Wall Street Journal - August 4, 2008
Marilyn Chase

MEXICO CITY -- Activists voiced anger over delays in the release of a report that the number of people infected with AIDS in the U.S. each year is likely 40% higher than previously estimated.

The Centers for Disease Control and Prevention said at a conference here that 56,300 people in the U.S. are likely infected with AIDS each year, up from previous estimates of 40,000. The Wall Street Journal reported in December, citing researchers and officials, that the CDC was likely to report a jump in the number of estimated infections. But the agency at the time declined to comment. Citing a need for peer review of the study, the CDC waited to publish its report in this week's Journal of the American Medical Association.

The data underscore that the AIDS epidemic isn't over anywhere in the world, said Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS. He expressed disappointment in the delay over releasing the CDC figures, adding, "timely information is important for prevention."

Activists note that any rise in AIDS infections should be met with stepped-up prevention, testing, counseling and community outreach to at- risk groups. They bemoan the delay in the release of the findings, noting that during this time, budgets could have been raised and programs launched.

*Video - At the International AIDS Conference in Mexico City, Kevin Fenton of the U.S. Centers for Disease Control and Prevention says new HIV infections in the U.S. is higher than previously estimated. He discusses the CDC's prevention strategies. (Aug. 4) Please click here to view video.

"Science-based AIDS prevention means having access to accurate data about how many people are becoming infected," said Kate Krauss, a spokeswoman for Physicians for Human Rights in Cambridge, Mass. "Without it, we are shooting in the dark."

The figures underscore that it is "imperative" to redouble prevention and testing efforts to relieve the "particularly devastating" burden of AIDS on minority youth, said Donna Futterman, director of the adolescent AIDS program at the Children's Hospital at Montefiore in the Bronx, N.Y.

Public-health and gay-community leaders have warned that modern treatments for the HIV virus have lulled the young to let down their guard. "The new HIV meds are so good [that] the result is less caution when having sex," said New York activist and playwright Larry Kramer.

Higher infection rates were discovered by the CDC's new blood-test technology, which can distinguish new infections from older ones based on changes in the kinds of antibodies, or natural infection fighters, that the human immune system makes to battle the virus.

Kevin Fenton, director of CDC's National Center for HIV/AIDS Prevention, said the higher infection rate wasn't believed to reflect a sudden spike, but apparently has smoldered for a decade undetected by older testing and sampling methods.

Dr. Fenton defended the timing of the report, which was finished in October and submitted to JAMA in November. "This is breakthrough technology," he said. "This wasn't a simple editorial."

About 33 million people world-wide are living with HIV and AIDS. The U.S. total of 1.2 million people -- estimated in 2003 -- will likely swell with the rising tide of new infections. About a quarter of Americans with HIV still don't know they are infected, despite a push by CDC to make testing a routine for Americans of ages 13 to 64 years.

The latest CDC report says African-Americans suffer seven times the risk of infection that whites do, because of poverty, gaps in care, drug use, incarceration and a stigma in the community that discourages testing and treatment. Hispanic Americans have three times the risk that whites have, Dr. Fenton said.

The U.S., while increasing its multiyear commitment to helping control AIDS abroad to an unprecedented $48 billion, has flagged in its commitments at home, critics in Congress said.

"The HIV epidemic within our own borders is even worse than we had believed," said U.S. Rep. Henry Waxman, D., Calif. Yet, he said, the CDC's prevention budget has shrunk 19% since 2002 when adjusted for inflation, and has been "hindered by politics and ideology."

The Bush administration -- while surpassing its predecessors in overseas AIDS funding -- has promoted abstinence as a centerpiece of prevention. Many AIDS researchers have said this is unrealistic in places where poverty and cultural coercion or violence force premature intimacy.

Dr. Fenton argues that the U.S. approach to prevention includes more than abstinence, with programs, for instance, targeting the spread of the disease through hookups arranged on the Internet by offering online notification of partners. The new CDC figures, Dr. Fenton said, "are a wake-up call, to reflect the crisis in our midst, and bring it to an end within our lifetime."

He said the latest study was based on a new methodology called Starhs (serological testing algorithm for recent HIV seroconversion), which uses a novel blood test known as BED to sample antibody patterns made by newly infected people.

Write to Marilyn Chase at marilyn.chase@wsj.com

080804
WJ080801

Copyright © 2008 - The Wall Street Journal. Reproduction of this article (other than one copy for personal reference) must be cleared through the WSJ Permissions Desk.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 2008. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2008. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .