Better Count Cited in Rise of AIDS Cases

After a decade of declines, the number of new AIDS cases reported in California increased 6% in 2002, to 4,437, according to the state Office of AIDS.

In Los Angeles County, the jump is even more striking: Cases were up 32%, to 1,789.

State and local health officials attribute the increase to better disease reporting by doctors and clinics, not a failure of HIV drug treatments or a recent resurgence in high-risk behavior.

Even so, the state stands to receive additional money to provide services to patients. The federal government bases its funding on each state’s tally of AIDS cases, although as early as next year it will tie funding to HIV cases as well. It is too soon to say how much new money will flow to the state.

The human immunodeficiency virus causes AIDS; infection can precede development of AIDS by a decade or more.

Many of the newly reported AIDS cases had been diagnosed in previous years but never reported. In fact, they probably were caught because the state began requiring medical providers to report HIV cases, beginning July 1.

Under the new system, California requires laboratories to automatically notify local health departments of every test that indicates HIV or AIDS infection. Health workers then seek additional information from medical providers.

The lab system “basically becomes your surveillance system for AIDS cases,” said Dr. Liza Solomon, director of the AIDS Administration office for Maryland’s health department. “You just find out about them a lot quicker.”

In the past, local health departments in California have largely relied on the goodwill of medical providers to track cases. Officials have said they were reluctant to fine providers who didn’t comply.

Since July, when mandatory HIV reporting took effect, the state has received 2,259 AIDS case reports, up 8% from the last six months of 2001.

Other states experienced similar spikes in their AIDS case logs after they implemented HIV reporting. Massachusetts recorded 1,521 AIDS cases in its first year of HIV reporting, in 1999, compared with 997 a year before.

Because many of the newly reported AIDS cases in California were diagnosed years ago, state and local officials don’t expect to see an increased demand for medical treatment and support services.

Requests for services are “not nearly to the same extent as the new AIDS cases would suggest,” said Gunther Freehill, a spokesman for Los Angeles County’s Office of AIDS Programs and Policy. “For the most part, people are already in care.”