Treatment Issues: Newsletter of Experimental AIDS Therapies - Volume 13, Number 5/6, May/June 1999

At the Centers for Disease Control's 1999 National HIV Prevention Conference in Atlanta, new data on AIDS deaths in the United States were released. In contrast with 1997, when a 42% decrease in AIDS deaths was reported, the decline from 1997 to 1998 was only 20%. Several reasons have been suggested for the decline including the fact that some people are not getting tested and treated for infection, they are infected with drug resistant strains of HIV, and they cannot adhere to complex, expensive, and sometimes unpleasant drug regimens. Dr. Helene Gayle of the CDC, who presented the data, noted that "in a period of only two years, new combination treatments cut the annual level of death in half, but it appears that on a population level, most of the benefit of new treatment has now been realized."

Women and minorities, especially African Americans, are especially hard hit: the declines in AIDS deaths for whites has been consistently better than that of African Americans, and that of men has been consistently better than that of women. African Americans, who make up 13% of the population, accounted for 49% of AIDS deaths in 1998, and their death rate is not decreasing as dramatically as whites. Mortality for African Americans is almost 10 times that of whites and three times that of Hispanics, and African American women are three times more likely to die of AIDS than either white or Hispanic women. Dr. Gayle argued that bringing the death toll down further would require an emphasis on HIV testing, combined with effective treatment and prevention services.

Dr. Mary Ann Chiasson of the New York City Department of Health reported that AIDS deaths in NYC declined from approximately 7,000 in 1995 to approximately 2,000 in 1998. However, she also noted that there were disparities based on race. 53% of NYC women with AIDS are African-American, and the decline in AIDS deaths among African American women was significantly smaller than that of white and Hispanic women. Moreover, gay and bisexual African American men were 2 to 3 times as likely to die from AIDS than white or Hispanic gay and bisexual men.

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