Maryland: As AIDS Cases Grow, a Call for New Fight

A Baltimore commission that measures the city's progress against HIV/AIDS said in a new report that efforts should be reinvigorated and better coordinated, especially among city housing, school and social service agencies. "It's not an issue that's at the forefront as it used to be," said Dr. William Blattner, chairperson of the Baltimore City Commission on HIV/AIDS. The commission is composed of 20 members, including doctors, clergy, business leaders and community advocates.

Though new HIV diagnoses have declined somewhat in recent years, Baltimore ranked fifth in per capita new AIDS diagnoses in 2003, when there were 40 AIDS cases per 100,000 population. Among those with AIDS, 40 percent are now women. Among those newly infected, 88 percent are African-American, according to the report. And African-American men are infected at 10 times the rate of white men.

Residents of West Baltimore neighborhoods have been hit especially hard by HIV/AIDS. The 21217 ZIP code area has 6 percent of the city population but 13 percent of residents living with HIV/AIDS, said the report.

"Overall, the strain on the system is definitely increasing," said Dr. Joshua Sharfstein, city health commissioner. In 2004, about 14,000 people were living with HIV/AIDS in Baltimore, compared with 4,100 a decade earlier, he said. Sharfstein said he fears that a proposal to reauthorize the federal Ryan White Act could jeopardize the city's funds for treatment and prevention. Ryan White supplies $19 million of the $28 million Baltimore is spending this year on treatment and prevention, and the city would lose some of the money under the Bush administration's current proposal.

Former Health Commissioner Peter Beilenson said that, due to expanded methadone and needle-exchange programs, the city has significantly reduced its drug-related HIV/AIDS epidemic. However, sexual transmissions are harder to reduce, especially among men who have sex with men but who do not identify as gay.

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