The number of new HIV diagnoses in Utah was up 32 percent during the first quarter of 2008 compared to the same time period the year before, while the median age of those affected has dropped, according to health experts and community advocates who cite misconceptions and an increase in substance abuse as among probable causes for the increase.
The "definite upward trend" began a couple of years ago, said Lynn Beltran, HIV and STD program manager for the Salt Lake Valley Health Department. Salt Lake County has been particularly hard hit, she said.
"This is what's considered the third wave of the epidemic. People have become complacent. They're not seeing people die from AIDS because medications are more effective in staving it off, so the fear factor is no longer present. And people are sick of hearing about" steps to prevent transmission, such as condom use, she said.
"I think that for the younger populations, their whole life experience is growing up in a world where, especially in western countries, there has been great improvements in retrovirals," said Stan Penfold, executive director of the Utah AIDS Foundation. "I've heard people say there's a cure there isn't or 'If I get sick, I can take some pills.' They have no sense of what that really means," including side effects or the cost and misery. Add in a youthful sense of invincibility, he said, and the fact that much of the discussion concerns AIDS rates in Africa and Asia "and there's a sense it's not really here, so we won't worry much."
The foundation is looking for new ways to get the message across, he said, because "we realize we're not nearly as well targeted as we have been in the past and we need to do something different."
Beltran said that, without exception, people are "devastated" when they get an HIV diagnosis.
Statewide last year, 91 HIV-positive individuals were reported to health officials, slightly more than half between the ages of 20 and 39. Eighty-six of those cases were in Salt Lake County. Statewide, of those infected, two-thirds had engaged in male-to-male sexual activity and/or injected drugs. The other third did not fit those categories, according to statistics from the Utah Department of Health. Nationally, those numbers are reversed.
Beltran said health officials are also concerned about an uptick in the number of cases of early-stage syphilis reported recently. "Ten to 20 years ago, the surgeon general predicted we would be able to eradicate that completely," she said. "It didn't happen. And it increases the risk for transmitting HIV dramatically. People with syphilis are more susceptible."
Already this year, about 45 new HIV cases have been identified, while it's believed many other cases have not been diagnosed. In Utah, the greatest increase is among young white men, Beltran said. Elsewhere in the nation, where cases are also increasing, the fastest-growing group is women of color, particularly black women, she said. Most of Utah's cases are among young adults, although recent diagnosis has been made across age groups, including a couple of cases involving people younger than 20.
Experts also attribute some of the increase to methamphetamine use, which raises the chance of "risky behaviors related to sexual health," Beltran said.Penfold said that HIV/AIDs typically takes a disproportionate toll on populations that live in poverty, but which don't necessarily see themselves as populations at risk. "There's a disconnect between who gets it and what you do to get it. People think they know what someone who might spread it looks like, not that it's behaviors that spread it."