The Bronx has almost twice the death rate from AIDS as the other boroughs and public health officials attribute this to people not getting tested until their disease is so advanced that the treatment is not effective.

This is EXACTLY the same obstacle antiretroviral treatment programs in Malawi face... in a population with an HIV prevalence of 14%, 80% of those infected have never had an HIV test.

There is an extremely high early mortality in ART programs in sub-Saharan Africa (patients dying within the first 1-2 months after starting therapy) which doesn't do much to encourage testing as starting the medicines and the death become linked in people's minds ("well my neighbor/friend/family member got tested and starting taking those drugs and she died, so there's no way I'm going to do that").

"New York City has highest rates of HIV/AIDS with 82 out of 100000 people in Manhattan, 75 in Bronx, 46 in Brooklyn, 26 in Queens, and 16 on Staten Island. Although Manhattan has the highest number of disease cases, Bronx has the highest number of death cases associated with the disease: 37 out of 100000 people in Bronx, 21 in Manhattan, 19 in Brooklyn, 8 on Staten Island, and 6 in Queens." reports eMaxhealth in the story Bronx Gets Free HIV Tests.

Source: Reported by Muli Bwanji http://lil-mzungu.blogspot.com/