Just before commemorating World AIDS Day on Tuesday, Fulton County’s health department released some rare good news on its efforts against the disease.
Citing a report from an independent program of the National Association of County and City Health Officials, the press release said the number of people dying here from HIV-related diseases plunged 59 percent between 2004 and 2012.
"Fewer people are dying from HIV/AIDS in metro Atlanta, in part, due to our Integrated Care Service Delivery of services," Dr. David Holland, chief clinical officer of Fulton’s Communicable Disease Prevention Branch, said in the release.
Could this be the same department that had to give back between $7 and 8.7 million of $20 million in federal grant money because it didn’t have enough programs to help stop the spread of HIV?
And are deaths declining even though at least a quarter of all new HIV diagnoses in Atlanta are for people who have already developed AIDS?
PolitiFact Georgia was skeptical.
The 27th anniversary of World AIDS Day comes at a time when both the rate of HIV infection and AIDS-related deaths are on a global decline.
Effective antiretroviral drugs can control HIV and help those with the disease live longer lives.
As of June, 15.8 million people were receiving antiretroviral treatment.
Worldwide, that has pushed down new HIV infections, which have fallen by 35 percent since 2000, and deaths, which have fallen 42 percent since a peak in 2004.
The 2015 report from NACCHO’s Big Cities Health Coalition examines health data from the nation’s 27 largest cities and counties, including a look at more local HIV and AIDS figures.
According to the Big Cities Health Inventory report, released in late November, cities experienced new cases of HIV and HIV-related deaths in higher numbers compared with the rest of the country.
But Atlanta (as reported by Fulton County’s health department) and every other city except Detroit saw drops, some significant, in mortality rates since the last report.
Atlanta had the fourth highest mortality rate of the cities, with 24.1 deaths per 100,000 people in 2004, according to the report. In 2012, the last year data was available for a majority of the cities, the rate was 9.8 – a 59 percent drop just as Fulton touted in the press release.
Data from Georgia’s Department of Public Health back up those figures on the mortality rate and also provide the specific numbers of deaths.
The number of people dying annually from HIV/AIDS in Fulton County dropped from 195 to 96 in those eight years, a 51 percent decline.
Further bolstering Fulton’s claim are figures showing continued drops in deaths for the past two years.
By 2014, 80 people in Fulton had died from HIV or AIDS, a rate of 8 percent. That’s a 59 percent decline by number or a 66.8 percent decrease in rate from the peak a decade ago.
Statewide, HIV/AIDS deaths also declined during this period by 47 percent said Nancy Nydam, spokeswoman for the Georgia Department of Public Health.
The state death rate from HIV/AIDS was 7.9 per 100,000 in 2004 and 4.2 in 2012, a 47 percent drop, she said.
All of this is to say, Fulton is on target with its figures. Missing from the press release, though, was the context that Atlanta remains in the top 5 cities for HIV-related deaths (and top 3 for new infections).
And, its 10 per 100,000 mortality rate is five times greater than the national average of 2.
"It’s a big improvement but obviously some big improvements still need to be made," said Chrissie Juliano, director of the Big Cities Health Coalition. "We know from other sources that challenges remain in Atlanta-Fulton County regarding HIV and AIDS."
Fulton is making headway. It completed an internal audit in October that found mismanagement and bureaucratic delays cost it the nearly $9 million in federal money to fight HIV.
It has since replaced the health department director and strengthened oversight of its grants.
Patrick Sullivan, an epidemiologist at Emory University’s Rollins School of Public Health, cautioned against reading too much into Atlanta’s ranking in comparison to national mortality rates.
He added that it would not be "informative" to directly compare Atlanta, or any city, to the overall U.S. rates on HIV mortality.
"HIV-related deaths are much higher in cities, because people living with HIV are more concentrated in cities," Sullivan said. "The high HIV-related mortality rate reflects the high impact of HIV in Atlanta."
At a time when new HIV infections and AIDS-related deaths are down globally, Fulton County touted a report that showed its mortality rate dropped 59 percent from a peak in 2004.
The report, and state data, back up the dramatic decline. While Atlanta remains in the top five cities in the nation for such deaths and still struggles with executing prevention programs, it also has seen the mortality rate drop since the report.
We rate the statement True.
World Health Organization. HIV/AIDS fact sheet, November 2015
The Joint United Nations Programme on HIV/AIDS (UNAIDS), 2015 fact sheet
Big Cities Health Coalition, accessed Nov. 30, 2015
Big Cities Health Inventory Data, November 2015 report
Big Cities Health Inventory Data, Atlanta/Fulton County data
National Association of County and City Health Organizations, accessed Nov. 30, 2015
WABE radio, "Fulton County Doesn't Spend, Loses HIV Prevention Money," June 8, 2015
Georgia Department of Public Health, Online Analytical Statistical Information System, accessed Nov. 30, 2015
Atlanta Journal-Constitution, "Audit: Mismanagement led to loss of millions in Fulton HIV grant," Oct. 6, 2015
Phone interview, Chrissie Juliano, director, Big Cities Health Coalition, Nov. 30, 2015
Email interview, Patrick Sullivan, epidemiologist and researcher, Rollins School of Public Health, Emory University, Nov. 30, 2015
Phone iInterview with Nancy Nydam, spokeswoman for Georgia Department of Public Health on Nov. 30, 2015
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