A new estimate suggests that more than 150,000 people in California are living with HIV infection, the virus that causes AIDS. The number of people living with HIV in California is at its highest point since the beginning of the epidemic, and is estimated to have increased significantly since 1998.
 
In a report just released by the Universitywide AIDS Research Program at the University of California Office of the President, it's estimated that the total number of Californians living with HIV increased from about 108,000 in 1998 to over 151,000 today.
 
The report also documents increases in high risk sexual behaviors, including increased unprotected sex among men who have sex with men in both San Francisco and Los Angeles, and among clients of the statewide Counseling and Testing Program. Widespread use of methamphetamines is demonstrated by the skyrocketing numbers of people who have sought treatment for the drug in recent years. In addition, syphilis infection rates have risen sharply from 0.8 per 100,000 people in 1999 to 3.7 per 100,000 in 2004. Nearly 60 percent of persons with syphilis also tested positive for HIV.
 
George Lemp, director of the Universitywide AIDS Research Program, said, "In recent years, we have seen a significant increase in the number of Californians living with HIV. This represents a challenge for California to continue to provide preventive services and health care for an ever-expanding population.
 
"Despite our success in greatly extending the lives of those living with HIV, we remain concerned about the significant increases in high risk sexual behaviors, and the impact of HIV infection within African American and Latino communities."
 
The reports are part of the California HIV Prevention Indicators Project coordinated by the Universitywide AIDS Research Program (UARP) and funded by the California State Office of AIDS at the Department of Health Services. The purpose of the project is to carefully track the statewide HIV epidemic to assess the impact of prevention programs, and it is part of the Office of AIDS' emphasis on evaluation research to support HIV prevention programs.
 
The development of anti-retroviral medications since the mid-1990s has vastly improved the health picture for those with HIV. The annual number who progress to AIDS and the annual number of AIDS deaths both fell dramatically.

However, new HIV infections continue to occur and the consequence is a rapid annual increase in the total number of people who are infected. This has led, in part, to a dramatic rise in the costs of health services for people with HIV, notably within the California AIDS Drug Assistance Program (ADAP) where annual costs for drugs have nearly doubled from $145 million in fiscal year 2000-01 to $270 million in the current fiscal year.
 
There is some good news in the report. Injection drug use appears to be declining and, while needle sharing is very common among injection drug users, there is evidence that they have become less likely to do so. On the other hand, there has been a substantial increase in the number of non-injecting methamphetamine, crack and cocaine users entering drug treatment, and these drugs are associated with higher HIV infection rates.
 
In California, more than 80,000 people with AIDS have died since the epidemic began almost a quarter century ago, and the number of people living with AIDS-related symptoms has increased dramatically from 15,000 in 1990 to more than 58,000 today. Nationally, an estimated 3.8 per 1,000 people were living with HIV at the end of 2003. The estimate for California is about 4.2 per 1,000 today.
 
About two-thirds of AIDS cases have been among men who have sex with men. Other high risk groups include injection drug users, transgendered persons, sex workers, female partners of men who have sex with men, and sex partners of injection drug users. While African Americans represent about 7 percent of California's population, about 18 percent of the AIDS diagnoses have been among African Americans.
 
The indicator reports are an accumulation of data from many sources. They are available athttp://uarp.ucop.edu/ for review or downloading.
 
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