The rate of new HIV diagnoses in South Florida spiked to more than three times the national average in 2015, according to the Centers for Disease Control and Prevention’s annual HIV Surveillance Report, which found that diagnoses in the Miami-Fort Lauderdale-West Palm Beach area last year averaged about 38.8 cases per 100,000 people.
Nationally, the rate of new HIV diagnoses in 2015 averaged 12.3 cases per 100,000 people, according to the CDC data, which is preliminary. The agency also reported a rise in other sexually transmitted diseases or STDs, including syphilis — an indicator that more people are having unprotected sex, particularly among the highest-risk group, men who have sex with men, public health experts said.
In 2015, a total of 39,513 people were diagnosed with HIV infection in the United States, including 4,864 in Florida, according to the Centers for Disease Control and Prevention.
“It’s kind of disheartening,” Paula Sparti, a retired family physician in Miami who has treated HIV and AIDS patients since the 1980s, said of the rise in STDs. “We saw them a lot early on, before we even had AIDS, and then it decreased to some degree because people were being more careful as they were watching their friends die.”
People who have STDs are more likely to contract HIV because both are likely the result of the same behaviors and circumstances, such as having multiple sexual partners or not using condoms.
But the concurrent increase in HIV and STDs, particularly in Miami-Dade, where the health department has reported a spike in syphilis cases over the past three years, reflects a more casual attitude about the risks associated with unprotected sex and the potential lifelong consequences.
Sparti said that when she first began working with HIV and AIDS patients in the 1980s, the high rate of mortality was a deterrent to unprotected and casual sex. But HIV infection is no longer seen as a death sentence because the virus can be treated with antiretroviral drugs and other medicines, causing a shift in attitudes.
“The younger people are not seeing that, so they’re not afraid,” Sparti said, “and they also see it as a treatable and chronic disease and aren’t worried about being on medication for the rest of their lives.”
The greatest number of HIV cases in Miami-Dade involve adult men who have sex with men, a group that accounted for 8,293 cases, or 52.6 percent, of the total through October, according to the health department’s latest surveillance figures.
51.2 Rate per 100,000 people in Miami-Dade County diagnosed with HIV in 2015
An additional 4,901 HIV cases in Miami-Dade, or about 31 percent of the total, are attributed to adult heterosexual contact. The greatest number of HIV cases are reported among men aged 20 to 49.
According to the CDC, the Miami-Fort Lauderdale-West Palm Beach area also reported the nation’s highest rate of syphilis infections in 2015 among the large metropolitan areas tracked by the federal agency, with an average rate of 61.3 cases for every 100,000 people — about twice the average of 31.4 cases per 100,000 people for the selected regions.
The rate of syphilis infections reported in Miami-Dade and Broward counties has risen faster than the rest of the state and much of the nation, according to the Florida Department of Health, which in July issued an alert letter to healthcare professionals warning about the rise in cases.
Florida health officials have said there is no single reason for the rise in syphilis infections, noting that more cases may be diagnosed because of expanded testing, though they also have acknowledged that high-risk behaviors also are contributing to the increase.
Florida Surgeon General Celeste Philip issued a written statement on Tuesday in response to questions about the CDC’s HIV surveillance data, which she noted reflect where Florida was last year.
“In December 2015,” Philip said in the statement, “we recognized we needed to adjust our approach to curtail new cases of HIV, and over the past year we have made tremendous strides.”
Philip said the health department has adopted a strategy that includes routine screening for HIV, increased testing for high-risk groups, prevention education and the use of pre-exposure prophylaxis, or PrEP drugs, to reduce the spread of HIV.
“So far, we have seen promising results from these pilot projects in South Florida,” Philip said in the statement. “And we have plans to expand them to other parts of the state to continue to meet the needs of this community.”
A previous version of this article used the phrases "new HIV infections" and "new HIV diagnoses" as synonymous. The Centers for Disease Control and Prevention's data for new HIV diagnoses in 2015 does not account for when the infection occurred. The data is preliminary.