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New AIDS Cases Show Decline in U.S.

Health: Incidence of disease among adolescents and adults fell 6% last year, the first drop since the epidemic was identified 16 years ago.


WASHINGTON — For the first time since the AIDS epidemic was identified 16 years ago, the number of newly diagnosed cases of the disease in adolescent and adult Americans declined last year, federal health officials reported on Thursday.

The incidence of the disease in people older than 12 fell 6% from 1995 to 1996, from 60,620 cases to 56,730 cases, the federal Centers for Disease Control and Prevention said.

The encouraging trend--going hand-in-hand with reports in recent months of dramatic drops in AIDS-related deaths--likely reflects the impact of powerful new drug treatments and prevention efforts that have prolonged symptom-free survival for those with the virus, health officials said.

The new CDC numbers represent individuals who developed clinically defined AIDS--that is, who experienced an AIDS-related infection or other symptom, or whose immune system CD4 cells have dropped to 250 or lower, or both.

The decrease has been reflected in Orange County as well, where AIDS diagnoses dropped from 563 in 1995 to 431 last year, according to the county Health Care Agency.

"That's wonderful information," said Ron Taylor, the agency's manager for HIV programs. But "those of us in this business are always afraid the public and legislators will interpret that kind of information as maybe now they can let up on their efforts. That isn't the case, of course, at all.

"This is just an incredibly wily virus," he said.

The figures do not represent a trend in the number of new infections; an individual can be infected with AIDS for years before developing symptoms.

Nor was all the news positive. The incidence of cases traced to heterosexual transmission continued to rise, jumping 11% among men and 7% among women.

James Loyce Jr., chief executive officer of AIDS Project Los Angeles, called this finding "a sober wake-up call to Americans that heterosexual AIDS is not a myth."

Still, health officials hailed the overall decline. "This is remarkable evidence that our efforts in prevention and treatment are allowing more people to live free of HIV while we are extending the healthy lives of those who are infected," Health and Human Services Secretary Donna Shalala said.

Dr. David Satcher, the CDC director and President Clinton's nominee for surgeon general/assistant secretary for health, called the new numbers an indication of progress on the AIDS front. But he added that working "to prevent new infections in the first place" should remain the first priority.

The CDC report found that:

* Among gay and bisexual men, newly diagnosed AIDS cases dropped 15% for whites, 8% for Latinos and 3% for blacks.

* Among all whites--men and women--the decline was 13%, while cases among all Latinos fell 5%. Among all African Americans, no change occurred in the incidence of cases between 1995-96.

* By region of the country, AIDS incidence declined 12% in the West, 10% in the Midwest, 8% in the Northeast and 1% in the South.

* Among the new cases traced to heterosexual transmission, the greatest proportionate increases occurred among African American men (19%), Latino men (13%), and African American women (12%).

Dr. Helene Gayle, a CDC official, said the changing trends in AIDS transmission demonstrated by the figures would likely alter the way the federal government tracks the epidemic. "We must improve our ability to monitor HIV infection to effectively determine evolving patterns . . . so that we can appropriately target resources for prevention and treatment," she said.

The CDC also reported that the number of people in the United States living with AIDS increased 11% between 1995 and 1996, an indicator that individuals with the disease are surviving longer. As of December 1996, Americans living with AIDS totaled 235,470.

While this is generally regarded as positive news, it also means "there will be more people to take care of," one CDC official said.

Despite the recent flood of decidedly upbeat news concerning the disease, AIDS experts and activists repeatedly have cautioned that the benefits of the new drug therapies could be short-lived and that no one should assume the crisis has ended. But many scientists believe that understanding gained during this period could lead to even better treatments.

"I think that the length of the benefits will vary from patient to patient, but we'll see better results as more drugs come along and we learn how to use them," said Dr. Robert T. Schooley, an AIDS specialist at the University of Colorado Health Sciences Center.

Doug Weiss, executive director of The Center--Orange County, a 25-year-old agency that offers HIV information and other services to the county's gay and lesbian community, said the CDC report "clearly makes a statement about the effectiveness of new treatments, for people who have access to them."

But because these treatments--sometimes referred to as medication cocktails--can cost up to $20,000 a year, not everyone can get them, at least not without insurance or some form of government help, he said.

"But the cost of treatments is far less than someone having to go on public assistance for treatment and housing," Weiss said.

Times staff writer Steve Carney contributed to this report.

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