Pubdate: Thu, 14 Aug 2003 Source: Baltimore Sun (MD) Copyright: 2003 The Baltimore Sun, a Times Mirror Newspaper. Contact: http://www.sunspot.net/ Details: http://www.mapinc.org/media/37 Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) LIVING WITH AIDS SHE WOULD get up in the morning about 5:30 so there'd be enough time before work to take the first of her medications, figure out what she could tolerate for breakfast, and then deal with the inevitable side effects: the nausea, the diarrhea. Compared to other women she knew with HIV, Roslyn was lucky; she didn't require a noontime dose that would make her sleepy, nor did she have to keep her condition a secret from her employer, a medical facility more sympathetic about such matters than most -- though she didn't want her full name in print. But even taking just five pills a day instead of the more typical 30, Roslyn coped with side effects so severe, she had to wear adult diapers on her honeymoon. She went off the medication shortly after: She considered the drugs worse than the disease. "I had to consider the quality of my life," she explained. In a triumph of modern medicine, more Americans each year are managing to live with HIV/AIDS. The death rate has dropped by 63 percent in Maryland, from its mid-1990s high. But make no mistake, it's often a very difficult existence. And increasingly, it's one endured by African-American women, most often infected by husbands or boyfriends, some of whom contracted the virus during sexual contact with men that their female partners knew nothing about. With the rate of new infections once again on the rise a decade after the AIDS epidemic apparently peaked in this country, prevention messages remain as vital as ever. Too many people aren't getting the word, have become complacent, are gambling by having unprotected sex, don't know they carry the virus, or are failing to inform their partners if they do. Maryland currently has the third-highest percentage of AIDS cases in the nation, largely because Baltimore ranks third among major metropolitan areas. Nearly 90 percent of Baltimoreans infected with HIV/AIDS are African-American; two-thirds are male. But here, the problem has much less to do with sex than with drug use. Because Baltimore's drug of choice is heroin, most often taken intravenously, about half of the AIDS victims here contracted it through needles. Nationally, intravenous drug use accounts for about one-fourth of AIDS cases. Thanks in part to needle-exchange programs, the rate of new HIV infections from drug use has dropped markedly in Baltimore. But the incidence of new cases contracted through heterosexual contact with an infected partner is rising here. Also, as new cases among men decline, the new infections among women are closing the AIDS gender gap. Overall totals in Maryland are fairly static, and the increase in new cases nation-wide is only 2.2 percent. But the demographic trend is alarming. Soon, thanks to ever-improving medications, deadly AIDS may become a chronic disease, like diabetes, that can be survived for many years with the appropriate care. But that is no cause for complacency. The medications only work properly when they are taken as directed. A hit-and-miss approach can cause the virus to mutate, and become immune to the medications. Worse, that mutated virus can be spread to others, upon whom the medication will be similarly ineffective. Living with AIDS is preferable to dying from it, but not by nearly enough to take the chance. - --- MAP posted-by: Josh