HIV-diagnosis delays worry health officials

State Health Department officials are troubled that too many gay men are not getting tested for HIV on a regular basis. The result: Those who don't find out they have the terminal virus until they become quite sick.

According to a February report, 63 percent of New Mexicans diagnosed with AIDS last year were unaware they had HIV, a virus that destroys cells in the immune system. AIDS, a later stage of the virus, takes five to 10 years to develop. The earlier the diagnosis, the better the life expectancy.

Many New Mexicans diagnosed with AIDS hadn't previously been tested for HIV. Then they fell sick enough to seek help. Two of the men with AIDS were already so sick, they died in emergency rooms.

"It's a shock," Lily Foster, HIV/AIDS surveillance coordinator and epidemiologist at the state Department of Health, said about what she sees as a trend.

Nationwide, intravenous drug users make up the largest group of those infected with HIV/AIDs. Not so in New Mexico. Here, the disease hits hardest men who have sex with men -- no matter where you go in the state, according to the Health Department. But with 1,965 residents living with HIV/AIDS, New Mexico is considered to have a low prevalence of the disease.

For years, the virus has been present in all ethnic groups in proportion to the HIV demographics of New Mexico. Differences have shown up, however, within the group of New Mexicans diagnosed with HIV and AIDS simultaneously. Every year since 1998, more Hispanic gay men than Anglo gay men have been diagnosed with HIV and AIDS simultaneously. The Health Department didn't recognize this as a trend until 2003.

"Hispanics are rising in the proportion of cases they contribute to the state," Foster said. "Not only are there more cases, but they're coming in sicker. Hispanics definitely have much more concurrent diagnoses."

The problem is strongest among Hispanic gay men, between the ages of 30 and 49, who live in Bernalillo County and southern parts of the state. Some might not consider themselves gay but practice gay sex, according to the Health Department. An estimated 4 percent of adult males, (34,000 in New Mexico), have sex with men.

Health Department officials speculate that complacency about the disease and its stigma keep people from getting tested. Access to HIV testing doesn't seem to be the issue, Foster said. Public-health offices offer free, anonymous screening to everyone in New Mexico.

In light of this trend, the Health Department has decided it's time to take a different tack on prevention. "Sometimes the blanket approach of targeting the general population isn't the most effective approach," said Dr. Joan Baumbach, a medical epidemiologist at the Health Department.

The state's campaign to reduce the transmission of HIV/AIDS has emphasized all high-risk groups, including men who have sex with men. In the near future, the Health Department and New Mexico Community Planning and Action Group, which is composed of members of affected communities, people living with HIV/AIDS and prevention providers, will instead take a more targeted approach that will include focusing on Hispanic gay men.

But first, Health Department workers must hold study sessions in communities to understand what's going on. They want to know why some Hispanic men who have gay sex aren't getting tested. From that deeper understanding, prevention workers will have a better idea on how to reach this group.

What's happening here reflects a national trend, Foster noted. The numbers of people sick with AIDS, before they know they have HIV, is on the rise everywhere and is prompting a push for routine testing.

Though better AIDS treatments have helped prolong life, this is no time for complacency, according to the Web site of the Mayo Clinic in Rochester, Minn.: "Despite some progress against AIDS, most experts agree that the epidemic is still in the early stages. Because it seems unlikely that a vaccine will be found soon, hopes for stemming the infection appear to lie for now in education, prevention and treatment."