San Francisco Chronicle - July 8, 2004
David Perlman, dperlman@sfchronicle.com.

"We are now concerned that our progress has stalled, and in some areas we may even be losing ground," Dr. George Lemp, director of the university's AIDS Research Program, said Wednesday.

Reported rates of unprotected sex, particularly among men who have sex with men, have increased recently, and among those men HIV infection rates have increased threefold, Lemp said in an interview. The discouraging trend followed many years in which infections by HIV, the virus that causes AIDS, had been dropping steadily, he said.

Although the number of California men being treated for injection drug use -- often accompanied by dangerous needle-sharing -- dropped from nearly 50,000 cases during the first AIDS panic year of 1982 to 40,000 in 2002, the number of cocaine and crack users seeking treatment nearly doubled in that same period -- from nearly 38,000 to more than 73,000, the state survey showed.

"And that's also a worrisome sign," Lemp said, "because the use of those drugs is so often accompanied by high-risk behavior."

Thanks to the more widespread availability and use of anti-retroviral drugs in recent years, the number of people living with diagnosed cases of AIDS has increased more than tenfold from 5,000 in 1987 to about 55,000 today, Lemp said. An estimated total of 127,000 men and women in California are living with signs of HIV infection, including those with AIDS itself.

According to State HIV Education and Prevention chief Drew Johnson, "Recent data indicate increasing infections among African Americans, Latinos and Native Americans. In these groups, women as well as men who have sex with men are most affected."

Unfortunately, firm statistics on increases in HIV infection rates as well as AIDS continue to be unclear, Lemp said, and three factors muddy the numbers:

-- One is an apparent increase in the numbers of men seeking sex partners on the Internet who often don't reveal whether they are positive for the AIDS virus.

-- Another is the number of African American and Latino men having sex with men who don't identify themselves as either gay or bisexual and therefore are unlikely to be reached by prevention programs focused on those communities.

-- And still a third problem muddying the effort to sharpen AIDS and HIV statistics -- and thus impeding prevention programs -- is the rising number of methamphetamine and cocaine users, among whom syphilis rates are increasing sharply without any obvious signs of increasing HIV infection rates among them.

"We may well be on the threshold of a new upsurge in overall HIV rates," Lemp said, "or it may already have arrived without our being aware of it. We're trying to get a firmer handle on it right now."

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