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Centers for Disease Control: "Oops, we were wrong"
Centers for Disease Control: "Oops, we were wrong"
by Paul Varnell - SGN Contributing Writer

For upwards of 15 years, the Centers for Disease Control and Prevention in its annual assessment of HIV and AIDS has stated that the number of new HIV infections was about 40,000.

Then, at the beginning of August, it published a study showing that its previous figures were significant underestimates and that the actual incidence of new HIV infections was somewhere between 55,000 and 58,000. In 2006, the latest year for which it has data, the CDC said that 56,300 people became infected.

According to the CDC, more than half of those new infections - 53 percent - were among Gay and Bisexual men, with an additional 4 percent among men who have sex with men and inject IV drugs. This means that 30,000-32,000 Gay men become infected each year. Further, while new incidence rates have declined for some groups in recent years, they have increased for Gay men.

There are a lot of things to say about this higher incidence estimate. First of all, no one, perhaps not even the CDC, actually believed that 40,000 annual incidence figure. It never varied, no matter the intensity (or lack of intensity) of AIDS education and other prevention efforts.

It never varied, no matter the introduction and increasing adoption of protease inhibitors which should have lowered people's transmissibility. It never varied, no matter the varying number of one's friends who became infected. In the last seven or eight years. 40,000 became the one grim laugh line in the CDC's annual AIDS report.

CDC Director Julie Gerberding called the new estimates "unacceptable," a feeble term, it would seem, and one which has the unfortunate (though no doubt unintentional) implication that she found the previous incidence rates somehow acceptable. Then she added, "We are not effectively reaching men who have sex with men ... to lower their risk."

Did she think the old estimate of 40,000 HIV infections each year meant the CDC was effectively reaching Gay men? Was this her first clue that it wasn't? All she needed to do was get out into the world and talk with a few Gay men; Gay men are no longer afraid of AIDS. We see few obituaries. Fewer Gay men are insisting on condoms. Condoms have largely disappeared from bars. Most of us are seeing few prevention messages.

Second, the new figures are also a guess, or "guesstimate," because they are based on data only from the 22 states that participated in the new study. Nationwide estimates are based on national projections from those 22 states - who knows with what accuracy? The presence of African Americans, Latinos, and Gay men varies considerably among the states, and our knowledge of where Gay men live and in what numbers is impressionistic.

Third, unfortunately, money for prevention efforts has been held constant for the last several years, resulting in a real-world decrease as the government's inflation reduces the value of the dollar. And President Bush's latest budget proposes an actual decrease. The Bush administration is willing to spend billions and billions of dollars to treat and prevent AIDS abroad (where the disease is more common among heterosexuals), supposedly to help prevent a "demographic crisis," but spends scarcely $600 million on AIDS domestically.

Fourth, domestic AIDS apparently has not been even a blip on Bush's or Karl Rove's issues screen. One would have to be more cynical than I am to conceive that the administration would not be too unhappy about AIDS-related deaths - although the constituencies most affected by AIDS preponderantly vote Democratic.

However, it is certainly true that the "core" Republican constituency of the Religious Right and its minions in the executive branch would strenuously object to creative and aggressive prevention messages such as public service announcements on television, similar messages in movie theaters, recommendations that men have themselves circumcised (as governments recommend in Africa), and emphasis on the importance of obtaining therapeutic drugs to lower a person's transmissibility. The Religious Right's exclusive focus on abstinence isn't working, does not work and cannot work.

Years ago I was interviewed at my home by a Chicago television station. The young women interviewing me asked what could be done to prevent AIDS. I pulled out a condom and said, "Your station could promote condoms." She immediately halted the interview, angrily said, "This station will never put that on the air," and stalked out with her camera crew.

And fifth it is important to realize that prevention is a stopgap measure. AIDS is never, never, ever going to end until there is a vaccine and a cure.

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