United Press International - Sunday, July 7, 2002
Ed Susman, UPI Science News

However, doctors from the Centers for Disease Control and Prevention in Atlanta, Ga., said they are seeing troubling signs that might mean the rate of infections will rise once again.

Overall, researchers said, an estimated 800,000 to 900,000 people in the United States are infected with human immunodeficiency virus (HIV), the organism that destroys a person's immune system and eventually allows development of deadly infections.

Among the signs that worry epidemiologists, said Dr. Ron Valdiserri, deputy director of the CDC's National Center for HIV, Sexually Transmitted Diseases and Tuberculosis Prevention, are:

-- Outbreaks of other sexually transmitted diseases among men who have sex with men in several cities in the United States -- including Seattle, San Francisco, Los Angeles, Houston, Chicago, New York City, Washington and Miami.

"We have seen the rate of syphilis increase from about 2.2 per 100,000 in men in New York City in 1996 to 6.9 per 100,000 in 2001," Valdiserri said, "and most of those infections are occurring in men who have sex with men." While many of these men are already infected with HIV, he suggested that a rise in these infections may be a prelude to new HIV infections.

-- Self reports that show that among HIV-infected individuals, 67 percent consider themselves to be sexually active.

-- Of those who are sexually active, 57 percent to 75 percent of the individuals use condoms while having sex with either their steady partner or a non-steady partner.

Overall, among men who have sex with men, about 65 percent use condoms during sexual activity. Heterosexual men infected with HIV use condoms 70 percent to 75 percent of the time when engaging in intercourse. Valdiserri said that women are least likely to engage in sex that includes condom use -- 57 percent report condom use when having sexual intercourse with a steady partner; 62 percent with a non-steady partner.

-- The figures are based on data from 25 states, but the data include only about 25 percent of HIV/AIDS cases. Data were not included from states with large hot spots of presumed infections: California, New York and Florida.

Valdiserri said that maintaining the message of safe sex is difficult. "Some people are getting bored with HIV. They are tired of the prevention messages. Many of them didn't realize that when they became infected with HIV, they were signing on for a lifetime of condom use," he said at a press briefing sponsored by the American Medical Association.

"The patterns reported in the United States are similar to what we are seeing in Western Europe," said Dr. Peter Piot, an undersecretary general of the United Nations. "We are seeing these same types of sexually transmitted disease outbreaks." Piot is also executive director of the Joint United Nations Program on HIV/AIDS, also known as UNAIDS.

Piot, who also spoke at the press briefing, said that in recent years the AIDS epidemic has moved into a new era -- one in which AIDS treatment and prevention "has become a top political agenda item."

That has been manifested by commitments to spend $2.8 billion this year on AIDS prevention and treatment in underdeveloped countries.

But Piot said that to make a real impact on reducing the epidemic that threatens to take 68 million lives in 45 underdeveloped nations by the year 2020, at least $10 billion a year needs to be raised.
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