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Increase in AIDS Cases
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By ED SUSMAN
LOS ANGELES, Feb. 28 (UPI) -- The AIDS epidemic in the United States has taken at least a temporary turn for the worse, health experts said this week.
"After years at a plateau of 40,000 new AIDS cases a year, there were 45,669 cases estimated in 2005 by the Centers for Disease Control and Prevention," said Harold Jaffe, a professor of medicine at Oxford University in England who spent 27 years at the CDC investigating the AIDS epidemic from its very beginnings in 1981.
Jaffe, in a lecture a the 14th annual Retrovirus Conference in Los Angeles, said the U.S. AIDS epidemic shows no signs of waning, and he called for a renewed attention to ways of preventing new infections with human immunodeficiency virus, the microbe that causes AIDS.
"Taking a realistic approach to HIV prevention, we have to use science rather than moral judgments, religious beliefs or wishful thinking," Jaffe said at the conference.
Jaffe suggested that abstinence-only programs, being promoted to tune of $200 million -- about the cost of one day's expenditure in Iraq -- by the Bush administration, have had little impact on keeping teenagers from engaging in sexual activity, although he noted that further studies are ongoing.
He said the total accumulated number of AIDS cases in the United States has reached 988,376 since the epidemic was recognized in 1981, and of those cases, 550,394 people have died, including nearly 5,000 children. The figures are for cases in the United States and its territories, including Puerto Rico, Virgin Islands and Pacific islands.
Jaffe said AIDS mortality rates in the United States are "twice that of any nation in the European Union and are 10 times that of the United Kingdom."
"We have known for a long time that the rates in the United States are higher than those in Europe," Robert Janssen, director of HIV/AIDS prevention at the CDC, told United Press International. "There are major differences between the epidemics in the U.S. and in Europe, so it is difficult to understand why there are such differences."
Jaffe, speaking to about 4,000 researchers and clinicians, noted that recent studies of sexual activity among men who have sex with men show worrisome behavior. He said one recent study found that 47 percent of that population had unprotected anal intercourse, and 11 percent of such men said that their last sexual experience occurred with an individual whose HIV status was unknown.
Men who have sex with men comprise about half of the people in the United States with HIV/AIDS.
Jaffe also noted that no federal government administration -- Democratic or Republican -- has ever spent a penny on needle-exchange programs that might interrupt part of the battle against the spread of HIV. About 14 percent of HIV cases in the United States occur in the injecting drug user population.
However, Janssen said that HIV rates among injecting drug users have been steadily declining due in part to changes in the behavior of the drug users themselves, and by changes in pharmacy laws in some states to allow easier access to clean needles.
He added that many states and cities and non-governmental organizations have set up needle exchanges.
"We have seen that needle-sharing among injecting drug users now involves just one other person," he told UPI. "Previously, large groups of people would share one needle."
However, Janssen said AIDS cases in the United States has been increasing since 2001, although he suggested that the final figures would be somewhat less than the 45,000 Jaffe mentioned. Janssen said that about 1 million people in the United States are living with HIV or AIDS, but 25 percent of those people are unaware of their HIV status.
Jaffe noted that the 45,000 new AIDS cases in 2005 represented a more than 10-percent increase over 2004. Janssen said he thought the numbers would turn out to be a bit lower.
He said that major advances during the course of the epidemic have virtually eliminated transfusion-borne infections. "Early in the epidemic, the rate of transfusion caused AIDS was about one in 100; now, with better testing, it is one in 2 million," he said.
He also cited the ability to reduce the United States' cases of mother-to-child transmission of HIV from nearly 900 cases a year to fewer than 100.
Jaffe said the goal of prevention efforts requires changing human behavior. "Changing human behavior is hard; changing human sexual behavior is even harder," he said.
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