Posted by Professional Networkers on June 25, 2003 at 10:33:54:
Increase reported in youth HIV cases
Rise also seen in those 50 and older
By JENNETTE BARNES, Standard-Times staff writer and THE ASSOCIATED PRESS
BOSTON -- The percentage of HIV and AIDS cases reported on both ends of the age spectrum has risen significantly over the past four years, according to public health officials, prompting the state to refocus and redouble its prevention message at a time of dwindling resources.
Teens and young adults, ages 13 to 24, made up 8.7 percent of the new cases reported in 2002, up from 6.1 percent in 1999, when the state first began its HIV surveillance system, according to statistics released yesterday.
In New Bedford, six young people aged 13 to 24 were diagnosed with HIV during that time. They represented 4.6 percent of total diagnoses, fewer than many other Massachusetts cities.
Youths made up 6.6 percent of new cases in Boston, 8.1 percent in Springfield, and 5.9 percent in Worcester.
Over the same time period, the number of new HIV cases among residents older than 50 has risen from 9.2 percent to 12 percent of those reported each year.
While the epidemic remains most prevalent among those in the 30 to 44 range, public health officials are concerned that the new statistics reflect a weakening public awareness of the perils of unprotected sexual encounters and intravenous drug use.
"People have lost the sense of urgency about the intensity of this disease," said Public Health Commissioner Christine Ferguson. "We have to really look at .... how to get people to relearn it, particularly among young people who are unaware or who have a sense of immortality."
In Greater New Bedford, young people seem to be less concerned about HIV than in the past, said Erin Almeida, director of the Youth Empowerment Program at Treatment on Demand, a substance abuse education and advocacy group.
Ms. Almeida, who is 27 years old, said AIDS education programs appear to have waned since she was young.
"I think we're reaching the end of that generation," she said. "(Today's youth) know about it, but there's not as much education as when it was a newer disease."
Symptoms of AIDS were first identified in the United States in 1981. A decade later, basketball star Earvin "Magic" Johnson announced he was infected with HIV and launched an AIDS awareness campaign.
Today, when Ms. Almeida holds youth workshops, she talks about HIV testing, but her focus is on substance abuse prevention, in keeping with the mission of Treatment on Demand.
"Most of the people that are transmitting the virus are doing it through intravenous drug use in this area," she said, speaking not of youths but of the population at large.
Youths are often unwilling to get tested for the virus, said Drae Perkins, Treatment on Demand executive director.
"It's very difficult for young people to be in a testing environment because they're afraid of it getting back to their parents," he said.
Statewide in 2002, just 10 percent of new HIV cases in people 13 to 24 years old were attributed to intravenous drug use.
Most are sexually transmitted, according to Kevin Cranston, deputy director of the HIV and AIDS Bureau of the state Department of Public Health.
Young men are most likely to contract the virus via homosexual activity, but for young women, heterosexual sex is the main transmission route, Mr. Cranston said.
He said drug-related cases of transmission are distributed evenly between young men and women.
Changes in risk-taking behavior, despite knowledge of HIV, could be a factor in the increased cases among young people, he said. Like Ms. Almeida, Mr. Cranston expressed concern about diminished prevention programs.
Over the past 18 months, state funding for AIDS prevention and counseling has decreased 31 percent due to several rounds of budget cuts. If Gov. Mitt Romney adopts the budget approved by the Legislature last week, the funding will dip another $3.7 million to $32.1 million, a total decrease of 35 percent since the state's financial difficulties began.
One of the first victims of the budget cuts was Project Teen Health, a $1 million initiative that operated 10 prevention centers across the state.
State public health officials said that it was impossible to draw any specific connections between the budget cuts and the rise of HIV and AIDS diagnoses in the younger and older age categories. But the scarcity of resources has forced them to consider where best to focus their resources, according to Jeanne McGuire, director of the health department's HIV/AIDS bureau.
"This is the environment we're in," Ms. McGuire said. "And it causes us to step back and look at where we put our emphasis. These weren't places that we were concentrating a lot of our attention on."
Advocates argue, however, that the evidence of the budget cuts will soon be evident enough in the state's AIDS statistics.
"The less resources we have, the more likely we will have new infections," said Rebecca Haag, executive director of the AIDS Action Committee of Massachusetts. She said that her group had also noticed the proportionate increase in younger and older HIV and AIDS cases.
Experts attribute the rise in these age groups to ignorance or recklessness in the younger HIV cases and a general sense of weariness in the older patients.
"Prevention fatigue is a real thing," McGuire said.
Over the past four years, 301 of the 4,219 new cases reported were among 13- to 24-year-olds.
Statistics show that 77 percent of the cases were diagnosed in 19- to 24-year-olds, although infection can happen much earlier than diagnosis.
Cities with the highest percentage of HIV and AIDS diagnoses within younger age groups were Chelsea, Medford, Lawrence, Chicopee, Brookline, Somerville, Holyoke, Everett, Brockton and Revere. Boston, Springfield and Chelsea have the highest total number of cases in these age groups.
According to the most recent report from the Pediatric Spectrum of Disease Study, no infants in Massachusetts contracted HIV from their mothers during 2001 -- the first time that has been achieved since the project began monitoring perinatal transmissions.
Since 1999, a total of 4,219 HIV and AIDS cases have been reported in Massachusetts. Since the onset of the disease in the mid-1980s, 17,998 residents have been diagnosed with AIDS. Sixty percent have died.
There are currently about 19,000 to 21,000 living with HIV or AIDS. According to public health officials, about one-quarter of them do not know their HIV status.
This story appeared on Page A1 of The Standard-Times on June 25, 2003.