Feature:
US
Has
More
Than
a
Million
People
Living
with
HIV,
Government
Says
--
as
it
Ignores
Prevention
for
Drug-Related
Cases
6/17/05
For the first time since the AIDS epidemic of the 1980s was at its height, the number of people in the United States has climbed over a million, the Centers for Disease Control and Prevention announced Monday. There is good news and bad news. The good news is that part of the increase in people with HIV is because with new drugs on the market, people with the virus are living longer. The bad news is that new HIV cases continue to occur at a rate of about 40,000 a year since the late 1990s, with some experts estimating that the number could be closer to 60,000 a year. Worse news is that new HIV cases related to injection drug use account for somewhere around one-half of all new HIV cases, while federal officials turn a blind eye to harm reduction measures, such as needle exchange programs, that have been repeatedly proven to reduce the rate of HIV infections. According to the CDC, somewhere between 1.04 million and 1.19 million people in the US were living with HIV in December of 2003. The most recent previous estimate, from 2002, put the number at between 850,000 and 950,000. "It is estimated that half of all new HIV infections in the US are occurring among injection drug users (IDUs)," noted the University of California at San Francisco's Center for AIDS Prevention Studies, based on data from the late 1990s. "For women, 61% of all AIDS cases are due to injection drug use or sex with partners who inject drugs. Injection drug use is the source of infection for more than half of all children born with HIV." IDUs made up 36% of all HIV-infected persons, that report found. Relying on somewhat more recent numbers from the CDC, the center also found that when it comes to people living with AIDS, IDUs accounted for 28% of the new cases and 36% of the cumulative total. Women and minorities are disproportionately affected by IDU-related AIDS. According to the center, 31% of Latino AIDS cases were IDU-related, 26% of black AIDS cases were IDU-related, and only 19% of white cases were IDU-related. For women, a shocking 62% of all AIDS cases are attributable to either personal injection drug use or having a partner who is shooting dope. But despite the enormous impact of injection drug use on HIV infection rates, dealing with the problem through scientifically proven methods such as needle exchanges is being ignored by officials and downplayed by some AIDS organizations. The national CDC conference on HIV prevention held this week in Atlanta didn't even have syringe access or harm reduction on the agenda. "We could completely eliminate HIV among injection drug users if they were given access to sterile syringes through paraphernalia law reforms or needle exchange programs," said Allan Clear, executive director of the Harm Reduction Coalition. "It has already worked dramatically here in New York City, where we have brought the number down from 60% to 16%," he told DRCNet. "It would really help if the federal government would lift the ban on funding for syringe exchanges," concurred Alisa Solberg of the North American Syringe Exchange Network, an umbrella group representing the more than 200 needle exchanges currently operating in the US, some legally, others underground. While that message seems to be getting through to the larger AIDS community to a limited degree -- the Campaign to End AIDS, for instance, includes a demand for ramped up prevention efforts "guided by science rather than ideology" -- a Wednesday evening appearance on PBS's News Hour by the CDC's Dr. Ron Valdeserri and the Black AIDS Institute's Phill Wilson made clear the degree to which injection drug users are the red-headed stepchildren of the AIDS movement. In the 15 minute discussion of HIV prevention, the words "drug users" were mentioned only once in passing by Wilson and not at all by Valdeserri, who made only a fleeting reference to "high risk groups." Similarly, needle exchange and harm reduction never came up -- a striking omission when we are talking about half of all new HIV infections. (Black AIDS' Wilson was traveling back from the conference late this week and unavailable to comment on the omission.) The oppressive political atmosphere in Washington is having an impact on science and policy, said Clear, who spent most of this week in Atlanta attending the conference. "I've been talking to people who work for the federal institutions, and no one doubts that needle exchange works, but because of the political atmosphere, they cannot promote it or even use the term except very guardedly. If you look at the topic and subject categories for this conference, you won't find the words 'needle exchange,' 'syringe exchange,' or 'harm reduction,'" he noted. "This is total censorship, it is politics over science every time. It must be really frustrating. You have these trained scientists at CDC who know what the truth is, but they cannot speak it." Any help on the score at the federal level appears a distant mirage, said Clear. "There is no will whatsoever at the federal level to reduce or eliminate HIV infections among drug users," he said. "Right now, it appears that the congressional attitude toward needle exchange programs is that they are something that should be done away with." The head-in-the-sand attitude toward preventing IDU-related HIV infections is part of a larger, abstinence-based conservative vision, Clear argued. "The people who run the federal government are opposed to sexuality, they are opposed to measures that could reduce harm, whether it is supplying condoms to teenagers or syringes to drug users. This is all part and parcel of the same conservative agenda." "This is not a time when we can be silent about federal inaction," said Clear. "We have to attack them. They are already attacking us. Tens of thousands of drug users are dead when they didn't have to be."
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