THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Monday, November 27, 1995 TAG: 9511270041
SECTION: LOCAL PAGE: B1 EDITION: NORTH CAROLINA
SOURCE: BY ELIZABETH TENNYSON, ASSOCIATED PRESS
DATELINE: RALEIGH LENGTH: Medium: 85 lines
The number of new AIDS cases in North Carolina has fallen steadily for the past three years. But activists preparing for World AIDS Day this week warn that the drop in reported cases may be deceptive.
``I think (AIDS) is on the rise in rural areas, and those people aren't getting tested and documented,'' said Cullen Gurganus, executive director of the AIDS Service Agency for Wake County.
The eighth annual World AIDS Day is Friday. Observances are planned in 190 countries, with a goal of raising awareness of the disease and how to prevent it.
AIDS is the second leading cause of death for North Carolinians between the ages of 15 and 44, and the leading cause of death for blacks in that age group.
From 1981 through September 1995, the total number of AIDS cases recorded in North Carolina was 5,981, according to statistics from the HIV-STD Control Section of the North Carolina Department of Environment, Health and Natural Resources.
But state statistics show that the number of new AIDS cases reported each year has dropped steadily from a high in 1993.
In 1993, the Centers for Disease Control liberalized the definition of AIDS to include a wider array of symptoms. That meant some people who had been considered HIV-positive were immediately categorized as having developed AIDS. HIV is the virus which causes AIDS.
``Every state experienced a peak of AIDS cases diagnosed in 1993'' because of the definition change, said Delbert Williams, head of the surveillance branch of the state HIV-STD Control Section.
If the cases created by the new definition are taken into consideration, the number of new AIDS cases in the state has dropped every year since 1992, Williams said.
A reporting lag may be one factor contributing to the drop in new cases for 1995, but it cannot account for declines in previous years, Williams said.
Gurganus says it is possible that the disease may spread in waves, and the current drop in numbers is simply part of the natural cycle.
He also thinks it indicates that in certain groups, AIDS education programs for targeted groups, like black teen dropouts, is beginning to make some difference.
Gurganus' group provides practical and emotional support for those with HIV and AIDS. To reach underserved groups, members of the service agency travel to gay bars, public basketball courts and housing projects to educate people who might not otherwise hear about prevention and testing.
Marks Lane, head of development for the Triangle AIDS Interfaith Network, says the number to focus on is not those with AIDS, but those who are not getting tested for it.
North Carolina's AIDS reporting requirements may be partly to blame for the reluctance of some people to be tested until they are actually sick.
North Carolina allows confidential testing, but requires that physicians report the name of anyone testing positive for HIV to the state. Once someone with HIV develops the disease, their name is transferred to the AIDS list.
``In North Carolina, this whole debate about anonymous and confidential testing has scared people off,'' Gurganus said.
Anonymous testing may only be performed at state health clinics. But the numbers of anonymous positives are not included in state statistics because many people refuse to say whether they have tested positive for the virus in the past, Williams said.
``It throws a major kink into statistics in terms of trying to really accurately reflect what the anonymous positives mean to the total HIV figures,'' Williams said.
Although anonymous testing might make it more difficult to keep an accurate count of the spread of the disease, many activists believe it would encourage more people to find out their HIV status.
The state has no immediate plans to study why the number of AIDS cases has begun to fall, and skeptics believe the decline will be short lived.
``What's happening in rural communities is they have high rates of STDs (sexually transmitted diseases). And if you have high rates of STDs, you're going to have AIDS down the road,'' Gurganus said.
``Until we see the understanding of HIV permeate the whole society, we're going to see pockets of it rise,'' he said. MEMO: TESTING FOR AIDS
North Carolina has been a battleground over AIDS testing and privacy.
Story on page B3.
by CNB