CDC: State does good job of detecting new HIV infections

MEXICO CITY -- In the fight against HIV, South Carolina does a good job with a key step detecting new infections that occur each year. Accurate numbers mean the state can make sound plans for HIV prevention and treatment.

An estimate of new infections was revealed in a new analysis for 2006, parts of which were released by the Centers for Disease Control and Prevention last week in Mexico City at the XVII International Conference on AIDS.

About 900 South Carolinians are estimated to have been newly infected with HIV in 2006, only slightly more than the number of actual cases diagnosed that year.

It is the first time South Carolina has a direct estimate of new infections in the state, rather than just actual diagnoses.

Not everyone who is infected is diagnosed, so having a good estimate of those newly infected helps with planning. As it turns out, the numbers public health officials use are relatively good.

About 25 percent of Americans who have HIV do not know it, according to the CDC. People who are infected but undiagnosed can unknowingly infect others and are going without life-saving medicines that can lower the amount of virus in their bodies.

"We don't detect all those cases we detect most, but we need to detect all of them and get them on treatment," said Dr. Jerry Gibson, DHEC infectious diseases chief.

The number of new diagnoses in the state has decreased by 3 percent to 4 percent each year over the past several years.

"We think it means we're doing a better job of prevention, because our numbers are not going up but going slowly down," Gibson said.

To get a better sense of which groups account for most of the new infections, over the next few weeks DHEC will break down the rate of new infections by age, gender, race and infection-risk category.

For the entire United States, instead of 40,000 new HIV infections a year as previously thought, 56,300 new cases are estimated for 2006 almost 41 percent higher, according to the report, published in the Journal of the American Medical Association.

"We're hoping that colleagues will use this data and see them as a wake-up call," said Dr. Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "It's providing us greater clarity on the epidemic."

The new numbers call into question national HIV policies and funding for prevention and treatment that for a decade have been based on lower, inaccurate estimates. The old estimates were based on small studies of high-risk groups, largely in Northern cities, that were extrapolated to the whole country.

"This marks an important moment in the history of the HIV/AIDS epidemic, said Jen Kates, vice president and director of HIV Policy at the Kaiser Family Foundation. "Having, for the first time, HIV incidence estimates for the nation and for a subset of states, including South Carolina, will help us all do a better job addressing the epidemic at home."

The new estimates are based on new blood test results and testing history from people who initially were diagnosed in 2006. The study was done in 22 states, including South Carolina, that have confidential, name-based HIV testing. The data from those states were used to derive a national estimate. The complex calculations took into account the level of HIV antibodies in a person's blood which gives a sense of how long someone has been infected; and how many times a person was tested before being diagnosed.

While the numbers are not good enough to tell an individual when he or she became infected, for a group, they can reliably tell how many were newly infected within a period of a few months.

The new estimates came the same week that S.C. HIV/AIDS Care Crisis Task Force leaders gathered in Charleston to plan for tackling the disease in the state.

Last year, the task force pushed state lawmakers to allocate $4 million for the AIDS Drug Assistance Program to eliminate a waiting list of close to 600 people. This year, an additional $2.4 million in state dollars was allocated for the program, which is mostly federally funded.

The money helped, but is not sufficient to effectively address HIV in South Carolina, state authorities say.

"In the future, as federal funds are threatening to go away, the state funding will be more important," said Andre Rawls, the new director of DHEC's STD/HIV Division. "There needs to be continued funding with emphasis on prevention and care."

Reach Reid at (803) 771-8378.