the highest risk groups do not identify themselves as being high risk and thus increase their susceptibility to HIV through unsafe behavior and a lack of knowledge."

Michael Kharfen, spokesperson for the D.C. HIV/AIDS Administration, said his agency has kept track of the total number of new HIV cases citywide, but wouldn't have the data compiled and ready for release until November or December. At that time, HAA will release the number of new HIV cases reported in the District only for 2007, Kharfen said.

The most recent citywide data on new HIV cases is for 2006, for which HAA reported a total of 403 new cases. HAA data gather between 2002 and 2006 show a yearly decline in the number of new HIV cases across the city.

The citywide HAA figure for all of 2006 shows 136 more cases than the 266 HIV positive cases Whitman-Walker reported for its clients during the first half of 2008.

Kharfen said the HAA figure for 2006, along with the HIV-case count for the preceding five years, was derived through a unique identifier system of HIV reporting, which the CDC has characterized as flawed.

He said HAA expects to have a more accurate count of new HIV cases for 2006 and beyond, and that those counts could be higher than previous years.

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