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It hasn't gone away

Rising HIV infection rates are causing worries about a resurgence of AIDS amid public complacency.

August 18, 2003|Jeannine Stein | Times Staff Writer

Marco Correa's wake-up call came last spring when a friend was diagnosed with AIDS. "He was this very cheerful person, and then all of a sudden he started getting sick," said the 27-year-old Los Angeles businessman. "They diagnosed him, and that opened my eyes."

Before that, Correa lived like many of his young peers, usually practicing safe sex but sometimes not. And like many of his friends, he felt invincible. "After my friend was diagnosed I went from one-night stands to no one-night stands," he says. "It's sad that I had to see it this way."

Federal health officials reported last month that the number of new AIDS cases was up for the first time in a decade. Along with a continued rise in new cases of HIV infection, the numbers are raising concerns that AIDS may be making a resurgence after years of progress had been made in battling it. Health experts are concerned that the statistics reflect a growing sense of public complacency about the disease, especially among homosexual and bisexual men. New HIV infection rates rose an alarming 7.1% among that group last year.

For years HIV cases were waning, a sign that prevention and education programs were getting through to the public. During that period there was also a dramatic reduction in AIDS deaths, which continued to drop last year despite the rise in HIV infection. But officials at the national Centers for Disease Control and Prevention fear that the HIV numbers may portend a rise in AIDS-related deaths years from now.

CDC officials say the increase in HIV cases cannot be attributed to a single group. However, officials are particularly concerned about younger Americans because regional data show that people in their 20s account for a sizable number of new diagnoses. Moreover, data show rising incidences of other sexually transmitted diseases in younger Americans, further suggesting that they are not heeding advice about condom use and the hazards of unprotected sex.

Experts said other possible reasons for the rise in HIV cases include the fact that more people are being tested, and an increase in substance abuse.


'People are still dying'

Many Americans in their late teens and 20s did not witness firsthand the devastation caused by AIDS in the 1980s and early 1990s. "They are not seeing in such a visible way the consequences of HIV and AIDS," said Darrel Cummings, 46, chief operations officer for the Los Angeles Gay & Lesbian Center. "One of the messages we need to make clear is the fact that people are still dying in huge numbers, and living with the disease can be a horrible experience."

None of this is news to Kent Dobbs, a 40-year-old former L.A. medical office worker who tested positive for HIV four years ago. As a volunteer for AIDS Project Los Angeles, he says it is sometimes difficult to get preventive messages through to younger men: "Oftentimes they'll say, 'I'm not at risk because I don't know anyone who's HIV positive.' " Dobbs remembers having a similar feeling of invincibility when he was younger. But during one year in the early 1990s, 36 friends of his died.

"I don't think sex and death are things your mind brings together very easily when you're 20," Dobbs says.

People with HIV are living much longer -- sometimes 20 years or more -- thanks to sophisticated drug regimens that have drastically reduced the risk of developing AIDS or dying from it. Magic Johnson, perhaps the most recognizable HIV-positive person today, looks fit and healthy in his public appearances -- and that may unintentionally be fueling a belief that HIV is not a big deal, despite Johnson's work in AIDS and HIV prevention.

And pharmaceutical companies have occasionally drawn criticism for advertisements that portray HIV-positive people as looking happy and healthy. A few years ago, AIDS activists and city officials in San Francisco were so upset at billboard ads that showed robust HIV-positive men in their 20s that they considered, but later rejected, a plan to ban the ads.

While it's true that AIDS therapies have been remarkably successful in helping many HIV-infected people to have longer and healthier lives, experts worry about an imbalance in the messages the public is hearing. After all, there is still no cure for AIDS, the medications can have severe side effects, and some patients' bodies are resistant to the therapies, said Dr. Ronald Valdiserri, deputy director of the CDC's National Center for HIV, Sexually Transmitted Disease and Tuberculosis Prevention. "The improvements in treatment are wonderful," said Valdiserri, "but unfortunately it minimizes the threat of HIV and AIDS. People say, 'Isn't that cured, like syphilis?' "

This suggests that despite the many millions the government is spending on AIDS prevention efforts, the message is not reaching everyone.

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