AEGiS-WSJ: Levels of HIV Infection, AIDS Fail To Decline in the U.S., Data Show

Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

Levels of HIV Infection, AIDS Fail To Decline in the U.S., Data Show

The Wall Street Journal - July 10, 2000
Ann Carrns, Staff Reporter

Levels of both HIV infection and AIDS continue to remain stable in the U.S., rather than dropping, and roughly five million Americans remain at high risk for HIV infection because of their sexual behavior and drug use, according to the latest federal health data.

Researchers with the federal Centers for Disease Control and Prevention in Atlanta released the data over the weekend, prior to the opening Sunday of the 13th International Aids Conference in Durban, South Africa.

The meeting's setting is aimed at highlighting the devastating AIDS crisis in Africa. But the CDC also warned that the disease is far from beaten in the U.S., where advances in treating AIDS with drugs has resulted in some complacency about prevention. That has officials worried about a resurgence of AIDS here among high-risk groups, such as gay men.

"Prevention is more critical than ever," said Helene Gayle, head of AIDS prevention for the CDC.

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If the U.S. is to meet a national goal by 2005 of cutting in half the number of new infections of the AIDS-causing HIV virus -- to 20,000 annually from 40,000 currently -- prevention efforts must be expanded, she said. She estimated that meeting that goal would cost government and private efforts an additional $300 million more a year than current spending levels.

AIDS cases and deaths fell dramatically in the past decade through mid-1998, due to testing and prevention efforts and the advent of powerful drug therapies but have remained roughly stable since then. The latest CDC data, from the first two quarters of 1999, confirm that the numbers continue to remain stable, at about 4,000 AIDS deaths and 10,000 AIDS cases diagnosed each quarter.

Dr. Gayle cited treatment failure, a lack of early testing and treatment for some people, and difficulty following new treatment regimens as contributors to the failure to further reduce the numbers.

Therapy with antiretroviral drugs is allowing millions of people to live longer with HIV infection, but shortcomings are becoming apparent. New data suggest patients must switch drug regimens more frequently to maintain the treatment's effectiveness, and that each change is effective for shorter periods of time. The best option, Dr. Gayle said, remains "living without HIV in the first place."

A new CDC analysis of data from several national surveys shows that at least 2% to 4% of the U.S. population, or roughly four million to five million people, remain at high risk for HIV. Those at highest risk include men who have sex with other men, prostitutes, users of crack cocaine or injection drugs, people who have six or more sexual partners, and those who have sex with partners known to be HIV-infected. Condom use has increased since the 1980s, but only 40% of unmarried people and 23% of drug users report using them.

A CDC analysis shows that HIV infection rates remain high among some populations, especially gay men. After declining during the 1980s, infection rates among gay men remained stable for the past decade, with rates of new infection averaging 1% to 4% annually. Rates are much higher among certain groups -- for example, among young gay men, and among those visiting clinics for treatment of sexually transmitted diseases. For African-American gay men treated at STD clinics, infection rates are as high as 11% a year.

Data show increases in bellwether sexually transmitted diseases among gay men in several cities. San Francisco health officials disclosed that HIV infections rose significantly in 1997-1999.

Write to Ann Carrns at ann.carrns@wsj.com2
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