New York Times, By Donald G. McNeil Jr.
Despite years of great progress in treating AIDS, the number of new infections with the virus that causes it has remained stubbornly around 50,000 a year for a decade, according to new figures released on Wednesday by federal officials.
The American epidemic is still concentrated primarily in gay men, and is growing rapidly worse among young black gay men.
That realization is causing a rift in the AIDS community. Activists say the persistent infection rate proves that government prevention policy is a flop. Federal officials are on the defensive even as they concede that the epidemic will grow if prevention doesn’t get better, which they know is unlikely while their budgets are being cut.
And some researchers believe it is impossible to completely wipe out even a fatal, incurable disease when it is transmitted through sex and carries so much stigma that people deny having it and avoid being tested for it.
Looking backward, epidemiologists at the Centers for Disease Control and Prevention believe new cases peaked at 130,000 a year in the 1980s, sank slowly during the 1990s and plateaued at 50,000 around the year 2000.
Both Dr. Kevin Fenton, chief of AIDS prevention for the C.D.C., and Dr. Anthony S. Fauci, chief of AIDS research at the National Institutes of Health, took issue with Mr. Kramer’s interpretation. While both agreed that 50,000 new annual infections was, in Dr. Fauci’s words, “a great concern,” both pointed to some areas where substantial progress had been made and said that new studies were seeking ways to get more people tested and treated early in the course of the illness, which would make them less infectious and drive transmission rates down.
“The C.D.C. is absolutely not resting,” Dr. Fenton insisted. “It was a major accomplishment to drop infections from 130,000 to 50,000, and we’re dealing with an epidemic that is dynamic.”
But, he conceded, 50,000 is an “unacceptably high level,” and without better prevention efforts, “we’re likely to face an era of rising infection rates.”
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