Box Turtle Bulletin
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News and commentary about the anti-gay lobbyFebruary 3rd, 2016
Over the past several years, the city government of Washington, DC, has dedicated itself to a comprehensive and concerted effort to reduce the number of new infections of the human immunodeficiency virus (HIV). It appears that the effort is working. (Blade)
A preliminary version of the city’s annual HIV/AIDS Surveillance Report shows that newly reported HIV cases in D.C. during 2014 declined for the seventh consecutive year.
The report, which the D.C. Department of Health released on Tuesday, shows there were 396 new HIV cases in 2014, a 29 percent decrease from the 553 new cases reported in 2013.
…
Whitman-Walker Executive Director Don Blanchon said the declining number of new HIV infections in D.C. reflects the value of community wide testing, treatment on demand and prevention efforts that include pre-exposure prophylaxis or PrEP, which involves providing a daily “prevention pill” to people who are HIV negative.“Simply put, it is saving peoples’ lives and reducing new infections,” he said. “Today’s update reaffirms that we are on the right path to getting to zero new infections in a given year.”
We appear to now be in possession of the tools that we need to end the HIV/AIDS pandemic. Combining testing with TasP (Treatment as Prevention) and PrEP (pre-exposure prophylaxis) and treating the virus as a public health matter instead of a behavioral matter are the steps that are working in the nation’s capital. As the social acceptance of PrEP increases (as it has tremendously in Los Angeles over the past year), we should expect to see even more improvement in the upcoming year.
Congratulations, Washington!
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Priya Lynn
February 3rd, 2016
You make it sound like Prep was the whole story – I’m sure its not.
enough already
February 4th, 2016
It’s about time this was treated for what it is – a question of public health, not forcing people to behave like brave little heteronormative de-sexed automatons.
Priya Lynn
February 4th, 2016
Let it go Enough Already.
Priya Lynn
February 4th, 2016
Timothy posted “Whitman-Walker Executive Director Don Blanchon said the declining number of new HIV infections in D.C. reflects the value of community wide testing, treatment on demand and prevention efforts that include pre-exposure prophylaxis or PrEP”.
And let’s not forget, that included condoms.
Oggbert
February 4th, 2016
Priya Lynn – I didn’t see Timothy Kincaid say PrEP was the whole story – he mentioned TasP (which has been a long term strategy in public health) and shift of treating HIV as a public health mater.
The fact that DC made the shift from treating HIV infections as a matter of individual risky behaviors to a matter of public health probably had the biggest impact. As mentioned, DC made a huge effort in the last 7 years to test everyone, even offering testing at the DMV at one point, and then connecting people who test positive to treatment.
Washington DC has one of the highest rates of undetectable persons with HIV in the nation and very high treatment rates, IIRC.
Many public health organizations in DC believe that continued focus on testing, treatment and prevention with PrEP, condoms and needle exchanges will continue to reduce HIV infections in DC and all are required to meet the 90-90-90 goal by 2020.
Priya Lynn
February 4th, 2016
“Priya Lynn – I didn’t see Timothy Kincaid say PrEP was the whole story”.
Technically he didn’t but given the discussions that have gone on here it suggests bias that he didn’t mention that condom usage was also part of the story about the reduction in new HIV cases.
Oggbert
February 4th, 2016
The article quoted from in the Blade also didn’t mention condom usage.
Priya Lynn
February 4th, 2016
I see. An oversight on their part as well.
enough already
February 4th, 2016
Priya Lynn, for the sake of all the gods in the Pantheon – give it a rest.
Nobody likes condoms.
Sheesh.
I can’t believe we are all still fighting the needle exchange fight. Talk about Hep and HiV prevention….
Double Sheesh.
Priya Lynn
February 5th, 2016
“Nobody likes condoms.”.
Now you’re just being a troll, repeating the same lie just to annoy people.
Nathaniel
February 5th, 2016
Priya, EA’s campaign against condoms aside, condom use would have to have increased for it to contribute to reduced numbers of new HIV infections. Given the relative novelty of PrEP and TasP technologies, it is safe to assume their use has increased (indeed, I suspect there are hard numbers that negate the need for assumption). But there is no word on condom use. That’s not to say it hasn’t helped protect anybody, but it is difficult to see condoms as contributing to decreases in new infections if they are not being used at greater rates. Since at no point did anybody try to say condoms were not playing a role, I’m not sure why you felt the need to cry foul. But it is clear to me why condoms were not additionally praised, either: the most obvious tools contributing to this rapid decrease in new infections is clearly the new tools that are being used more extensively – more readily available testing, treatment for those that test positive, and additional prophylaxis for those that test negative.
Priya Lynn
February 5th, 2016
I never argued anything to the contrary Nathaniel.
Priya Lynn
February 5th, 2016
Upon re-reading your comment Nathaniel I take issue with this part ” but it is difficult to see condoms as contributing to decreases in new infections if they are not being used at greater rates. Since at no point did anybody try to say condoms were not playing a role, I’m not sure why you felt the need to cry foul. But it is clear to me why condoms were not additionally praised, either: the most obvious tools contributing to this rapid decrease in new infections is clearly the new tools that are being used more extensively…”.
If it is clear to you why condoms were not additionally praised you’re showing poor judgement, that is merely an unsupported assumption on your part. You don’t know if condom usage contributed to the decline or are being used at greater rates.
I don’t know why you’re crying foul when that is the reason why I originally posted.
Timothy Kincaid
February 5th, 2016
I think that the reason that condoms were not praised for the decrease in seroconversion rates is because they had little to do with the decrease in seroconversion rates.
This is not to say that condoms do not contribute to the overall prevention of transmission. Surely they do, just as they have for many years. And for many years there have been significant numbers of new transmissions each year.
But this is not a report about ‘things as usual’; this is a report about how things are dramatically NOT as usual. And the explanation of the dramatic reduction in transmission rates is not “people are still using condoms”.
Rather, the explanation is:
Priya Lynn
February 5th, 2016
“I think that the reason that condoms were not praised for the decrease in seroconversion rates is because they had little to do with the decrease in seroconversion rates.”.
That’s merely speculation on your part. None of us know what role they did or didn’t play in the decrease.
Timothy Kincaid
February 5th, 2016
While it is entirely possible that you are right and Whitman-Walker Executive Director Don Blanchon is wrong, I think for now I’ll stick with Blanchon’s explanation.
Priya Lynn
February 5th, 2016
“Rather, the explanation is:
Note: “prevention efforts that include“. That does not say that only Prep was responsible for the drop, but rather says that factors other than Prep also played a role. You don’t know whether those other prevention efforts responsible for the drop includes condoms.
Priya Lynn
February 5th, 2016
Blanchon did not say what you’re attributing to him.
Priya Lynn
February 5th, 2016
Timothy, you’re usually such a stickler about not making assertions not founded in a document, its surprising to see you doing so now. And I never asserted that Blanchon was wrong, rather that the explanation he gave doesn’t exclude condoms from being partly responsible for the drop in seroconversion rates.
This is not me contradicting what Blanchon said, rather it is you reading into his explanation something he didn’t say.
Timothy Kincaid
February 5th, 2016
If you choose to believe that condoms were some significant contributor to the drastic change in conversion rates in Washington DC, you may do so.
Priya Lynn
February 5th, 2016
I don’t require your permission to think anything.
Priya Lynn
February 5th, 2016
And I make no assertion that condoms were a significant contributor to the change in conversion rates.
enough already
February 6th, 2016
Timothy, have you seen that Fulton County, Georgia has launched a PrEP clinic Friday? They commented that they have one tool in their toolbox and they’re going to leverage it.
enough already
February 6th, 2016
Timothy, have you seen that Fulton County, Georgia has launched a PrEP clinic Friday? They commented that they have one tool in their toolbox and they’re going to leverage it.
enough already
February 6th, 2016
Priya,
If the only thing available is a condom, then it should be used. Obviously.
One thing I’ve forgotten in dealing with the condom lovers. There is a very small group of men who don’t experience jiz-joy and, in fact, hate semen. Maybe I should be cutting them some slack. Just as they should accept that nearly all gay men like semen and experience jiz-joy.
Oggbert
February 8th, 2016
Considering the reduction has been over a 7 year period, PrEP is logically not the only, or even main factor in the long term decrease. The distribution of free condoms, a tenfold increase from 2007-2013, by the same orgs dedicated to testing and treatment also clearly played a major roll. In 2009 (when the big push in DC started), his clinic found 70% of those surveyed did not used condoms during a recent sexual encounter, which led them to focus on risk education (including the use of condoms). Given Blanchon’s previous statements (particularly in regards to this annual report), I think he was talking about PrEP as a new tool in the toolbox, as opposed to condoms, which have had a long history of supporting.
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