WASHINGTON, D.C.--In another tantalizing sign that the AIDS epidemic is abating in the United States, dramatic data presented here today reveal a sharp drop in AIDS-related deaths in New York City in 1996. The 30% decline from 1995 to 1996--from 7000 AIDS deaths to 5000--is a promising sign for the country as a whole, for New York City accounts for 16% of all U.S. AIDS cases.
The new figures were presented this morning at the 4th Conference on Retroviruses and Opportunistic infections by epidemiologist Mary Ann Chiasson, assistant commissioner of New York's Department of Health. Chiasson outlined an analysis of trends in AIDS cases and deaths from 1983 to 1996. Although total cases began to plateau in 1991, Chiasson said, mortality rates only began to drop at the beginning of last year. "It's good news, which we haven't had a lot of in AIDS up until now," said epidemiologist Harold Jaffe of the Centers for Disease Control and Prevention.
Chiasson suggested that one driving force behind the decline could be better access to drugs used to treat the opportunistic infections that plague HIV-damaged immune systems--the death blow for most AIDS patients. Getting these and other drugs to patients in New York City has improved dramatically over the last couple years, Chiasson said, as the federal government upped its contribution to health care for AIDS patients in the city from $44 million in 1993 to more than $100 million in 1996.
The decline also appeared to mirror the introduction last year of powerful new anti-HIV drugs called protease inhibitors. In January 1996, New York City averaged 19.5 AIDS deaths per day; the rate began to drop in the spring--about the time protease inhibitors went on the market--and reached 10.1 deaths a day by November, when the drugs were being widely used. Chiasson, however, doubts that protease inhibitors could have had such a big impact so fast. The death rate, she told ScienceNOW after her presentation, "clearly dropped before most people had access."