Advocates, Officials Respond to CDC Data Showing 2.2% Increase in Number of AIDS Cases, Increase in HIV Among MSM
HIV/AIDS advocates and officials are calling for "renewed efforts" aimed at preventing the spread of HIV after the CDC's announcement yesterday at the 2003 National HIV Prevention Conference in Atlanta that there was a 2.2% overall increase in the number of new U.S. AIDS cases in 2002, the San Francisco Chronicle reports (Heredia, San Francisco Chronicle, 7/29). The CDC yesterday also announced that the number of new HIV diagnoses among men who have sex with men rose for the third consecutive year in 2002, increasing 7.1% from 2001 to 2002. The data, which were collected from 25 states that have long-standing HIV reporting systems, support recent findings showing that MSM remain at high -- and perhaps increasing -- risk for HIV infection. HIV diagnoses among MSM have increased by 17.7% since the lowest point in 1999; however, HIV diagnoses among other high risk groups have remained stable since 2001. In addition, the CDC announced a 5.9% drop in AIDS-related deaths. The data suggest an ongoing plateau in the progress made in the fight against AIDS following the introduction of highly active antiretroviral treatment in the mid-1990s. The stability could be due to several factors, including treatment failure, difficulty in adhering to treatment regimens and late diagnoses delaying treatment initiation (Kaiser Daily HIV/AIDS Report, 7/28).
Dr. Harold Jaffe, director of the CDC's National Center for HIV, STD and TB Prevention, said, "Our biggest concern is what appears to be a resurgent epidemic in gay men. ... Some of it may be related to treatment optimism: 'So what if you get infected? You can get treated.' Some of it may be related to the belief that if you are in treatment, you may not transmit the virus. Some may be epidemic fatigue -- being tired of hearing about it." Jaffe added, "I think the most compelling reason is that people aren't scared anymore. If you were a gay man in the 1980s, you were scared. You had a lot of friends who were sick and dying. If you are a gay man today, you don't have a lot of sick peers" (Stein, Washington Post, 7/29). Pete LaBarbera, an analyst with Concerned Women for America's Culture and Family Institute, said, "The safer-sex message is not working. If gay men haven't heard of HIV and health risks, nobody has," adding that despite the "millions" spent on HIV/AIDS education, "the reckless behavior continues." The "CDC and federal government [should] research the particular health risks associated with gay sex," LaBarbera said, adding, "The federal government studies the health risks of smoking. Maybe there needs to be some public education on the risks (of homosexuality)" (Wetzstein, Washington Times, 7/29). "Frustration with increased HIV diagnoses among gay and bisexual men should not cause us to grasp for seemingly easy prevention solutions or to place blame," Craig Thompson, executive director of AIDS Project Los Angeles, said, adding, "HIV prevention needs for gay and bisexual men in the United States in 2003 are exceedingly more complex than the 'A, B, C' strategy of abstinence, being faithful and using condoms highlighted during President Bush's recent trip to Africa" (APLA release, 7/28).
"HIV/AIDS continues to be a major threat to America," Dr. Ronald Valdiserri, deputy director of NCHSTP, said, adding that efforts based on the CDC's new prevention strategy are "critical to reducing new infections" (McKay, Wall Street Journal, 7/29). Under the new strategy, which was announced in April, the CDC plans to shift funding from traditional prevention programs to initiatives that offer testing and counseling for HIV-positive people (Kaiser Daily HIV/AIDS Report, 7/28). David Munar, director of public policy for AIDS Foundation of Chicago, said, "This is an enormous shift. Our big concern is that this program won't reach populations that are disenfranchised from the health care system" (Wall Street Journal, 7/29). Larry Kessler, founding director of the AIDS Action Committee, said, "We're far from where we were prior to 1996 when we were having two deaths a day, but we're seeing two every week or 10 days." He added, "The disease is far from whipped. We have to make sure the research keeps evolving and that people have access to really good health care" (Dembner, Boston Globe, 7/29). Valdiserri said that the data serves as reminder that "the only truly effective protection against [the] consequences of AIDS is to prevent HIV infection in the first place" (Lorge, Atlanta Journal-Constitution, 7/29). "We continue to sound this warning note to communities and state and local health departments that we need to redouble our (prevention) efforts. ... We're not finished with the war," Valdiserri said (San Francisco Chronicle, 7/29).
A kaisernetwork.org interview with Jaffe is available online, along with webcasts of select conference sessions. Jaffe said of the data released yesterday, "Our feeling is that even though we've been at this plateau for a while ... that's not really good enough. We've got to rethink a lot of our prevention strategies, and we need to target better if we're going to reduce the number of AIDS cases" (kaisernetwork.org, 7/28).