The number of people in Chicago newly diagnosed with HIV has decreased for the fourth year in a row, according to a new report from the Chicago Department of Public Health.

The city released its annual HIV/STI Surveillance Report on Monday, showing about 27 in every 100,000 Chicago residents were diagnosed with HIV in 2018. This is down 3% from new diagnoses reported in 2017 and down 19% since 2014.

“This is also the lowest number of new diagnoses we’ve seen since 1988, so that’s the big takeaway from this report,” said David Kern, deputy commissioner of the HIV/STI Bureau at the city health department. “It’s a signal that we’re moving in the right direction.”

In total, about 874 in every 100,000 Chicago residents were living with HIV in 2018. This is up about 2% from 2016 (when the ratio was 859 in every 100,000 people), but Kern said that rate has been increasing more slowly over the years.

Kern said that number continues to rise because “people are living longer, healthier lives with HIV,” but the slower rate of increase can be “cautiously attributed” to the decline in new diagnoses.

Kern said the city is doing “a really good job” of linking people newly diagnosed with HIV with medical care. In 2018, 81% of people newly diagnosed received care within one month; 95% received care within a year.

However, Chicago “falls far below” national goals in making sure people with HIV continue to receive medical care retaining people with HIV in medical care and the number of people with HIV achieving “viral suppression,” meaning their viral load has become undetectable.

The United States’ National HIV/AIDS Strategy, released in 2015, aimed for at least 90% of people living with HIV to be retained in medical care and at least 80% to achieve viral suppression. According to city health department data, only 41% of people living with HIV in Chicago were retained in medical care and just 52% were virally suppressed.

“We’ve seen some modest increases, but we believe there may be more effective and efficient ways to do our work and accelerate progress in that area,” Kern said.

Men, LGBTQ people and non-Hispanic black people have been disproportionally affected by HIV “year after year” in Chicago, Kern said.

In 2018, men saw 5.2 times as many new HIV diagnoses as women, according to the report. Additionally, people 20–29 years old made up 43% of all new diagnoses.

Non-Hispanic black people made up 55% of all new HIV diagnoses, 60% of AIDS diagnoses and 56% of late HIV diagnoses, according to the report.

Men who have sex with other men saw 3.8 times as many new HIV diagnoses as heterosexual men, according to the report.

“This signals to us that we have to do an even better job addressing health disparities and promoting health equity among these populations,” Kern said. “We can’t end the HIV epidemic in white communities alone. We have to end it in all people living with HIV across Chicago.”

By neighborhood, Washington Park, Chatham and Grand Boulevard saw the most new HIV diagnoses in 2018, according to the report. Washington Park and Chatham had also seen the most new diagnoses the year before.

The neighborhoods with the highest rates of people living with HIV remained consistent from 2017 to 2018, comprising of Uptown, Edgewater and Rogers Park, according to the report.

“But when you look at the groups that are disproportionately affected by HIV infections, you have to recognize that they have some important assets that the city can better leverage in our work,” Kern said.

He said the city has spent the last four years working with community partners, organizations, healthcare providers and researchers to examine Chicago’s HIV data and existing services to strategize how to end the epidemic by 2030. He said that strategy includes prioritizing access to quality healthcare, addressing health disparities, ensuring stable housing for people with HIV and increasing education about the virus.

“A world where we end the HIV epidemic is within our reach, and these latest findings prove that Chicago is on track to end the HIV epidemic by 2030,” Mayor Lori Lightfoot said. “Chicagoans will not rest until we achieve functional zero, meaning we will continue to increase access to care and services, expand our work with community partners and strengthen the quality of life for every city resident.”

Kern said the city will soon roll out housing initiatives to help people with HIV access healthcare and reduce HIV transmission among the most at-risk populations.

“Housing is a form of healthcare,” Kern said. “By ensuring people have safe, stable housing, you’re helping people with HIV have greater opportunities to receive treatment or at-risk people to stay negative.”

STI cases on the rise

While new HIV diagnoses declined in 2018, STI rates in the city have risen.

“In the shadow of HIV, we’re seeing increases in chlamydia, gonorrhea and primary and secondary syphilis,” Kern said.

According to the new report, 2018 saw 30,608 cases of chlamydia, compared to the 30,292 seen in 2017. Gonorrhea cases rose from 11,730 to 12,679; and primary and secondary syphilis cases rose from 788 to 877.

Kern said the city will form task forces of health care professionals and affected residents to come up with strategies to address these STIs.

“This is a trend across the country,” he said, “but regardless, it’s concerning to us in Chicago.”