Pubdate: Fri, 25 Apr 1998 Source: Seattle-Times (WA) Contact: http://seattletimes.com/ Author: Rick Weiss, The Washington Post HIV STILL SPREADING IN U.S. WASHINGTON - Although the number of new AIDS cases in the United States has declined substantially in recent years, HIV continues to spread through the population essentially unabated, according to data released yesterday by the Centers for Disease Control and Prevention. The first direct assessment of HIV infection trends shows that the recent decline in U.S. AIDS cases is not the result of a notable drop in new infections. Rather, improved medical treatments are allowing infected people to stay healthy longer before developing full-blown AIDS, masking the reality of an increasingly infected populace. "The findings of this report give us a very strong message, that mortality may be going down - therapy is working - but HIV continues its relentless march into and through our population," said Thomas Quinn, an AIDS specialist at the National Institute of Allergy and Infectious Diseases. "These data tell us we have a lot of work to do." The findings also confirm previously identified trends showing that women and minorities are increasingly at risk. Especially worrisome, officials said, is that the annual number of new infections in young men and women 13 to 24 years old - a group that has been heavily targeted for prevention efforts - is virtually unchanged in recent years. "It certainly documents that we have ongoing new infections in young people," said Patricia Fleming, chief of HIV/AIDS reporting and analysis at the CDC in Atlanta. The report also shows continuing high numbers of new infections among intravenous drug users, a population that has recently been the focus of a political debate over the value of needle-exchange programs that offer drug users clean syringes to prevent the spread of HIV, the virus that causes AIDS. CDC officials would not comment directly on President Clinton's controversial decision earlier this week to extend a ban on federal funding of needle exchanges. But both Fleming and Quinn said that current AIDS prevention programs in this population need to be improved. Yesterday, international financier George Soros offered $1 million in matching funds to support needle-exchange programs around the country. The new figures, in today's issue of the CDC's Morbidity and Mortality Weekly Report, are based on HIV test results compiled by 25 states from January 1994 to June 1997. They indicate that the number of new infections during that period remained "stable," with just a "slight" decline of 2 percent from 1995 to 1996, the most recent full year included in the new analysis. By contrast, deaths from AIDS declined 21 percent in 1996 and dropped 44 percent in the first six months of last year. From 1995 to 1996, the number of HIV infections increased 3 percent in women. And it jumped 10 percent in Hispanics, although officials said that figure was imprecise. Infections declined by 2 percent in whites and 3 percent in African Americans. All told, the study tallied 72,905 infections during the survey period. The number nationwide is much higher, as participating states account for only about 25 percent of U.S. infections. The new figures don't include California and New York. The survey is the first to track infection trends by looking directly at HIV test results in people coming to clinics and other health-care outlets. That's a major change from the previous system, in which officials simply estimated the number of new infections by counting the number of people newly diagnosed with AIDS. With drug therapies now slowing disease progression, however, the number of new AIDS cases no longer reflects the number of new infections, and public health officials were becoming uncertain about how they were doing in prevention efforts. The new reporting system, now spreading to other states, has helped officials regain those bearings, Fleming said. And although everyone wishes the numbers were more encouraging, she said, at least officials now have a clearer picture of the task at hand. Information from The Associated Press is included in this report.