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Charting the Incidence of HIV/AIDS Across NJ's Counties and Cities

HIV/AIDS has become a chronic illness, rather than a death sentence, but individuals and populations remain at risk

There were nearly as many New Jerseyans living with HIV/AIDS last year as the total number who have died in the state in the three decades since the disease and virus that causes it exploded into the nation's consciousness.

According to the annual HIV/AIDS report of the state Department of Health, 37,511 New Jerseyans were diagnosed as living with Acquired Immune Deficiency Syndrome or Human Immunodeficiency Virus, which causes AIDS, at the end of 2013. That's nearly 1,000 more than in 2012 and about 20 percent more than a decade ago. The actual number of people with HIV/AIDS is likely higher, the report states, since people may have the virus and not know it or have not sought diagnosis.

The rise in those living with HIV/AIDS is primarily due to the shift in the diseases from a once near-certain death sentence to a chronic illness.

"Significant advances in anti-retroviral drug therapy over the past 25 years have dramatically reduced side effects, transforming HIV from a swiftly fatal disease in the early 1980s to the chronic, manageable disease that it is today,” said Deputy Health Commissioner Dr. Arturo Brito.

The DOH's 2012 report lists the total number who have died from HIV/AIDS since the state began keeping track in the 1980s as 41,842. Nearly 90 percent of those died after the virus developed into AIDS. In 2012, 21 deaths were attributed to HIV/AIDS, compared with 66 in 2011, 589 in 2002, and 4,472 in 1992, the year with the single-largest number of deaths in the state.

Similarly, the number of newly diagnosed cases has been declining: 925 in 2012, 1,133 in 2011, 2,219 in 2002, and 6,565 in 1992, also the year with the most newly diagnosed cases. Education about HIV/AIDS and ways to prevent it have contributed to the decline in new cases.

“HIV prevention efforts, in combination with today's highly effective anti-retroviral treatment have resulted in a steady decline in new HIV infections since the mid-1990s,” Brito said. But that doesn't mean officials can stop worrying about the virus, he continued, adding, "we must remain vigilant and focused on preventing transmission.”

The first news in the United States of what would eventually be known as the "AIDS epidemic" came in a June 1981 report from the U.S. Centers for Disease Control and Prevention about a rare lung infection among formerly healthy gay men in Los Angeles. The international charity AVERT estimates HIV probably entered the United States around 1970. In September 1982, the CDC gave the name AIDS to the growing number of opportunistic infections. As awareness grew, so did the number of cases and the number of deaths.

Education efforts to prevent the primary means of transmission -- sexual contact and the reuse of intravenous needles -- and screening of donated blood led to a decline in new cases. And the development of drugs to keep HIV at bay helped lead to a reduction in deaths.

"As new therapies become available, a larger percentage of cases will remain HIV positive for longer periods of time before developing AIDS," notes the DOH's 2013 report.

HIV/AIDS disproportionately affects the black population both nationally and in New Jersey, where about 1 in 62 African-Americans is living with the disease, compared with 1 in 701 whites. Essex County, with the state's largest African-American population, had the highest incidence -- more than 23,000 cases, 1,237 per 100,000 people. Newark had the largest number of cumulative cases since the 1980s, more than 14,000, and nearly 8,600 deaths through 2012. Its incidence in Newark is about 2,100 per 100,000 people, with an estimated 5,900 people living with AIDS in 2012. East Orange and Irvington in Essex County also each had more than 1,000 diagnoses.

All three Essex County cities are among 10 statewide with the highest number of cases that are part of the IMPACT Initiative designed to lower the incidence of HIV/AIDS through concentrated education and other efforts. The other cities are Atlantic City -- whose 1 in 31 incidence rate of blacks living with HIV/AIDS is the highest in the state -- Camden, Elizabeth, Jersey City, Paterson, Plainfield and Trenton.

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