Bay Area Reporter - November 24, 2005
Bob Roehr

However, the rate dipped about 5 percent among blacks and increased among men who have sex with men. Those findings were based upon data from 33 states that use names-based reporting of HIV diagnoses.

This is the first time that the CDC has included data from New York, which has about 20 percent of the national burden of HIV infections. It does not include numbers from states that do not report diagnoses by name, such as California and Illinois, as the CDC believes that other systems are not as reliable.

Ronald O. Valdiserri, acting director of the CDC's National Center for HIV, STD and TB Prevention, said 38,685 people were newly diagnosed with HIV in those 33 states in 2004. That reflects both recent infections and those that occurred years ago. The CDC continues to estimate that about 40,000 Americans become infected with HIV each year.

"Over the four-year period, the rate of diagnoses did decline among African Americans by roughly 5 percent every year," Valdiserri said. "But in 2004, the rate of HIV diagnosis remained 8.4 times higher among African Americans than among whites."

Blacks constitute 51 percent of those diagnosed with HIV over the four-year period; whites 29 percent; Hispanics 18 percent; and other groups less than 2 percent.

Men who have sex with men (MSM) constituted the largest risk for transmission (44 percent) while MSM who also injected drugs added another 4 percent. Heterosexual transmission was 34 percent, and injection drug use as the only factor was 17 percent over the four-year period.

The decline in diagnoses among injection drug users "largely occurred in New York" and likely are attributed to comprehensive prevention programs, including needle exchange programs, said CDC epidemiologist Lisa Lee. This "may have also contributed to the decline in diagnoses among African Americans."

"Among men who have sex with men, diagnoses remained roughly stable for the first three years of the period, but increased 8 percent between 2003 and 2004," consistently across all races, Lee added. She warned that this increase among gay men could reflect "increases in risk behavior and syphilis." Valdiserri said it "could reflect increased HIV incidence, increased testing, or some combination of both."

Critics of the Bush administration would add other factors into the mix as well. They point to harassing audits of HIV prevention programs that serve gay men and a shift in resources to abstinence-only prevention programs. Far right groups also have undermined safe sex messages through vigorous attacks on the effectiveness of condoms at preventing infection.

"Clearly, the Bush administration's de-funding, de-prioritizing, and de-gaying HIV prevention programs has been nothing short of a disaster and we call upon Congress to act immediately to begin to address this tragedy," said Matt Foreman, executive director of the National Gay and Lesbian Task Force.

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