WASHINGTON – New cases of HIV have fallen for several years in Maryland, evidence that prevention efforts have paid off, said an official with the Maryland AIDS Administration.
The number of newly diagnosed cases fell from 2,374 in 1999 to 1,977 in 2003, the latest year for which figures are available from the administration. Colin Flynn, the administration’s chief of epidemiology and health services research, called the shift “statistically significant.”
“We are confident that it is declining and that it’s not due to random fluctuations in the data,” Flynn said.
He said the decline began in 1999, the same year that the administration began a campaign in northwest Baltimore “to interrupt the transmission of HIV” by getting people tested and treated, and expanding needle-exchange services.
But while the number of new HIV diagnoses is declining slightly, the number of AIDS cases in the state remains high. A person with HIV has been infected with the virus that causes AIDS, the ultimately fatal disease that weakens the body’s immune system.
The Centers for Disease Control and Prevention said Maryland had the eighth-highest number of new AIDS cases in the nation in 2003, with 1,570 diagnosed that year, and 10th-highest cumulative number of cases, with 26,918 cases through that year.
The Kaiser Family Foundation said Maryland also had the fourth-highest rate of AIDS cases in 2003, with 28.5 cases per 100,000 population.
“AIDS cases have been relatively constant in terms of numbers and demographic composition,” Flynn said. “But there is a small decline of new HIV infections in the last couple of years.
An AIDS count is “a very old picture of what’s going on,” he said. “It takes eight to 10 years for AIDS to develop for one who is not receiving treatment and longer for one who is.”
That is why he said it is important to consider the numbers of new HIV cases, not merely AIDS numbers, when assessing the state’s health issue.
Glenn Clark, director of the Whitman-Walker Clinic of Suburban Maryland, agreed that “it makes sense to look at both numbers.”
HIV numbers reflect the success of prevention efforts, while AIDS cases measure the efforts to get proper treatment for people with HIV, Clark said. His clinic works in communities that are of high risk of contracting HIV, such as African-American heterosexuals and male homosexuals, Latino gay men and the city of Baltimore.
But Clark stressed that other factors also need to be taken into account.
“There are a number of factors to look at — the viral load, T-cell count, associated illnesses and rates of hospitalization,” he said.
The challenge with HIV statistics is that people carrying the virus must be examined. “There are still a lot people who aren’t getting tested,” Clark said.
Wendy Briscoe, senior health educator at Whitman-Walker, said that as testing methods improved over the years, by making the process painless and convenient, more people have been willing to get tested.
“A lot of people are afraid of needles” and are less eager to be tested, Briscoe said.
Instead of drawing blood, people can now choose to be tested by getting a finger prick or a mouth swab, she said.
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