Pictured Campaign to End AIDS tombstones at the White House. Photo by Bob Roehr
A media frenzy about a possible HIV 'superbug' gripped New York City in February when health officials breathlessly spoke of a single person who had become infected with a multiple drug-resistant variant of HIV and had rapidly progressed to AIDS-defining symptoms.
Many outside experts acknowledged that it indeed was bad news for the individual patient but expressed skepticism that it represented anything truly new. Drug resistance is an increasing problem, and a small percentage of persons are rapid progressors. There was nothing suggesting that the virus had changed significantly, no others were infected by it, and most signs pointed to the patient who was unique.
Months later those same health officials said the patient was doing well on his regimen, and perhaps they did overreact.
The other great demon of the year was crystal methamphetamine. A swell of concern over meth use within the community reached a hysterical crescendo and then abated to a more sustainable level of concern.
The first national conference on meth and HIV, in Salt Lake City in August, offered an historical framework of drug use in American society. It made the point that use and abuse are not synonymous. Behavioral interventions have been useful in helping some to quite meth, while ongoing trials suggest that pharmacological interventions used to help stop cocaine addiction also can be used to treat meth abusers.
Syphilis and gonorrhea rates increased among gay men in 2004, according to figures released by the Centers for Disease Control and Prevention in November. But unlike earlier years when CDC officials warned that this may lead to an increase in HIV infections among gay men, this year they acknowledged that may not be occurring. They speculated that it might be because of serosorting—men consciously having sex with people of the same HIV status as they are.
The number of Americans living with HIV passed one million, according to estimates released by the CDC in July. However, resources are not keeping pace with the caseload. HIV programs are tightening their eligibility, cutting back services, and some state ADAP programs are creating waiting lists for access to life saving medications. The Ryan White CARE Act technically expired at the end of September while reauthorization continues to languish in Congress.
One of the more encouraging organizational signs is the rebirth of AIDS activism at the grassroots level. The Campaign to End AIDS grew out of an organizational meeting in January, with the aim of training and empowering a new generation of activists. It used a series of caravans from across the country in the fall to raise awareness, and demonstrations in Washington in November to catch the media's eye.
Internationally, the fight against AIDS swung between the euphoria of initiating therapy among large numbers of people in the developing world, and the realization that the task is tremendously difficult, given the limited healthcare infrastructure in most of those nations. And it will be hopeless unless the number of new infections can be curbed.
