Issues facing New Hampshire: AIDS Prevention
One of the biggest issues facing New Hampshire in the fight against AIDS is the low rate of testing among its residents. Only 41% of New Hampshire residents have ever had an HIV test. Of those tested, 70% hadn't had a HIV test done within the past year. Half of those tested were last tested over four years ago. Low rates of testing stem largely from the notion that we, as a state, are not at risk. That simply is not true (1). There are several populations within the state that are at a high risk of contracting HIV. Also, since it only takes having sex with one infected partner, having unprotected sex even once puts an individual at risk.
In addition to the problem of HIV positive individuals unknowingly infecting others, these infected individuals are aren't being treated. New Hampshire has a very high rate of concurrent AIDS diagnoses. An individual is considered to have a concurrent AIDS diagnosis if he or she progresses to AIDS within one year of the original HIV diagnosis. In 2004, 60% of individuals were concurrently diagnoses with HIV and AIDS. This figure has ranged from a low of 58% in 2003 and a high of 75% in 2001 (1).
The cumulative AIDS rate for blacks in New Hampshire is fourteen times higher than that of whites. While there are still more cases of HIV/AIDS among white individuals than black individuals, the extent to which the rate is increasing among the black community warrants attention. A higher proportion of AIDS cases in black individuals in New Hampshire has been reported in the last five years. In 2000, 10% of new infections were found in individuals who are black, in 2004, this number rose to 26% (1).
The cumulative AIDS rate in New Hampshire is largely correlated with distance from Manchester and population density. Although Hillsborough county houses most of the states inmates, data suggests that these individuals are not likely to be infected with HIV/AIDS. As of 2000, only 0.7% of males and 1.3% of females in New Hampshire State and Federal Prisons were HIV positive. Of the states in the Northeast, only Vermont has a lower rate of HIV prevalence in prisons (2).
The most common mode of HIV transmission in New Hampshire is MSM. MSM accounts for 48% of the cumulative AIDS cases. Injecting drug use comes in second, accounting for 19% of cases. 5% of cases are MSM/IDU. 13% of cases are a result of heterosexual contact (3).
These issues: low rate of HIV testing, MSM transmission, and higher infection rates in the urban and black community, are the ones most in need of addressing by New Hampshire's Department of Public Health.