WIRE: 05/31/2001 4:57 pm ET

Study Notes Risk of AIDS Resurgence

By Paul Simao

ATLANTA (Reuters) - AIDS may be poised for a resurgence in the United States, especially among young gay and bisexual men, who are contracting the disease at rates similar to those at the height of epidemic in the mid-1980s, federal health experts warned on Thursday.

In a study released to mark the 20th anniversary of the emergence of the disease, the Centers for Disease Control and Prevention said an alarming number of gay and bisexual males between the ages of 23 and 29 were contracting HIV, the virus that causes AIDS.

The Atlanta-based federal agency said testing of nearly 3,000 young gay and bisexual males in six U.S. cities showed that 4.4 percent became HIV-positive each year between 1998 and 2000. The rate for blacks in the group was a staggering 14.7 percent, almost six times the 2.5 percent rate for whites.

"These are explosive HIV incidence rates," said Dr. Linda Valleroy, the CDC epidemiologist who led the study.

The CDC said insufficiently targeted health education programs, growing complacency in the wake of successful drug therapies and the stigma attached to AIDS patients could be fueling riskier behavior among young gay and bisexual males.

CDC researchers noted that the new HIV infection rates it found among blacks within this group were comparable to rates recorded in parts of sub-Saharan Africa, considered the region hardest hit by AIDS.

Health officials said stigma in the black community toward gay men and AIDS sufferers may prevent many black gay men from being tested. One-third of all U.S. black gay and bisexual males under the age of 30 are HIV-positive, the CDC said.

"Whether you look at this country or throughout the world, this disease is becoming concentrated in marginalized populations," U.S. Surgeon General David Satcher said at a press conference in Washington.

Satcher, who described the anniversary as a "solemn milestone," added that there was a desperate need to find an AIDS vaccine.

Development of a vaccine, however, is years away and would not likely help the millions around the world already infected by the virus.

The CDC, which hopes to cut the annual rate of new HIV infections in half within five years, is concentrating its efforts on prevention programs, especially among young gay males and others at high risk of infection.

20 YEARS OF A DISEASE

Although based on an admittedly small sample size, the CDC study provided a sobering snapshot of the AIDS epidemic, which has killed more than 21 million people around the world, including nearly 450,000 Americans, since it was first diagnosed in June 1981.

The human immunodeficiency virus, which destroys the immune system and leaves victims vulnerable to an array of opportunistic infections and aggressive cancers, is the leading cause of death in Africa and the fourth leading cause of death globally.

About 1 million Americans have been infected since the virus began spreading quickly in the early 1980s through unprotected sex, intravenous drug use, blood transfusions and workplace accidents.

The deaths of actor Rock Hudson, tennis star Arthur Ashe and Ryan White, a young U.S. hemophiliac, highlighted the plague's indiscriminateness.

"This virus goes where ever it's taken. And it doesn't really care what color you are; it doesn't care whether you are heterosexual or homosexual," Satcher said.

40,000 NEW CASES A YEAR

Although HIV has stabilized in the United States at a rate of about 40,000 new infections per year, down from a peak of 160,000 infections in the mid-1980s, the public should not become complacent, the CDC warned.

"We have definitely seen declines in new (full-blown) AIDS cases and declines in new AIDS deaths since the advent of better therapies. On the other hand, we're starting to see a plateau in those declines," said Dr. Helene Gayle, director of CDC's National Center for HIV, STD and TB Prevention.

"That's a real concern," said Gayle, who noted that the virus, which mutates quickly, was developing resistance to previously successful drug therapies, leading to more treatment failures.

Ironically, the battle against AIDS may have been undermined by the discovery of new drug therapies to combat the disease, including the introduction of powerful combinations, or cocktails, of anti-viral drugs.

Some health experts believe that the new drugs, which help keep the so-called viral load in a patient's body at a manageable level, have led to complacency about the epidemic and a return to risky sexual behavior, especially among young gay and bisexual men.

"Many of these young men were children when the epidemic started," said Phill Wilson, executive director of the African-American AIDS Policy and Training Institute at the University of Southern California.

"There is a perception that AIDS affects older men."

-- Anonymous, May 31, 2001