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Newport News has highest HIV/AIDS rate in region

The 23607 ZIP code encompasses Newport News city offices, a swath of land occupied by the shipyard, and the ribbon of a residential area along a length of Jefferson Avenue. It also is home to the greatest concentration in the region of those living with an HIV/AIDS diagnosis, according to AIDSVu, an Emory University study released this month.

The study is in its fourth year, but Hampton Roads is included in its analysis for the first time, thanks to the dubious distinction of its high incidence of HIV/AIDS. The Virginia Beach-Norfolk-Newport News MSA, metropolitan statistical area, ranks 20th, ahead of Richmond (24th), among 103 metropolitan areas examined across the country.

The study's purpose is to help localities place resources for early diagnosis and treatment in areas of high need, said principal scientist Patrick Sullivan, professor of epidemiology at Emory University in Atlanta. "According to the national HIV strategy, the smart thing to do is to put resources where they can do the most good."

On the Peninsula, the rate in the city of Newport News is recorded as 538 per 100,000. By comparison, the rate in James City County is 56, in Virginia Beach 305, and 94 in York County. Residents in the Newport News ZIP code 23607 that includes Newport News City Jail account for more than 500 of the city's cases, though AIDSVu cautions that numbers may be skewed by an incarcerated population.

"It's not new information to us," said Dr. Nzinga Teule-Hekima, director of the Peninsula Health District, which oversees public health in Newport News. "We are aware that those areas have a higher incidence of all sexually transmitted diseases — not just HIV/AIDS, but gonorrhea and chlamydia too." She commended the study for providing focus. "We're increasing our education efforts at the clinics," she said. "We're looking at ways to prevent disease and using treatment as prevention to help reduce transmission."

Teule-Hekima likened the numbers to those of other chronic diseases, such as diabetes and high blood pressure, which occur in similarly disproportionate numbers in the same neighborhoods. "They're the same that have difficulty with access to medical care," she said.

For the most part, the numbers are stable. "HIV prevalence changes are more gradual over time," said Sullivan. "They tend to be stable, modest changes year to year. The maps help target where to do prevention programs," he added, emphasizing the importance of early diagnosis and treatment. In Virginia, the study reveals that late diagnoses result in 30.2 percent of cases developing into AIDS within 12 months, which is comparable to the national percentage. The Centers for Disease Control estimates that one in five people with HIV are unaware they have the disease. If diagnosed and treated early, transmission rates are cut by up to 96 percent.

At the state level, Anne Rhodes, HIV surveillance manager for the Virginia Department of Health said there "weren't any real surprises in the report." Her colleague Celestine Buyu, assistant director, noted that the department provided the data, but AIDSVu made it more accessible. "It's useful for people in the community. There are certain populations where we tend to see increases — in young black men, ages 18 to 24, who have sex with men," said Rhodes. She pointed to several interventions targeting the region, from one that funds patient navigators to link people with care, and others making HIV testing available through community organizations.

The AIDSVu analysis, using data gleaned from health departments and the U.S. Centers for Disease Control, breaks down the incidence by city and county, gender, race and age. It also provides corresponding data on poverty and education levels, to which there's a high correlation. "We're looking at the social determinants of health, how low education and poverty shape the prevalence of disease," said Sullivan. He pointed out that only 75 percent of the residents in 23607 had a high school diploma or equivalent. "It lets you see how these factors stack up together. Nationally, county to county — more than 2,000 — it shows this," he added.

Race and gender are also major determinants. "There's a big disparity in black/white rates even in the same ZIP code," Sullivan said. Nationally, he put the incidence for black women as 20 times greater than white women, with a rate in Virginia of 15.4 to 1. By contrast, black men are infected at 5 1/2 times the rate of white men. "Two-thirds of the cases are men having sex with men. That's the reason for the lower disparity," he said.

The study has gradually expanded its reach. It started by gathering data at the state level in 2010, part of the national HIV/AIDS strategy to focus on areas that are most heavily impacted, Sullivan said. In 2011, it added data from three cities; in 2012 it delved into incidence at the census tract level; and in 2013, it added MSAs and included both the rate and numbers.

(Note: The Virginia Beach-Norfolk-Newport News MSA includes Virginia Beach, Norfolk, Newport News, Hampton, Portsmouth, Chesapeake, Suffolk, Poquoson, York County, Gloucester County, Isle of Wight County, Mathews County, James City County, Williamsburg, Currituck County (NC), Gates County (NC).)

To check the incidence of HIV/AIDS in your ZIP code, go to http://www.AIDSVu.org.

Salasky can be reached by phone at 757-247-4784.

Copyright © 2014, The Baltimore Sun
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