By Geoffrey Cooper
Alvin Lewis has a front-row seat to the destruction that HIV/AIDS is causing in Richmond’s more impoverished areas.
Every day, the lifelong city resident and HIV outreach specialist hears pleas of help from victims in his own backyard. About 2,330 Richmond residents are infected with HIV/AIDS, and the city’s infection rate is the highest in Central Virginia – almost four times the statewide average.
Lewis says it’s up to educators like him to reach the city’s at-risk population before it’s too late.
“Some people have no worries. They think it can’t happen to them,” he said. “Then all of sudden, it’s there, and it doesn’t go away.”
As of March, more than 25,000 people in Virginia had HIV or AIDS. (AIDS – acquired immune deficiency syndrome – weakens the immune system, destroying the body’s ability to fight infections and certain cancers. HIV stands for the human immunodeficiency virus, which causes AIDS.)
The statewide total includes about 12,600 people with HIV and 12,460 with AIDS, according to the latest Virginia HIV Surveillance Quarterly Report by the state’s Department of Health.
The Central Virginia region was one of the state’s hotbeds for residents living with HIV/AIDS. It accounted for more than 5,800 cases of all HIV diseases – a rate of 420 cases per 100,000 population. (The statewide rate was 309 HIV-infected people per 100,000 population.)
The city of Richmond led the region with the highest concentration of those infected. Of every 100,000 Richmond residents, 1,228 were living with HIV. Along Interstate 95 South to Petersburg, the rate was slightly lower – 1,175 HIV-infected individuals per 100,000 population. Greensville County ranked third in the Central Virginia region with a rate of 956 per 100,000.
The Eastern Virginia region, which includes Virginia Beach, Newport News and Norfolk, had the most people living with HIV or AIDS – about 7,630. The rate there was 410.5 infected residents per 100,000 population.
Lewis, who does community HIV outreach for Richmond Behavioral Health Authority, said he’s not surprised at the city’s numbers. Richmond’s poverty, crime, drug activity and prostitution create a playground for both HIV and AIDS to fester, especially in the city’s poorer areas, he said.
But Lewis said he has noticed a bright spot: The perception of HIV/AIDS has changed drastically over the past two decades.
“Most people will come forward because (HIV/AIDS) is treatment-friendly now,” he said.
“I think more people are aware and conscious of (HIV/AIDS) now versus 20 years. When someone found out that a person had HIV in the city, it wasn’t talked about. Now, that’s not the case.”
Diane Cooper, the HIV project coordinator for the Richmond Behavioral Health Authority, said that when HIV/AIDS surfaced in the early 1980s, reactions from city residents were a mix of fear and ignorance. She said many residents thought only homosexuals or avid drug users could get the disease.
Those attitudes have eroded somewhat, Cooper said. She said her agency is targeting residents dealing with substance abuse and those considered at risk because of dangerous habits that lead to HIV/AIDS -– primarily intravenous drug use and erratic sex behaviors.
“The stigma still exists, but now people understand more about the disease and its transmission routes,” Cooper said.
Jenny Calhoun, senior nurse for the STD/HIV Program at Henrico County Health Department, said her coverage area is usually not far behind Richmond when it comes to HIV/AIDS cases.
Henrico County had 944 cases of all HIV diseases as of March, for a rate of 243 infected residents per 100,000 population. Henrico’s numbers were higher than in Chesterfield County, which had 715 cases and a rate of 193 per 100,000 population.
Calhoun said cities with major highways, like Richmond, usually have higher rates because sexually transmitted diseases are mobile, especially along Interstate 95 -– a gateway to many major East Coast cities.
One key group that continues to worry Calhoun is young, gay, black men. She said that among other races and among women, transmission rates have decreased, but the number of young, black, homosexual men visiting her office with HIV/AIDS continues at an “alarming” pace.
Of the 10,145 cases of black men with either HIV/AIDS, over 50 percent have transmitted the disease through male-to-male contact. About three-fourths of white males statewide with HIV or AIDS also fell into that category, of the total of close to 6,500 actually infected with HIV/AIDS.
“There’s a disconnect somewhere,” Calhoun said. “I would think if it was a matter we’re not getting the education or the awareness out there, we would see it not just in that particular group – we would see it across young people.”
Calhoun acknowledges that many technological and scientific advances have occurred over the past 20 years to suppress the damage HIV/AIDS does to an infected person. Still, she said she doesn’t want residents believing there’s a “quick fix” to the epidemic.
“It’s just so much more than that,” Calhoun said. “People still die, and their lives become much more complicated because they have to manage this disease for the rest of their lives. People make those human mistakes and for some people, those mistakes end up being life-long consequences.
“Traditionally young people go through that period of life where they feel invincible. So even though they might know a lot about things, it doesn’t always stop them from engaging in risks – whether it’s riding a motorcycle too fast, or having unprotected sex.”
Virginia mapped by HIV-AIDS rates
Click on a locality for more information. Here is the map as a Web page.
The data used in this report are from a Virginia HIV Surveillance Report by the state Department of Health. The data show the number of HIV/AIDS cases and rates for localities as of March 31. You can access our analysis of the data as a Web page or a Google Spreadsheet.