Progress against HIV; Viral spread slows, but some groups at high risk.
More than two decades into the global HIV/AIDS epidemic, there are some encouraging signs of progress in preventing the spread of the virus, but certain groups still have stubbornly high burdens of disease.
While 17,295 people are living with HIV/AIDS in Massachusetts, new cases are down, according to a new Massachusetts Department of Public Health report. From 2001 to 2004 there were 900 to 1,000 new diagnoses a year, but that fell to 886 in 2005 and dropped further to 744 in 2006. New diagnoses have declined among injection drug users and heterosexual men and women in the state. And condom use is up to 56 percent among gay and bisexual men, a jump from 36 percent reported in 2000.
Central Massachusetts has the highest proportion of women with new HIV infections in the state, at 37 percent of people in the region diagnosed from 2004 to 2006. Next highest are Northeastern and Western Massachusetts, where the proportion of women diagnosed with HIV was 35 percent.
"We have a fairly high rate of women being infected with HIV and AIDS as compared with other parts of the state," Joseph D. McKee, executive director of AIDS Project Worcester, said in an interview between World AIDS Day events yesterday. "Another phenomenon we have here is roughly 33 percent of women at the time of diagnosis not only have HIV, but already have AIDS."
Women may not have known they were infected with the virus that causes AIDS, meaning they haven't taken advantage of medical care that could prolong life, Mr. McKee said. They could also be inadvertently exposing other people to infection.
The stigma and discrimination still associated with homosexuality may be keeping people from getting themselves tested for HIV or from telling their partners about their risk of infection.
Information about the virus, first identified in 1981, is a powerful tool in stemming its transmission.
"We have no vaccine and we have no cure," Mr. McKee said. "All we have to stop the spread is prevention."
Prevention is also the focus of state recommendations for another group: men having sex with men.
Statewide, gay, bisexual and other men who have sex with men still account for more than half of HIV infections in Massachusetts, mirroring national trends reported earlier this year from the U.S. Centers for Disease Control and Prevention. That's despite only 4 percent to 9 percent of men in Massachusetts saying they have sex with other men.
"Although the overall new cases of HIV are significantly down and down in almost every population, they are pretty much staying the same in a steady-state epidemic among gay and bisexual men," Kevin Cranston, director of the state HIV/AIDS bureau said in an interview. "It's not in and of itself surprising. I would say it's more frustrating after 25 years and what is known about HIV and how to prevent it."
The report urges wider availability of condoms, more HIV screening, and further research into risk factors for becoming infected.
"We clearly know that behavioral change and getting people tested and into medical care is an effective way of addressing this epidemic," Mr. Cranston said. "We know gay men are using medical services well and using testing services in great numbers, but we have a lot of work to do still on the prevention side."
ART: PHOTO; CHART
CUTLINE: (PHOTO) From left, Luis Cantres, Itiel M. Febles and Alexis Santiago listen to speakers last night during a World AIDS Day service at United Congregational Church in Worcester. (CHART) Communities with highest rates of people living with HIV/AIDS
PHOTOG: (PHOTO) ED COLLIER (CHART) T&G Staff/VILAYPHET KRUOCH