AIDS deaths decline in New York prisons 60 deaths in 1997 fewest since 1984's 57

September 23, 1998|By NEW YORK TIMES NEWS SERVICE

ALBANY, N.Y. -- The number of AIDS-related deaths among New York state's prison population hit a 14-year low last year, according to a report by the state's Department of Correctional Services.

The report showed that 60 inmates died as a result of AIDS in 1997. The trend has continued this year, with 18 deaths in the first six months. Those figures are a striking contrast to the 181 AIDS-related deaths in 1996 and the 258 the year before. The 60 inmates who died of the disease last year were the fewest since 1984, when there were 57 AIDS-related deaths.

The decline comes at a time when state prison officials have stepped up their efforts to fight the disease by, among other things, increasing the use of promising but expensive new drugs. As a result, the cost of AIDS-treatment programs in state prisons has grown 66 percent in the last four years, to $63 million in the 1998-99 fiscal year from $38 million in 1994-95.

New York's efforts run counter to those in other states, where correction officials have been so overwhelmed by the cost of the new treatments that they have not been widely prescribed, health officials said. The costs of the new drugs, known as protease inhibitors, have increased the annual expense of treating an HIV-infected patient from about $2,000 to as much as $13,000, state officials said.

Mixed reactions

In a statement, Gov. George Pataki said the state had little choice but to provide HIV-infected inmates the most appropriate medical care available.

"Once they are incarcerated," he said, "we are obligated to provide them with medical care that is the equivalent of that found in the community. Clearly, the people of New York are meeting their obligation."

But the report drew a mixed reaction from advocates for people with AIDS. While they lauded the declining death rate among HIV-infected prisoners, many warned that the improvement should not be taken as a sign that the AIDS epidemic had been brought under control, particularly because the state's prison system has the highest rate of infection of any system in the country.

"It's great news that people are able to live with AIDS longer," said Greg Lugliani, a spokesman for the Gay Men's Health Crisis, an advocacy group for people with AIDS. "But there's this incorrect perception that AIDS has been reduced because of this reduction in mortality. The real driving force in the AIDS epidemic is the incidence of new infections."

The new report is considered significant because of the high rate of infection in the state's prison system. In 1997, the state's prisons housed an estimated 7,500 HIV-positive inmates, or slightly under 1 percent of all the HIV-infected people in the country.

Because there is no mandatory HIV testing in the state system, officials have no way of tracking exactly who has the virus, but they said 2,800 inmates had come forward to receive treatment.

Rate of infection down

The report also found that the rate of infection among inmates entering the prison system had declined. It showed that male inmates arriving at state prisons in 1996 and 1997 had an infection rate of 9 percent, compared to the 12 percent rate of infection of men who entered the system in 1992 and 1993. The infection rate among women was higher - 18 percent in 1996 and 1997, down from 20 percent in 1992 and 1993.

The report also showed that the sharp decrease in the death rate among inmates with AIDS led to a similar decline in the number of terminally ill inmates who qualified for early medical release. In 1994, 54 such releases were approved, compared with 20 in 1997 and 8 in the first six months of 1998.

The decline in the death rate was largely attributed to the state's increasing practice of using protease inhibitors in combination with other drugs, a so-called cocktail that has produced sharp reductions in viral activity in some patients.

Health-care experts have long argued that prison was an especially good setting for this sort of treatment. The treatment relies on identifying the virus early and then following a strict regimen of medication to guard against breeding a strain of the disease that is impervious to treatment.

Pub Date: 9/23/98

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