AEGiS-WSJ: Rise in HIV Cases Stirs Fears of a Resurgence: Diagnoses of HIV Rise Among Gays, Bisexuals

Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Rise in HIV Cases Stirs Fears of a Resurgence: Diagnoses of HIV Rise Among Gays, Bisexuals

Wall Street Journal - July 29, 2003
Betsy Mckay, Staff Reporter of The Wall Street Journal

ATLANTA -- The number of gay and bisexual men diagnosed with the AIDS virus rose in 2002 for the third year in a row in the U.S., fueling concerns about a potential resurgence of the disease and a growing debate over the federal government's plans for fighting it.

After steady declines during the late 1990s, diagnoses of HIV, the virus that causes AIDS, rose 7.1% in 2002 among men who have sex with men, according to data collected by the U.S. Centers for Disease Control and Prevention in 25 states with longstanding reporting records. While rates of diagnoses remained fairly stable among other groups considered vulnerable to the disease, such as intravenous drug users, diagnoses climbed 17.7% among gay and bisexual men since hitting a low point in 1999, the agency said.

The upward trend suggests those most at risk may be growing complacent about contracting the deadly virus. "HIV/AIDS continues to be a major threat to America," Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention, said at an HIV prevention conference in Atlanta. He cited improved treatment and outdated prevention messages among some possible causes for the rise in diagnoses. Whether the trend is representative of the entire U.S. population isn't completely clear, the CDC said. The increased diagnoses, while consistent with earlier findings, could be due in part to an increase in the number of people getting tested, the agency said. The numbers also don't include some states with high HIV prevalence, such as New York and California.

The new data comes as AIDS activists increasingly are critical of the federal government's new plan for attacking the spread of the virus, which they say is skewed to prevention among people who already have the AIDS virus. The four-point plan, announced in April by CDC Director Julie Gerberding, focuses federal funding on routine HIV testing for high-risk groups and pregnant women, as well as improved prevention counseling for HIV-infected people and their partners. Proposals include training doctors to talk with their HIV-positive patients about safe sex, and making an HIV test that gives results in a matter of minutes more widely available.

About one-quarter of the 850,000 to 900,000 people in the U.S. infected with HIV don't know they carry the virus, the CDC says.

While praising those moves, some activists warn they may come at the expense of prevention programs targeting uninfected people, such as promoting the most effective use of condoms among high-risk populations.

Such programs have been effective in preventing the further spread of HIV, they say.

"This is an enormous shift," said David Munar, director of public policy for the AIDS Foundation of Chicago, a nonprofit organization. "Our big concern is that this program won't reach populations that are disenfranchised from the health-care system."

Dr. Valdiserri, after releasing the new statistics, defended the federal government's HIV initiatives. "CDC is not abandoning prevention efforts" directed toward uninfected high-risk individuals, he said. But he said community-based organizations that are applying for federal funding are being asked "to put much stronger emphasis on getting people diagnosed early and into treatment."

"Efforts to increase the number of HIV-infected people who are aware of their HIV status and to link these infected individuals to testing, treatment and prevention services are critical to reducing new infections," he said.

HIV diagnoses among men who have sex with men rose 7.3% in 2000 and 2.4% in 2001. Overall, the number of people diagnosed with HIV rose 3.8% in 2002, to 16,968 from 16,352 in 2001. The CDC also said AIDS diagnoses rose 2.2% to 42,136 cases last year, but improved treatment helped the number of deaths decline 5.9%, to 16,371.

Write to Betsy McKay at betsy.mckay@wsj.com
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