Sunday, December 08, 2013

NYC DOH 40% Drop of HIV Rates Report Issued on 'Black Friday'

(Charts from DOH's new report showing drops of HIV continue.)

Almost a week ago, I blogged about the new annual HIV epidemiological profile for New York City from the Department of Health and mentioned several questions for the department to address, and they have provided me with answers via spokeswoman Diane Hepps.

In response to the question of when the profile was published to the web, DOH said:

The report was posted online on Friday, November 29th at approximately 5pm EST.

Late Friday afternoon is the traditional time for government agencies to dump what they consider to be bad news, hoping the data released won't get much mainstream or blogger attention. Here we have DOH not only dumping the HIV report at the end of the Friday workday but it also was the day after Thanksgiving, Black Friday.

Was DOH trying to bury the report and the many pieces of good developments contained in it releasing it on a holiday Friday? No one except for this blogger was paying attention to the DOH HIV stats page over the Thanksgiving weekend.

Here what they say about how they called attention to the profile:

The Health Department issued a press release on December 2, 2013 that highlighted the report. A link to the website location for the report was also provided in that press release. Link to press release. Link to report.

Fair enough, to issue the release on a Monday, however, the headline and sub-head reveal much about what I believe is a deliberate effort to obscure the good news about successful prevention programs bringing down new HIV infections:

Health Department Launches Texting Service to Link People Newly Diagnosed With HIV to Care;

New HIV Data Report Shows New Diagnoses in New York City Have Decreased 40 Percent From 2002-2012

A new texting effort leads off and the significant drop of HIV come second. Seems to me a seriously robust fall in HIV diagnoses over a decade is more newsworthy than a texting service. The body of of the release begins thus:

At an event commemorating World AIDS Day, the Health Department today released a new annual HIV data report showing that over the past ten years, HIV diagnoses in New York City have decreased by 40 percent. Despite this progress, the report shows that 3,141 New Yorkers were newly diagnosed with HIV in 2012 and, of those, 20 percent already had AIDS when diagnosed.

That opening sentence is the only one devoted to the decline and as I've seen so many times when similar drops of HIV were recorded here in San Francisco, the decrease is spoken of really in passing and then it's on to news that is not so good. I'm not saying DOH should not herald the texting service or refrain from discussing the 2012 stats. I want the NYC health officials to more fully laud the decline of HIV, explain in some detail why it's happening and how DOH will keep the number of new HIV incident going down.

I also asked how to square a new CDC report about increasing self-reported rates of butt sex without among gays and how that might lead to higher HIV overall rates, yet New York City's rate was plummeting, and the DOH reply surprised me:

New York City’s local data through the National HIV Behavioral Surveillance (NHBS) system show that the proportion of men who have sex with men who report unprotected anal intercourse (UAI) has been stable from 2005 to 2011. In each of the survey cycles, approximately 50% of participants who self-reported negative or unknown HIV status reported UAI with a male partner in the past 12 months.

Curious that over a seven year period the self-reported number of gays engaging in butt sex without rubbers remained stable. A positive development, right? I think so.

Finally, here's what DOH said about the rise in HIV diagnoses where the person shows resistance to AIDS drugs:

The 2012 transmitted drug resistance data are preliminary. It is possible, after additional genotype data are reported to the Health Department for this period, that 2012 data will possibly move downward closer to prior levels. Additionally, given that this preliminary data reflect an increase for one year only, we cannot yet say that this is a trend: we don’t know what will happen in 2013. Transmitted drug resistance (TDR) is resistance in a newly infected, ART-na├»ve person who typically would not yet have received compliance counseling from his or her doctor about second or third-line regimens. TDR reflects resistance in the person who transmitted the infection, including: a person with a high viral load who might have very early, possibly undiagnosed infection; someone who has elected not to start therapy; someone whose therapy has failed; or someone who is non-adherent to treatment.

We'll have to wait for the 2013 report to come out and see what new data is gathered about drug resistance. It's my hope that the 2012 HIV epi profile is widely discussed among AIDS service organizations, especially those engaged in prevention work, and at ACT UP meetings.

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