AIDS Deaths Drop Further, U.S. Reports

By MARLENE CIMONS

July 15, 1997 12 AM PT

TIMES STAFF WRITER

WASHINGTON —

AIDS deaths fell 19% over a nine-month period last year compared with the same period in 1995, accelerating a decline reported earlier this year, federal health officials said Monday.

Although the figures were considered encouraging, they continued to reflect disparities among various groups. The sharpest decrease was among white men, while the number of deaths fell less among women, minorities and poor people, who may lack access to the powerful and expensive new generation of AIDS drugs.

“We have entered a new era in the HIV epidemic, both in terms of treatment and prevention,” said Dr. Helene Gayle, director of the national center for HIV, STD and TB prevention at the Centers for Disease Control and Prevention in Atlanta.

The estimated number of deaths from the disease from January to September of last year was 30,700, down from 37,900 during the same nine months of 1995, according to CDC statistics.

The greatest successes in reducing the incidence of AIDS have been seen in gay and bisexual men. Gayle said, however, that at least 40,000 new infections are occurring annually and that “much work is left to be done.”

Heterosexual transmission is the fastest growing mode, the CDC said. Heterosexually transmitted cases are increasing by 15% to 20% annually, compared with an increase of 5% or less among gay men and intravenous drug users, the CDC reported.

The decline in deaths is an acceleration of a trend first reported in February, when health officials said AIDS deaths had dropped 13% during the first six months of 1996, compared with the same period in 1995. That was the first recorded drop since the initial reports of the epidemic in 1981.

“Dramatic progress has been made in preventing new infections and in slowing the progression of disease for those infected,” said Gayle, whose remarks were made at a forum sponsored by the AIDS Action Council, a Washington-based lobbying and education group.

Health officials said the continuing decline is linked closely to two factors: new drug combination therapies--which include protease inhibitors, a powerful new class of antiviral drugs--and increased resources devoted to treatment and prevention.

Public health officials have noted repeatedly, however, that the drugs do not work for all infected individuals and not everyone can get them. They can cost about $15,000 a year, a sum out of the reach of many whose insurance does not pay for the treatment or who are not eligible for public assistance.

“Social safety nets are collapsing,” Doug Nelson, executive director of the AIDS Resource Center of Wisconsin, said at the AIDS forum.

He said health programs in Milwaukee that serve the indigent have closed and he predicted that changes to state welfare programs “will further limit access to financial assistance for low-income individuals . . . our most difficult challenge today and in the years ahead will be to assure access to health care as HIV treatment costs go up, and social safety nets come down.”

In addition, global health officials have been disappointed that the new drugs, so successful in this country, are unavailable or unaffordable to AIDS sufferers overseas, particularly in developing countries.

“As we continue to work to develop better treatment options, we must not lose sight of the fact that preventing HIV infection is the only way to reduce the burden of this disease,” Gayle said.

The biggest decline in deaths in this country was recorded among men, with the number falling 22%. Deaths among women dropped only 7%. Still, this was the first time a mortality decrease among women with AIDS was reported.

Similar death-rate disparities exist among racial and ethnic groups. Deaths among whites dropped 28%, compared with 10% among African Americans and 16% among Latinos.

“As the CDC data indicate, the fact remains that there is not equal access to the continuum of care people with HIV/AIDS require to stay alive and healthy,” said Daniel Zingale, executive director of AIDS Action Council. “AIDS continues to ravage communities of color and women--populations which represent the fast growing groups of new AIDS cases.”

The statistics, while encouraging, nevertheless “underscore the need for a concerted national effort to remedy the inequities that exist in access to federal HIV prevention programs and health care services--inequities which significantly contribute to the spread of HIV,” he added.

In Los Angeles, health officials have not broken down the local AIDS data in the same way that the CDC has analyzed national death rates, but the trend is much the same.

The number of AIDS deaths reported to the county in the first six months of this year was down 56%, compared with the same period last year, from 1,345 to 586, said Dr. Paul Simon, a medical epidemiologist with the Los Angeles County Department of Health Services. He said there was no readily available data on local racial or ethnic trends in AIDS mortality.

He attributed much of the decline to improved treatments, such as the combination drug therapies. “What it suggests is that it’s more important than ever for a person at risk of HIV infection to seek out an HIV test” and get treatment, he said.

“It’s wonderful news,” the director of education for AIDS Project Los Angeles, Lee Klosinski, said of the new national figures. But he said there was evidence that not all groups in Los Angeles were benefiting equally from the treatment advances.

Research by the advocacy group on 6,000 Los Angeles County people with AIDS showed that “African American and Latino people are much less likely to know about combination therapy, much less likely to be on it and much less likely to be offered it than their Caucasian counterparts,” he said.

“It’s wonderful that these drugs have such a powerful effect,” Klosinski said, “and it’s a tremendous challenge to get information and access to these drugs to people of color.”

Times staff writer Terence Monmaney in Los Angeles contributed to this story.

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Drop in AIDS Deaths

Deaths from AIDS are declining--19% during the first nine months of 1996--with white men accounting for most of the change, the government announced.

Total U.S.

Number of deaths 1995: 37,900

Number of deaths 1996: 30,700

% change: -19

Men

Number of deaths 1995: 31,500

Number of deaths 1996: 24,700

% change: -22