Aids Epidemic

Dr. Angela Wakhweya began her medical career in her native Uganda, at the height of the AIDS epidemic in sub-Saharan Africa, where she saw many patients, friends and even some family members succumb to the deadly disease. The experience propelled her into the public health field, and eventually led her to Maryland, where she worked on infectious disease prevention at the state health department in Baltimore. Maryland ranks fourth in the nation in terms of newly diagnosed HIV/AIDS cases.

A little over two years ago, I had the pleasure of visiting Cedar Rapids, where I took part in the wedding of two old and dear friends. The happy pair had been a warm, stable and loving couple for as long as I'd known them (about 25 years), so you might wonder why they took so long to tie the knot. The answer is simple: Both of my friends are women, but they have the good fortune to live in Iowa, and they got their license on the first day that it became possible for them to do so. Being able to be a part of their happiness was one of the great joys and privileges of my life, and I'm pleased to be able to note that my own marriage of well over a quarter-century to the same woman (how many has Newt Gingrich run through in that time?

For years programs aimed at preventing the spread of the AIDS epidemic followed a scattershot approach intended to reach as wide an audience as possible. Now a new study by the National Research Council disputes the conventional wisdom. It argues that AIDS could be wiped out even in the absence of a cure or new drugs by prevention efforts that zero in on 25 to 30 of the most affected neighborhoods in the nation.The study, entitled "The Social Impact of AIDS," challenges the view that everyone is equally at risk for contracting AIDS.

Dr. Angela Wakhweya began her medical career in her native Uganda, at the height of the AIDS epidemic in sub-Saharan Africa, where she saw many patients, friends and even some family members succumb to the deadly disease. The experience propelled her into the public health field, and eventually led her to Maryland, where she worked on infectious disease prevention at the state health department in Baltimore. Maryland ranks fourth in the nation in terms of newly diagnosed HIV/AIDS cases.

A little less than a decade ago, when scientists began unraveling the mystery of a deadly new disease that seemed to strike homosexual men with particular fury, gay activists were among the first to sound the alarm over what was to become a world-wide AIDS epidemic. They pushed for stepped-up medical research and were on the front lines of a public relations effort to promote "safer sex" through the use of condoms. As a result, the rate of new infections among gay men fell sharply in the late 1980s.

The news about AIDS is as ominous as ever.The latest international conference, bringing together the world's top AIDS researchers, adjourned last week in Amsterdam on an unsettling note. Scientists puzzled over reports of at least two dozen people who exhibit the classic symptoms of AIDS, but have no detectable sign of either of the two known strains of HIV, the virus that causes AIDS.Has the virus mutated into a different strain unrecognized by current testing methods? Do these cases represent a new virus, or an animal virus that has crossed over to infect humans?

RIO DE JANEIRO, Brazil -- Flourishing amid sexual promiscuity, hypocrisy and haphazard prevention, Latin America's AIDS epidemic is on its way to surpassing that of the United States, scientists say.Much of the growth comes from rising infection rates among Latin American women, a fact that doctors attribute to a propensity for homosexual and heterosexual affairs by men and a traditional reluctance to discuss these with their wives.While much of the world's concern about acquired immune deficiency syndrome has focused on Africa, Asia, and the United States, the rising number of infections in Latin America is prompting growing alarm about this region as well.

The world AIDS epidemic continues to worsen and could kill at least 68 million people in the next two decades, defeating earlier predictions that it would have peaked by now, a United Nations report warns. Though the epidemic has subsided in some Western countries, including the United States, infection rates are reaching levels in sub-Saharan Africa that were once considered unimaginable. The virus also is spreading rapidly in China, Russia and many other countries where AIDS arrived late.

NEW YORK - Before Ellen, Will & Grace and Queer Eye for the Straight Guy, before "Don't Ask, Don't Tell," domestic-partner benefits and gay marriage, before AIDS, there was Larry Kramer, movie producer, writer and self-described pain declaring that being gay was not about stereotypes, shame or sex. But when the AIDS epidemic hit in the '80s, Kramer found his most important role in life, one that would transform him, help redefine the gay community and...

Puzzled by news the governor planned to disband them, members of Gov. William Donald Schaefer's advisory council on AIDS decided last night to work as an unofficial watchdog for the legislature or anyone else who wants to listen.The decision came at the end of a meeting in which members, although clearly miffed, seemed resigned to extinction after five years of advising a governor with whom they were frequently at philosophical odds.But the council shifted direction after a few of its members and several activists said Maryland needs their technical advice, especially on the raft of AIDS-related proposals likely to face the legislature this session.

In the 1980s, when researchers first identified the virus that causes AIDS, a positive HIV test was a virtual death sentence. There was no cure for the disease and no effective treatment; patients usually died within a few months or years of being diagnosed. But beginning in the 1990s, with the development of powerful antiretroviral drugs, that began to change. AIDS became a manageable, chronic illness rather than an invariably fatal disorder. Today, people infected with the virus are living longer even as their numbers have grown and the rate of new infections has declined.

With Baltimore facing a growing AIDS caseload and an epidemic that increasingly strikes women, a city commission is urging officials to make good on a "state of emergency" declared three years ago. Describing the city's response as splintered and lacking in direction, the group called yesterday for renewed attention to risk groups that also include African-American men and residents of hard-hit neighborhoods in West Baltimore. "It's not an issue that's at the forefront as it used to be," Dr. William Blattner, the commission's chairman, said at a news conference.

J. Lawrence Miller remembers the moment he began to feel hope that politicians were finally combating the AIDS epidemic among African-Americans - it came last Wednesday. "It was 9:37 p.m.; I have TiVo, I recorded it," said Miller, a Baltimore AIDS-prevention advocate, who was watching President Bush's State of the Union address at the time. Bush asked Congress to reauthorize the Ryan White CARE Act, with focus "on fellow citizens with the highest rates of new cases: African-American men and women."

Every day, Dorothy Murray files into a downtown clinic, raises a glass of grape juice and downs three pills under the eye of a pharmacist. It has been her routine since March, when she left the hospital after nearly dying from an AIDS-related infection that reduced her weight to 70 pounds. "I was an intravenous drug user, but I didn't like taking pills," said Murray, 38, who's back to 100 pounds, which sit well on her diminutive frame. "I figured this was the only way I'd take my medication."

In 1981 the Centers for Disease Control (CDC) identified a new infectious disease, AIDS (acquired immune deficiency syndrome), which had appeared in a few dozen American men, mostly white, mostly gay. Within a scant few years, the number of deaths from the disease exploded from fewer than 100 to more than a quarter million, and the demographics were global -- no one was immune. On July 6, 2004, the United Nations issued its latest report on the global AIDS epidemic. Dr. Peter Piot, the UNAIDS executive director, revealed grim statistics: more cases than ever, more than half of them in women, with outbreaks spreading through Asia and Eastern Europe.

NEW YORK - Before Ellen, Will & Grace and Queer Eye for the Straight Guy, before "Don't Ask, Don't Tell," domestic-partner benefits and gay marriage, before AIDS, there was Larry Kramer, movie producer, writer and self-described pain declaring that being gay was not about stereotypes, shame or sex. But when the AIDS epidemic hit in the '80s, Kramer found his most important role in life, one that would transform him, help redefine the gay community and...

We have now moved into the second decade of the AIDS epidemic.It was 10 years ago this month that the Centers for Disease Control published a short item on an outbreak of a rare form of pneumonia among five homosexual men in Los Angeles, a disease doctors had seen before only in patients with suppressed immune systems.Since then, 175,000 Americans have been diagnosed with AIDS and more than 110,000 have died. AIDS experts say that another 1 million in this country may be infected with the AIDS virus.

IT'S past time for Americans to start treating the AIDS epidemic more like a deadly disease and less like a political problem.The worldwide AIDS epidemic is outstripping all predictions by health experts at the World Health Organization and the U.N. AIDS program.A costly epidemicEven in the United States, where more than $600 million has been spent on federal prevention programs, the rate of new infections has stayed at 40,000 or so per year. A new, alarming study reports that four of 10 Americans infected with HIV refuse to tell their sexual partners that they are carriers of the deadly human immunodeficiency virus.

BEIJING - Former President Bill Clinton addressed a conference on AIDS at one of China's most prestigious universities yesterday, delivering a message to top officials that they must confront the country's HIV epidemic - but the top officials weren't there to hear him. Qinghua University's AIDS and SARS Summit symbolized China's muddled approach to HIV and AIDS. That the conference was even held reflected an increasing official acceptance that the nation faces a crisis, with as many as 2 million people infected with HIV and projections of 10 million to 20 million cases by 2010.

MOSCOW - Most days, 33- year-old Alexander Alexandrov lies curled on the cot in his hospital ward, listening to the drone of the radio, the chatter of the television, staring out at the gray fog that so often shrouds the city. Once in a while, when he's feeling restless, he will pick up his worn copy of his favorite novel and reread the story of how the devil came to Moscow. The former aeronautics machinist is the gaunt face of Russia's maturing AIDS epidemic. HIV, the virus that causes AIDS, came late to Russia, arriving only with the economic and social collapse of the 1990s.