With many public health services crumbling for lack of money, Baltimore officials had one reason to celebrate yesterday: Progress is being made in the effort to treat people in the early stages of infection with the AIDS virus.
Mayor Kurt L. Schmoke announced yesterday that two city clinics that have long treated people with venereal diseases, such assyphilis and gonorrhea, are now also equipped to treat people who test positive for the human immunodeficiency virus, which causes acquired immune deficiency syndrome.
Quietly, the clinics began providing early treatment for HIV-infected patients last June. But program officials said yesterday that they postponed an announcement until the service was fully geared up to accept large numbers of patients.
And they expect large numbers:
Since 1988, the clinics have provided HIV testing, and each year an average of 550 people have tested positive. But the clinics had no way to furnish them with continuing medical care and counseling -- so many simply vanished from the health care system until they were desperately ill in the advanced stages of AIDS.
Now, a person who tests positive can quickly see a personal doctor, have his or her immune system monitored on a regular basis, get drugs such as AZT and visit counselors who can help patients adjust psychologically and get linked to public assistance programs.
The city estimates that 10,000 to 14,000 Baltimore residents are currently infected with the virus.
The clinics are located at 1515 W. North Ave. in West Baltimore, and at the corner of Caroline and Monument streets in East Baltimore.
Last May, a study at the Johns Hopkins Hospital documented the fact that half of Baltimore's patients who could have benefited from life-extending AZT in the early stages of their infection failed to get it. Most were poor, black and from inner-city neighborhoods.
"We couldn't go on diagnosing them and then sending them out to a no-care system," said Dr. Jonathan Zenilman, a Johns Hopkins physician who also directs the city's "early intervention program." He said the patients simply weren't sufficiently "plugged into" the medical system to find their own doctor, many lacked insurance, and those who flocked to AIDS clinics at Johns Hopkins and the University of Maryland found five-month-long waiting lists.
"This is the plug," Dr. Zenilman said.
In a ribbon-cutting ceremony at the North Avenue clinic, Mayor Schmoke acknowledged that the city is facing devastating budget cuts that could decimate many health programs. Recently, his chief budget officer announced a series of impending budget cuts that, among other things, would eliminate all but four nurses from the city school system.
But he said the AIDS epidemic -- the number of full-blown cases is growing by 20 percent each year -- demands special attention. Officials said they managed to shuffle $250,000 from other city health programs; an additional $100,000 comes from a federal "disaster relief" grant.