AIDS: After 20 years, complacency

Ann Silversides

An unexpected side effect of the much- heralded introduction of protease inhibitors is a new complacency about risk and prevention involving HIV, attendees at the 10th Annual Canadian Conference on HIV/AIDS Research were told.

Indeed, after years of lower rates, some North American cities — San Francisco is one — have seen a rise in new HIV infections among gay men in the past year. Thomas Coates, director of San Francisco's Centre for AIDS Prevention, blames the rise in large part on the “euphoria and giddiness” that surrounded the 1996 introduction of the new drugs. (The Centers for Disease Control and Prevention report that HIV infection rates in major US urban areas have quadrupled in the past 5 years, with black and Hispanic gay men accounting for 52% of new cases.)

Coates thinks the media and some scientists were too quick to declare the end of AIDS. Meanwhile, the perception grew that people on highly active antiretroviral therapy were not very infectious, he added. The San Francisco AIDS Foundation has responded with a prevention campaign designed to encourage those already infected to insure that “HIV stops with me.” Health officials and activists also argue that drug advertisements need to be more balanced and include information about prevention and drug side effects. “We have 20 to 40 more years before we have effective vaccines and therapies, and the hardest work is ahead,” said Coates.

In Canada, the number of positive HIV tests continues to decline for men and hold relatively steady for women. The latest Health Canada data indicate that the number of positive tests reported among adult males has declined every year since 1995, with an overall drop of 28% between 1995 and 2000. During the same period, the number of cases involving adult women ranged from a low of 429 in 1997 to a high of 515 in 1999.