While there have been great strides in the fight against HIV infection and AIDS, the problem is not going away anytime soon. Science Magazine and PBS News Hour in conjunction with support from the Pulitzer Center are focusing on the issue specifically in the area of South Florida.
According to the CDC, in 2016, Miami, Florida topped the charts for the rate of new HIV infections. The area showed 47 new infections in 2016 per 100,000 citizens. This is the highest rate in the country and more than twice the rate of large cities like New York, Los Angeles or San Francisco.
In an interview with Science Magazine, virologist Mario Stevenson, who directs the infectious disease department at the Miller School of Medicine at the University of Miami stated, "Miami is the epicenter of the epicenter of HIV/AIDS in the United States. There's no abatement in our upward slope." Stevenson began his career in molecular biology, looking at how the disease acts in cells and chromosomes, but his focus now is on stopping the spread of the disease in Florida. Miami isn't alone in the high number of cases. The Florida cities of Orlando, Jacksonville and Fort Lauderdale are all in the top ten of US cities for the rate of new HIV diagnoses. In addition to more HIV positive patients, the state has the highest rate of progression to full-blown AIDS. Stevenson wants to get more involved in the problem, telling PBS News Hour, "Stemming the tide is going to need more than just working at the bench doing molecular biology. We're saying, ‘Hey, guys, we're in a mess.'" Stevenson hopes to get help from the Florida Department of Health and state and federal legislators to address the issue.
A task force that Stevenson was involved in called Getting to Zero for Miami, issued a report last year that prevention is the key to keep the HIV infections from reaching even higher numbers. Once a patient has tested positive for HIV, antiretroviral drugs (ARVs) can prevent progression to AIDS. In addition, a prophylactic strategy using ARVs to uninfected people (referred to as pre-exposure prophylaxis, PrEP) is also part of the agenda rolled out by the Florida DOH, but nothing is happening fast enough right now to keep new cases from showing up.
The reasons for the spike in HIV cases in Miami and other parts of Florida are varied. The state attracts a lot of tourists and Miami and other areas have a "party hearty" reputation. The state's population continues to rise every year, including large numbers of residents who came from countries in Latin America and the Caribbean where HIV infections are much more prevalent than in the US. Public attitude is also a factor. Cancer, heart disease and Alzheimer's claim more lives than HIV and AIDS, so legislators and others focus more on those issues, believing that AIDS is a problem that was solved back in the late 80s and early 90s. There is still no cure for AIDS and ARVs and PrEP are not 100% in treating and preventing the disease.
There are some hopeful measures being taken. The Florida DOH is now offering a free 30 day supply of ARVs to any newly infected patients and making HIV testing part of routine medical care. Florida Surgeon General Celeste Philip issued a mandate in December 2017 that required every country health department in the state to offer PrEP at no cost. The University of Miami has a mobile clinic called "Gamechanger" that spends time in the city doing outreach and offering protection, HIV testing, and other services. In addition, community organizers, many of them fluent in Creole and part of the Haitian population, are doing their part to reach residents and offer counseling and care, regardless of insurance or immigration status. Check out the video below to learn more. Episodes of PBS News Hour on AIDS can be found here.
Sources: Science Magazine, SunSentinel PBS HIV.gov