WASHINGTON – Maryland had the fourth-highest rate of new AIDS cases in the nation in 1998, up from sixth the year before, according to state and federal health officials.
While Maryland’s rate of new infections dropped by 13 percent in that period, it could not keep pace with drops in other states, despite state-of-the art healthcare for AIDS patients here, a “generous” medication program and two of the country’s top clinical programs.
Health officials attribute Maryland’s slower rate of improvement to the state’s mostly urban character and the fact that an unusually large number of its AIDS patients are drug users.
“AIDS is a major public health concern for us in the state. It is certainly under control,” said Liza Solomon, director of the AIDS Administration in the state Department of Health and Mental Hygiene.
Maryland had 8,650 people with AIDS in 1998, of which 1,629 were newly reported cases. That translates into an infection rate in 1998 of 31.9 new AIDS cases per 100,000 residents. That was down from the 1997 rate of 36.8 new cases per 100,000, according to the federal Centers for Disease Control and Prevention.
Yet New Jersey and Connecticut, which ranked above Maryland in 1997, moved lower in the list after bettering their rates by about 35 percent and 45 percent respectively.
Nationally, the AIDS rate fell 19 percent, from 21.8 newly reported cases per 100,000 residents in 1997 to 17.6 cases per 100,000 in 1998. The CDC attributes the drop in AIDS rates around the country to better medication, which is slowing down the onset of AIDS among HIV-positive people.
Maryland’s slower rate of decline may be due to the fact that an unusually large number of its AIDS patients are drug users, said Solomon. They are less likely to take advantage of the range of free medical services available to them, she said.
“Drug users are often unable or unwilling to take care of themselves,” Solomon said.
In Maryland, 43 percent of the AIDS cases are attributable to injectible drug use, as compared to 26 percent nationwide. The state AIDS Administration said that, from 1998 through 1999, injectible drug use was to blame for 41.6 percent of all new AIDS cases among men in the state and 40 percent of the new cases among women.
Drug use and AIDS are a particularly big problem in the Baltimore area, where 67 percent of the state’s new AIDS cases were diagnosed, according to health agencies. But Debra Wymer, a member of the AIDS Legislative Committee, said that concentration of cases does not necessarily make it easier to treat the disease in Baltimore.
The overwhelming poverty and lack of education in the city about AIDS made it harder for patients to access testing facilities and medical care, even when those services were present in sufficient numbers, said Wymer.
Solomon said Maryland has some of the latest treatments to provide care to AIDS patients, including the most effective medication yet in the battle against the disease — inhibitors. Protease inhibitors are anti-viral drugs used in the treatment of AIDS and HIV.
She added that the state has a generous medication program called MADAP — Maryland AIDS Drug Assistance Program — under which patients without Medicaid or other health insurance can get treatment for free. There are 77 publicly funded health care facilities in the state that treat AIDS patients or refer them to other facilities.
“We also have two of the best clinical programs in the country, at the Johns Hopkins University and the University of Maryland,” Solomon said.
Despite this, the disease is the leading killer of men aged between 25 and 44 years old in the state.
Michael Holder, director of the Maryland branch of the Whitman-Walker Clinic, said the presence of both Baltimore and Washington, D.C., contribute to the state’s high rate of new AIDS cases. The CDC said that Washington had the fourth-highest number of AIDS cases among all metropolitan areas in the country from 1997 to 1998.
Not coincidentally, the two Maryland counties with the largest number of AIDS cases in the state, Montgomery and Prince George’s, border the District. Nearly one-fourth of the total number of AIDS patients in the state live in these two counties.
“There is a great deal of contact between people in Washington and Baltimore,” he said.
Wymer said more efforts are needed to reach the poor in Baltimore if the state wants to control the spread of AIDS.
“There is a need for better education in schools because many people are infected with HIV while at school age,” she said.