New HIV cases are on the decline nationwide — except for the Southeast. Nearly half of all HIV cases are now in minority communities in Southern states, and Miami's rate of HIV infection is nearly four times that of the U.S. average. The most recent data shows 27,969 Miamians were living with HIV/AIDS by the end of 2017. Neighborhoods with the greatest number of cases include South Beach, Wynwood, and Little Haiti.
Now, as Miami has become the new face of AIDS in America, the National Institutes of Health (NIH) has granted researchers at the University of Miami $14 million to study HIV in aging populations.
"We are hoping to learn about the long-term consequences of HIV infection in men and women," says Deborah Jones Weiss, a leader at the Center for HIV Research and Mental Health (CHARM) at the University of Miami. "Understanding HIV better will allow us to design guidelines for health over the patient's entire lifespan."
Jones Weiss is one of three principal researchers from the Miami Center for AIDS Research spearheading the Miami component of the study, which will be conducted in collaboration with 12 additional sites across the nation. She will be joined by Dr. Margaret Fischl, the director of the Miami Center for AIDS Research; and Dr. Maria Alcaide, the director of UM's infectious disease research unit. The project will track noninfectious health conditions that HIV patients experience as they age. Those conditions include cardiovascular and pulmonary diseases, metabolic and degenerative diseases such as diabetes and osteoporosis, and mental-health issues.
Thanks to modern medicine, HIV is no longer a death sentence. Patients can now treat the virus as a chronic health condition as opposed to a life-threatening one. With treatment, the life expectancy of HIV patients has improved dramatically in the past two decades. The life expectancy of a 20-year-old with HIV was 39 years in 1996, according to a Kaiser Permanente study, but by 2011, total life expectancy was clocked at 70 years. In 2016, Georgetown University began treating the first known HIV patient with Alzheimer's disease.
Jones Weiss says Miami's health disparity is a key issue in the city's fight against HIV. Although Miami has worked to strengthen testing and HIV-prevention services in recent years, there is still a lack of access and uptake in at-risk communities. A lack of safe needle-exchange programs, comprehensive sex education, and access to pre-exposure prophylaxis (PrEP) medication also contribute to the spread of infection.
"It is also important for those living with HIV to have access to health care and medication to stop the spread of the infection," Jones Weiss says. "Once the virus is suppressed with medication, it cannot be transmitted."