Advertisement

SKIP ADVERTISEMENT

AIDS Deaths in U.S. Drop by Nearly Half As Infections Go On

See the article in its original context from
October 8, 1998, Section A, Page 1Buy Reprints
TimesMachine is an exclusive benefit for home delivery and digital subscribers.

The number of Americans who died from AIDS fell to 16,865 last year, almost half the number of the year before and well below the 43,000 deaths in the peak year of 1995, Government figures released today show.

The increased access to new and effective drug treatments took the death rate from AIDS to the lowest since 1987, the first year epidemiologists tracked mortality data related to the disease.

Researchers at the National Center for Health Statistics said the number of deaths in 1997 decreased by 46.4 percent from the 31,130 people who died from the illness the year before. The fall in AIDS deaths was much steeper than the previous record decrease, the 29 percent drop from 1995 to 1996.

Still, other studies show that the annual rate of new infections of H.I.V., the virus that causes AIDS, has remained stable at about 40,000 in the United States in recent years, which means that more and more people are living with the virus. But longer life means a greater chance of infecting others, officials said, and they expressed concern that the good news was bringing a complacency about the deadly disease.

''This reflects the tremendous power of the new combination drug therapies, the enormous effort to get the drugs to people and the huge Federal effort to pay for these drugs,'' said Donna E. Shalala, the Secretary of Health and Human Services, of the drop in AIDS deaths. ''What this also tells us is that we have serious problems when we have not brought down the rate of new infections.''

Though 83 fewer people died of AIDS in 1988 than last year, the 1997 death rate of 5.9 deaths from AIDS per 100,000 people was the lowest since 1987.

News of the drop in AIDS deaths is in the report on vital statistics, produced twice a year by the National Center for Heath Statistics. Based on an examination of birth and death records provided by the states, the latest report shows a country in which many of the leading causes of death, like AIDS, homicide, heart disease and cancer, which were once considered scourges, are at record or near-record lows.

Indeed, when adjusting for the country's aging population, the death rate in 1997 was the lowest on record, 478.1 per 100,000 people. The report indicated that only 48 more people died last year than in 1996.

One result of the startling decline is that AIDS went from the eighth leading cause of death in the United States in 1996 to the 14th in 1997. Once the leading cause of death of people 25 to 44 years old, the disease is now the fifth leading cause of death for that age group.

Other highlights of the report include these:

*Infant mortality fell to 7.1 deaths per 1,000 live births, a record low, from 7.3 the previous year.

*Life expectancy for those born in 1997 rose to 76.6 years, the highest ever recorded.

*A 7 percent decline in death rates for black males, mainly the result of the continuing drop since 1993 in the overall homicide rate.

*Declines of 3 percent in the death rate for heart disease and 2 percent in the death rate from cancer.

But it was the sharp drop in the death-rate from AIDS that surprised researchers the most. ''We expected there to be a decline, but we didn't expect it to be quite so big,'' said Robert N. Anderson, a statistician at National Center for Health Statistic and the author of the mortality section of the report. ''We expected to see something on the order of 29 or 30 percent. We're talking about 15,000 fewer deaths than the year before. In terms of the human equation, that's a big deal.''

Researchers and other experts credit the increased use of newer combinations of drugs, including those known as protease inhibitors, with preventing people who are infected with H.I.V. from developing full-blown AIDS and with keeping those who have the disease from succumbing to opportunistic infection that in the past easily and painfully killed them.

''We now have the ammunition and already made a major positive impact on H.I.V.-infected individuals when it comes to longevity and quality of life,'' said Dr. Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases.

But even as researchers and AIDS advocacy groups rejoiced over the hefty declines in AIDS deaths, many expressed concern that apparently the rate of people becoming infected by the virus that causes AIDS has not gone down. Some researchers and advocates say this indicates that while great strides have been made in treating the disease, efforts to prevent the spread of the disease have not born fruit.

That, some epidemiologists say, presents a new set of worries. A much larger number of people who are infected with the AIDS virus are now living longer, and, therefore, have a much greater chance of infecting others.

''We have people who, in the past, might have been very ill, in bed, not able to be sexually active who now are much more active and potentially could continue to pass on H.I.V.,'' said Dr. Helene Gayle, Director of the National Center for H.I.V., Sexually Transmitted Diseases and and Tuberculous Prevention. ''We don't yet know if people on these therapies are less infectious or not.''

Already, some researchers say there are signs that complacency is seeping into the population of people who are most susceptible to H.I.V. infection. Researchers report a surge in unsafe sexual practices among gay men, and they say it remains difficult to carry out effective prevention programs among intravenous drug users.

''This is great news,'' Dr. Gerry McQuillan, senior infectious disease epidemiologist at the National Center for Health Statistics, said of the drop in AIDS death. ''But, I have a 23-year-old son, and I'm periodically shocked when he says things, like, 'It's not a problem anymore, right, Mom?' ''

A version of this article appears in print on  , Section A, Page 1 of the National edition with the headline: AIDS Deaths in U.S. Drop by Nearly Half As Infections Go On. Order Reprints | Today’s Paper | Subscribe

Advertisement

SKIP ADVERTISEMENT