Continuing a steep decline first reported earlier this year, AIDS deaths over a nine-month period last year fell 19 percent from the same period in 1995, federal health officials said Monday.
Although the figures are encouraging, they continue to reflect disparities among various population groups. The sharpest decrease was among white men, while the number of deaths fell less dramatically among women, minorities and poor people who may lack access to the powerful and expensive new generation of AIDS drugs.
“We have entered a new era in the HIV epidemic, both in terms of treatment and prevention,” said Dr. Helene Gayle, director of the national center for HIV, STD and TB prevention at the Centers for Disease Control and Prevention in Atlanta.
The estimated number of deaths from AIDS from January to September of last year was 30,700, down from 37,900 during the same nine months of 1995, according to CDC statistics.
The greatest successes in reducing the incidence of AIDS have been among gay and bisexual men. However, Gayle pointed out that at least 40,000 new infections still are occurring annually and said “much work is left to be done.”
The growth rate of AIDS among women now outpaces that of men, and heterosexual transmission is the fastest-growing mode of spread, CDC said. Heterosexually transmitted cases are increasing by 15 percent to 20 percent annually compared with a rise of 5 percent or less among gay men and intravenous drug users, CDC said.
The decline in deaths is an acceleration of a trend first reported in February, when health officials said AIDS deaths had dropped 13 percent during the first six months of 1996 compared with the same period in 1995. That was the first recorded drop since the epidemic began in 1981.
“Dramatic progress has been made in preventing new infections and in slowing the progression of disease for those infected,” said Gayle, whose remarks were made at a special AIDS forum sponsored by the AIDS Action Council, a Washington-based lobbying and education.
Health officials said the continuing decline is linked closely to two factors: the new drug combination therapies, which include protease inhibitors - a powerful new class of antiviral drugs, and increased resources devoted to treatment and prevention.
However, public health officials have noted repeatedly that the drugs do not work for all infected individuals, and not everyone can get them. They can cost about $15,000 a year, a sum out of the reach of many whose insurance does not pay for the treatment or who are not eligible for public assistance.
“Social safety nets are collapsing,” Doug Nelson, executive director of the AIDS Resource Center of Wisconsin said at the AIDS forum.
Also, global health officials have been disappointed that the new drugs, so successful in this country, are unavailable or unaffordable to AIDS sufferers overseas, particularly in developing countries.
“As we continue to work to develop better treatment options, we must not lose sight of the fact that preventing HIV infection is the only way to reduce the burden of this disease,” Gayle said.
The biggest decline in deaths was recorded among men, with the number falling 22 percent. Deaths among women dropped 7 percent. Similar disparities exist among minorities, with deaths among whites dropping 28 percent, compared to 10 percent among blacks and 16 percent among Latinos.
The statistics, while encouraging, nevertheless “underscore the need for a concerted national effort to remedy the inequities that exist in access to federal HIV prevention programs and health care services - inequities which significantly contribute to the spread of HIV,” said Daniel Zingale, executive director of AIDS Action Council.
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