Dramatic surge seen in local HIV cases

AIDS virus infections among gay men have increased dramatically over the past two years in King County, and health officials are renewing their pleas for caution and vigilance against the deadly disease.

A new analysis shows HIV infections diagnosed in public health clinics jumped 40 percent last year and are projected to increase by another 60 percent this year.

"It's the most dramatic increase since the beginning of the epidemic" more than 20 years ago, said Dr. Bob Wood, director of AIDS control for Public Health — Seattle & King County.

Decreased fears of the disease, based on the availability of new drugs, have combined with burnout on safe-sex messages to cause riskier sexual behavior here and in other cities, officials said. Gay and bisexual men comprise about 85 percent of the cumulative AIDS cases in King County.

Health officials based their analysis on HIV test results from the public clinics beginning in 2000. The clinics generally see patients who have high infection risks, so increases seen in private clinics likely are fewer, Wood said. Officials estimate 400 to 500 new HIV infections in King County each year, including those discovered at private clinics, but don't know the latest rate of increase among the broader group.

The health department and community-based organizations concerned with HIV are urging gay men to be tested for the virus, disclose their status to sexual partners and practice safe sex.

"We need to take HIV out of the closet. It's the responsibility of all guys who are sexually active to be talking about it. And don't be afraid to talk about it if you have it," said Jack Johnston, program coordinator for Positive Power, a group that helps HIV-positive men.

In an effort to encourage testing, Public Health last Friday began a pilot project offering a new "rapid" HIV blood test that gives results in about 20 minutes, instead of the week that is needed with a conventional test.

Volunteers are recruited along Broadway, on Capitol Hill, then asked if they would like to take the test, called OraQuick, in a nearby private office. They are offered an "incentive" of $10. Counseling about the meaning of the test is given before and after results are known. The test is quite accurate, but is also confirmed by a conventional test, Wood said.

Wood said if the project is successful over about a year, the health department hopes to expand the testing to gay bathhouses and sex clubs. Recently approved by the Food and Drug Administration, the new tests assure that patients learn results quickly, while some who take the conventional tests never return to learn their results, Wood said.

"One of the most important things you can do in HIV prevention is make sure people know if they are positive or negative," he said. "Studies have shown that people make major changes in behavior when they learn their status."

Health authorities have long feared the increase in HIV because other, more easily tracked sexually transmitted diseases (STDs) — syphilis, gonorrhea and chlamydia — have been on the rise for more than three years.

The diseases indicate unsafe sexual practices among some men. And the lesions the diseases cause make it easier for HIV to enter the body.

About 11 percent more gay men were tested for HIV in public health clinics last year than the year before. Wood said that is an encouraging sign, but it can't explain the increase in the number of infections.

Wood estimated about 8,400 King County residents are living with HIV, compared to 7,500 two years ago. About 3,000 have full-blown AIDS.

Health authorities renewed their pleas for caution and safe sex practices when STDs began to increase in gay men. But Wood said a number of factors have contributed to the apparent increase in HIV here, as they have in other major cities such as San Francisco and Vancouver, B.C.

New drugs have made it possible for many to live much longer with HIV, so the fear has decreased for many. Many men are burned out on the safe-sex messages they have heard for years and feel they can't stay safe forever in the absence of a vaccine. And there have been few gay community leaders to sound the alarm about the new wave of infections.

"I think a lot of my friends who have died would be rolling over in their graves about now," said Wood, who has battled AIDS for years, but is relatively healthy now. "I think they would say to the community, 'Don't you guys care? Did I have to die for nothing?' "

Warren King: 206-464-2247 or wking@seattletimes.com