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Document 5 of 7.

March 12,2000, Sunday

SECTION: NEWS, Pg. 1D

LENGTH: 854 words

HEADLINE: AIDS, HIV GOING UNCOUNTED FAULTY FIGURES LEAVE STATES WITH INADEQUATE FUNDING

BYLINE: Mark D. Somerson, Dispatch Medical Reporter

BODY:

For two years, Michael hid his HIV infection and subsequent AIDS diagnosis from the world.

When he finally did see a doctor in 1987, his AIDS status was sent confidentially to the state, where Michael, 41, was turned into a number -- one of 412 diagnosed AIDS cases entered into an Ohio Department of Health database that year.

He's not the only one keeping a secret.

State health officials say there could be thousands of people with HIV and AIDS who are uncounted, either because they're unaware they are infected or don't want to risk the possibility of others finding out.

In either case, the result does more than put people at risk for serious health problems. If the state can't count them, it can't provide increased funding for AIDS services to communities.

"The bulk of people (with HIV or AIDS) want to take some time to think about it before they receive health services,'' said Michael, who spoke on the condition that his last name would not be used.

"If you seek services, you are disclosing your disease to someone. There is a lot of fear over confidentiality.''

For Ohio and other states, inaccurate counts can mean the loss of federal funds allocated according to AIDS incidence.

Now, states are being urged to count HIV diagnoses as well. HIV is the virus that causes AIDS.

"AIDS case reports have decreased, but rate of infection has not declined at all and is remaining stable,'' said Carol Lynne O'Neil, who manages the AIDS program at the Columbus Health Department. "Our population of people living with HIV far exceeds those living with AIDS.

"Counting HIV will be a tool for us to communicate to the public and to funders that the epidemic is not over.''

In 1993, 1,300 newly diagnosed AIDS cases were reported to the health department. In 1998, that number dwindled to 542.

"HIV no longer develops into AIDS as quickly as it did before,'' said Kara Manchester, an epidemiologist with the Ohio Department of Health. "And people are not dying (of AIDS) like they were.''

But HIV incidence is on the rise. In 1996, 733 cases of HIV were diagnosed statewide; in 1998, 924.

Ohio and 31 other states count HIV cases, and the U.S. Centers for Disease Control and Prevention is urging more to do so.

Ohio has tracked HIV since 1992, and in December began reporting HIV incidence, in addition to AIDS cases. This gives both the public and the federal government a better understanding of the epidemic in Ohio.

"The CDC encouraged us to see who is living with HIV, so we are pulling that information together and are looking at it,'' said Elizabeth Cross, chief of HIV/AIDS surveillance for the Ohio Department of Health.

"This opens a whole new way to look at data.''

The surveillance program is not without problems. As of Dec. 31, there were 9,716 people in Ohio reported as living with HIV or AIDS -- 4,280 with AIDS and 5,436 with HIV.

But the state estimates there are between 10,000 and 18,000 people living with HIV or AIDS statewide.

Why the disparity?

Health officials say there are thousands of Ohioans who don't know they are infected, or have tested anonymously and have yet to seek medical attention. Until a doctor diagnoses an infection, it is not reported to the state Health Department.

"It can take years for some people to get into the system,'' O'Neil said. " I was working with one women who tested positive seven years ago and is now just getting help.

"We will get them sooner or later, but it can take a long time.''

Lag time can hurt local health departments that rely on federal AIDS funding, including the Ryan White Comprehensive AIDS Resources Emergency Act, which provides care and support services for low-income, uninsured and underinsured people and families affected by the disease.

Because not every state requires HIV reporting, the federal funding is based solely on AIDS incidence.

Ohio, however, began including HIV incidence last year in its statewide funding formula. The state funnels Ryan White funds to 11 health districts, one of which includes central Ohio.

When only AIDS cases were counted in Franklin County in the 1998-99 funding cycle, central Ohio received $ 372,132 in Ryan White dollars.

When HIV cases were added to the mix during the current 1999-2000 funding cycle, Ryan White money increased to $ 441,336.

"When the government changed the formulary to include the HIV- positive population, it changed our funding for the better,'' O'Neil said.

"Funding goes where it is needed the most. If we don't communicate the need, we are strapped for resources. Folks with HIV have significant health issues and service needs.''

Ohio's 11 health districts received $ 2.1 million for the 1999-2000 funding cycle.

Michael, who has lived with AIDS for nearly 15 years, said people who test positive for HIV need to seek care immediately.

"I am someone who uses Ryan White services,'' he said.

"My biggest concern is that too many people don't get help. The problem is that there are a lot of people with HIV who don't think they can access services as easily as someone with AIDS.''

GRAPHIC: Graphi, Graphi

LOAD-DATE: March 12, 2000

Document 5 of 7.


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