Sun misrepresented Baltimore HIV rates

March 14, 2012

There is no dispute that 30 years after the first HIV cases were documented in Maryland, the deadly virus continues to be a major public health epidemic in Baltimore City. A recent article in The Sun ("Black women's HIV rate is high," March 9) misrepresents the results of a multi-city study of women and HIV and does a major disservice to Baltimore.

The study, in which Johns Hopkins was leading the Baltimore component, was not designed to estimate the incidence of HIV in African-American women here. It evaluated new HIV infections for 2,100 women at particularly high risk for contracting HIV in 6 high HIV prevalence U.S. cities including Baltimore. The authors themselves note as a limitation of the study that the "results are not generalizable to the general population of women."

High risk behavior in a high prevalence area is a "perfect storm" for new HIV infection. That was the focus of this study. This is not reflective of all women in Baltimore or of all women in the U.S. In fact, HIV diagnosis rates (a reasonable proxy for incidence) among African-American women in Baltimore declined from 18/10,000 to 8/10,000 during the 2008-2010 period — though we recognize that in some zip codes the rates remain unacceptably high. The media support our work by helping reduce the stigma around being tested for HIV.

HIV disproportionately weighs on Baltimore. It is incumbent on all of us to ensure we are clear on what the science demonstrates because lives are at stake. To adequately address the ongoing epidemic, we need sound research, sufficient and strategic programmatic responses, strong community partnerships, and clearer and more accurate public statements that engage our citizens.

Drs. Oxiris Barbot and Michael J. Klag, Baltimore

The writers are, respectively, Baltimore's commissioner of health and dean of the Johns Hopkins Bloomberg School of Public Health.

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