Washington Blade - August 24, 2001
Eric Erickson

"This is not the time for us to declare any kind of victory in terms of HIV prevention," said Dr. Ronald Valdiserri, deputy director of the Centers for Disease Control & Prevention's National Center for HIV, STD & TB Prevention. "We obviously made some really significant successes. We're really at a critical juncture in terms of continuing forward with these successes."

Researchers at the conference discussed the trend of new HIV and AIDS cases leveling off and an increase of risky sexual behavior among men who have sex with other men, as well as an increase of sexually transmitted diseases other than HIV.

Another startling statistic showed that almost half of people infected with HIV don't know their status until just before developing full-blown AIDS, causing them to miss out on almost a decade of important treatment.

Many of the speakers at the conference pointed to these studies as possible proof that the United States is on the verge of a dramatic increase in the number of people infected with HIV.

"When you begin to connect all the dots, it is not unreasonable to believe the CDC's analysis of this data," said Cornelius Baker, conference speaker and executive director of Whitman-Walker Clinic.

But while the CDC is crunching the numbers and looking ahead to an upswing in the epidemic, some AIDS activists accused the government of being "alarmist" with the predictions.

"The CDC is grasping at straws," said gay author and activist Andrew Sullivan. "There are so many variables out there right now, it's almost impossible to know what's going on. I'm afraid I've become highly skeptical of the CDC in all this. Their recent track record of scare-mongering and headline-seeking is truly saddening."

Baker said he disagrees with activists questioning statistics that speak to an HIV resurgence.

"I find it ironic that 20 years into the epidemic, we're now accusing the government of overreacting, when all of this began because the government didn't react enough," Baker said. "When you hear people saying 'they're alarmist,' when you look at the health statistics and racial disparities in health in this country, the problem is we're not being alarmist enough."

Valdiserri said one reason the CDC presents statistics that show a new tide of HIV infections is because prevention methods are often overshadowed by news of new medications to fight the disease.

"When we talk about prevention being lost in the mix, what we're referring to is the American public and perhaps even policy makers in American society who have really become very focused on the improvement in treatment advances," said Valdiserri. "We also want to remind people the best way to cure HIV is never get it in the first place."

While the CDC said statistics suggest a resurgence of infections, another AIDS activist argued the numbers are not solid enough to predict trends in the epidemic.

"[The CDC] doesn't have a lot of hard verifiable statistics at this point," said activist Michael Petrelis. "At the same time, they keep getting these hysterical stories planted. If you come along and ask the question, 'Can you prove your data?' They'll say 'No, it's preliminary, we've got to keep studying the problem.'"

Another question raised at the conference is why there may be an impending increase in the number of HIV infections despite a variety of aggressive HIV treatments on the market.

Baker suggested an increase in risky behavior among gay men could be one reason for an increase in HIV infections. He also said people living with HIV are healthier than ever before and therefore may be more apt to participate in sexual activities. He pointed to the number of syphilis cases reported as evidence to support his theory.

"We have a healthier population that is engaging in sex that can lead to greater risk," said Baker. "In some cities, around 87 percent of the people who contacted syphilis were also people with HIV."

Yet not everyone believes such statistics point to a possible increase in the number of HIV cases.

"I'm an optimist," said Sullivan. "I think that the reason we have not seen a new explosion in HIV transmission is probably related to the fact that most HIV-negative guys are still, more or less, using condoms. And that many HIV-positive guys have such low viral loads that they are not very infectious, and that when they have condom-free sex, they tend to do so with other HIV-positive guys."

Despite any controversy, Valdiserri called the conference a success. Almost 2,700 doctors, researchers, activists and prevention counselors attended the conference-1,000 more than attended the last prevention conference two years ago.

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