Deaths from AIDS in California have plummeted, falling 60.1
percent in one year, state health officials said Friday.
San Francisco followed the trend, showing a marked decline in
the first half of last year in the number of deaths among
people with AIDS.
The Department of Health Services said the decline was due to a
slowing in the rate of new HIV infections and improved
treatments with potent new drugs, which have extended the
average time - now more than 10 years - between infection with
HIV and the onset of illness.
State epidemiologists estimated that 1,112 people died of AIDS
in the first half of 1997, down from 2,788 in the first half of
1996. From the peak of the state epidemic in 1994, the death
rate has fallen 72.1 percent.
During the same period, 297 San Franciscans died of the
disease. In the first half of the previous year, 639 San
Franciscans died of AIDS. The peak number of AIDS deaths in San
Francisco - 830 - was reported between January and June of
A similar decline in deaths has been reported elsewhere in
North America, in cities as diverse as Vancouver and New York.
But outside the United States, the death toll is accelerating:
Nearly a quarter of the 6.4 million AIDS deaths occurred in the
last year, according to the World Health Organization.
The drop in deaths coincides with the introduction of a potent
new class of anti-viral drugs called protease inhibitors and
expansion of efforts such as California's AIDS Drug Assistance
Experts also attribute the decline to broadened access to
effective treatment and care. The federal government has
boosted funding of the Ryan White CARE Act, offering patients
access to better care and treatment of often-fatal
The drop also reflects decreases in HIV infections among gay
and bisexual men and injecting drug users that occurred more
than a decade ago. The number of new deaths are only now
reflecting this change because of the incubation period between
HIV infection, AIDS and death. Because of the decline in the
number of AIDS deaths, the number of people living with AIDS in
the state has increased.
"With more people living with AIDS, we will need to maintain
our array of community services and some costs - such as those
for drug therapy and outpatient medical care - will actually
increase, rather than decrease. Clearly, continued funding is
needed," Dr. Mitchell Katz of the San Francisco AIDS Office
The declining U.S. death rate is no signal to let up on efforts
to treat the infected and educate people to avoid contracting
the virus. Barring a scientific breakthrough, the task of
containing the threat will be a major one for decades.
There is yet no cure: recent scientific studies suggest that
anti-HIV drugs that lower the virus to undetectable levels
leave a silent infection in patients' immune systems that can
rebound dangerously if the expensive treatment is ever stopped.
Scientists have found evidence of the virus hiding in "resting
cells" of the immune system - white blood cells known as CD4
T-cells, according to Dr. Anthony Fauci, director of the
National Institute of Allergy and Infectious Diseases.
Implications of the declining death rate include the fact that
more people are living longer with AIDS and putting greater
demands on treatment facilities and other forms of support.
Moreover, the populations affected by HIV are increasingly
poor, heterosexual minorities, intravenous drug users, and
women, most of whom have not been able to obtain private
insurance coverage to pay for their expensive anti-viral
therapy and monitoring.
Fewer than one in five people with HIV are covered by private
health insurance. The rest depend either on public assistance -
or have no insurance at all.