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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United Press International - Saturday, 8 July 2000
Ed Susman, UPI Science News
The report from the Center for Disease Control and Prevention (CDC), Atlanta, was presented at a special press briefing of the American Medical Association in conjunction with the XII International AIDS Conference in Durban, South Africa.
"We (may) have another generation of gay men suffer though HIV infection as a right of passage,'' said Dr. Helene Gayle, director of the National Center for HIV, STD (sexually transmitted disease) and TB (tuberculosis) Prevention at CDC. "These new figures do paint a picture of a real potential for resurgence."
Gayle said increases seen in high-risk activity -- unprotected sex and injecting drug abuse -- lead to increased sexually transmitted diseases and then to AIDS.
"Despite the dramatic benefits new treatments have had in extending the lives of individuals with HIV, the overall shortfalls of AIDS treatments are becoming increasingly apparent, and HIV infection and risk behavior continue at levels far too high," said Gayle. "Now more than ever, it is critical that we expand successful HIV prevention programs to bring infection rates down."
Gayle said that since July 1998, the number of AIDS deaths and new cases of the disease have remained steady at about 12,000 deaths and 40,000 new cases a year. Before then, deaths had steadily declined since 1993; and cases of AIDS had been declining since 1995 as combination therapy for HIV infection became the standard of treatment for the disease.
She said the lack of progress in further reducing AIDS statistics is likely caused by: treatment failures, the fact that most people who would benefit from treatment are already being served, the lack of early testing and treatment for some infected individuals and difficulty in adhering to new treatment regimens.
In addition, Gayle said, "I am scared by the trends we are seeing. I'm scared when we see increases in rates of sexually transmitted diseases; I'm scared when I see rates for gonorrhea among gay men increasing; I'm scared when I see the rates of AIDS cases in San Francisco -- which have been declining for six years -- rise again."
Gayle said that even the stable rates are troublesome.
"Stable means that some rates are going up and others are decreasing. I'm concerned that the AIDS cases among young women are increasing," she said.
"We estimate that we need $300 million a year more in AIDS prevention programs in order to reduce new cases of AIDS by 2005, our new national goal," Gayle said. "In the scheme of things that is not a lot of money and the cost of inaction is great."
By contrast, Dr. Peter Piot, executive director of UNAIDS, said that in order to get a handle on the out-of-control epidemic in Africa -- where 25 million people live with AIDS -- would cost $3 billion. "That's what is needed for basic care and prevention," Piot said at the AMA briefing, "before we even consider the issue of combination therapy." He said African nations spend just one-tenth of that amount.
In the United States, an estimated 850,000 people are living with HIV/AIDS. However, Gayle said that as many as 5 million Americans are at risk of AIDS due to risky behavior.
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