Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
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San Francisco Examiner - July 09, 2000
ULYSSES TORASSA, EXAMINER MEDICAL WRITER
On the eve of the opening of the 13th International AIDS Conference here, the U.S. Centers for Disease Control and Prevention announced the results of a survey of nearly 3,500 men ages 15 to 22. Subjects were recruited at gay bars, nightclubs and social events in the Bay Area and six other urban areas. The rates of infection ranged from 12.1 percent in New York to just 2.2 percent in Seattle, with the Bay Area reporting a 6.2 percent rate.
Infection rates were higher for African Americans, Latinos and people of mixed race. Only 18 percent of those who were infected knew it. Close to half of those infected reported having unprotected anal sex in the past six months. The full report is being published in the July 12 edition of the Journal of the American Medical Association.
"We cannot allow the next generation of young gay men to suffer HIV infection as a rite of passage," said Helene Gayle, the CDC's director for HIV, STD and TB prevention. "On the one hand we've made considerable progress. But what we've got to ask ourselves, in light of the evidence, is whether the gains will be maintained and can we do even better?"
Also troubling to Gayle is recent data showing a doubling in the rate of gonorrhea among people with HIV - indicating they are having unprotected sex with greater frequency than before. And last month it was revealed that the San Francisco Department of Public Health has documented a threefold increase in the percentage of men showing up at sexually transmitted disease clinics who test positive for HIV.
"I'm scared of the trends we are beginning to see," Gayle said. "It scares me to see a doubling of the rates of gonorrhea in people who are HIV-infected." Public health officials have been worrying openly for the last year about the troubling signs, which include the emergence of so-called "barebacking" parties where men gather to have unprotected anal sex, and the increased use of party drugs, also linked to unsafe sex.
Gayle said the lack of progress is due to complacency among people who think HIV has been conquered by anti-retroviral therapies, even though such therapies are beginning to fail a significant number of patients. The agency is also reporting at this week's conference that more than half of patients on highly active anti-retroviral therapy see the benefits erode after a year. Patients are having to switch regimens frequently to keep the virus in check.
The latest figures are a further disheartening note at the beginning of the conference, which for the first time is being held in the developing world, where 95 percent of AIDS cases exist. If Western nations with their vast scientific and health resources can't eliminate the spread, it doesn't bode well for African nations trying desperately to stem their own, far worse, epidemic, Gayle said.
"In the United States, we already have the tools we need to end HIV as a public health threat," she said. "We as a nation ought to set an example." Also on Saturday, the CDC released new figures indicating that 4 million to 5 million Americans are at a high risk for getting HIV. High risk was defined as having six or more sexual partners in the last year, having sex with people known to have HIV, exchanging sex for money or drugs, using crack cocaine, injecting drugs during the past three years and having male-to-male sexual contact.
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