Researchers find an HIV epidemic centered in downtown metro Atlanta

Infection with HIV, the virus scientists say causes AIDS, was once considered an automatic death sentence. But today HIV positive people can often live long and relatively healthy lives with early diagnosis and appropriate treatment. However, that doesn’t mean that HIV is no longer a serious public health threat. A new study says metropolitan Atlanta has an HIV epidemic concentrated primarily in one specific geographic area consisting of 157 census tracts the downtown area.

In fact, this area is where 60 percent of Atlanta’s HIV cases are found, according to research conducted by investigators in the Emory Center for AIDS Research (CFAR) and recently presented at the 17th Conference on Retroviruses and Opportunistic Infections (CROI) held in San Francisco.

Is calling this cluster an “epidemic” an exaggeration? Not according to the World Health Organization (WHO). WHO (http://www.who.int/hiv/en) labels a location where HIV infection is over one percent an area of a “generalized epidemic” and the Atlanta cluster, according to CFAR (http://www.cfar.emory.edu/index.php) is higher than that rate – 1.34 percent. Outside of the metro cluster, HIV prevalence in the state is about .32 percent.

"Atlanta includes more than 60 percent of HIV cases in Georgia, but the distribution of the epidemic has not previously been explored," author and presenter Paula Frew, PhD, MPH, assistant professor of medicine at Emory University School of Medicine and a CFAR investigator said in a statement to the media.

The CFAR researchers assessed the prevalence of HIV cases in four metro area counties -- Clayton, DeKalb, Fulton and Gwinnett -- by studying data, as of October 2007, from the Georgia Division of Public Health (http://health.state.ga.us/programs/stdhiv/index.asp) . Then they matched this information to census tracts. They also looked at data from the 2000 census to investigate the characteristics of those populations that comprise the largest metro Atlanta HIV cluster.

The results revealed the Atlanta concentration of HIV cases is characterized by neighborhoods of poverty and a greater percentage of African-American residents. What’s more, those living in these neighborhoods have a high prevalence of behaviors that increase the risk of HIV exposure , including unprotected male-to-male sex and IV drug abuse.

Approximately 42 percent of HIV service providers in Atlanta are found where the HIV cases are clustered in downtown Atlanta. That, concluded the Emory researchers, should facilitate better prevention and treatment of HIV/AIDS.

According to the CDC (http://www.cdc.gov/hiv/), the HIV/AIDS epidemic is an ongoing public health problem, with more than 50,000 new HIV infections reported yearly in the United States. "Prevention efforts targeted to the populations living in this identified area, as well as efforts to address their specific needs, may be most beneficial in curtailing the epidemic within this cluster," Dr. Frew stated.