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Show HIV/AIDS In Utah: A Challenge to a Medical Center by Kristen Ries, M.D. and Maggie Snyder, PA-C Statistics for the State of Utah: A Growing Epidemic By the end of June 1995, 1,095 cases of AIDS (Acquired Immunodeficiency Syndrome) had been reported to the Utah Department of Health since the beginning of this epidemic in 1981 (Bureau of HIV/AIDS, 1995a). Currently, an additional 778 cases of HIV (Human Immunodeficiency Virus) infection have been reported that have not progressed to AIDS. This totals 1,873 patients with HIV/AIDS. AIDS is now the leading cause of death among Utahns age 25-44. Six hundred thirty-seven or 58% of the patients with AIDs have died. There is a large preponderance of men, 1,702 (91%) with only 171 women. Twenty children (age 13 and younger) have been reported with AIDS and five reported with HIV. The Utah Department of Health, Bureau of HIV/AIDS continues to estimate that approximately 4,936 individuals are infected with HIV in Utah (within the range of 3,635 to 6,415 at a confidence level of 95%). Thus, over half of the projected number of patients with HIV have not been reported to the state of Utah.1 In fact, the majority of these patients most likely have not been tested and are unaware of their sero status or risk of carrying HIV. The majority of Utah adults with HIV/AIDS (67%) are in the transmission category of men having sex with men. This proportion is true for both AIDS and for HIV positive adults. This number has been stable since 1981 and is different from national statistics. This difference is not totally explained by less drug use. Analysis of surveillance data by the Bureau of HIV/AIDS indicates a trend towards increasing infection through drug use in women and adolescents. These data suggest target areas for prevention efforts in Utah. Minority groups, excluding gay men, are also over-represented in the HIV/AIDS cases reported. African Americans account for 6% of the cases of AIDS and 9% of the cases with HIV. This rate is alarming in a state in which Blacks make up only 0.6% of the state population. The Hispanic population accounts for 7% of AIDS cases and 8% of HIV cases; 4% of Utahns are Hispanic. Overrepresentation of mi- nority groups is a national trend as well (Bureau of HIV/AIDS, 1995b). There are 95 reported cases of AIDS and 76 cases of HIV reported in Utah women. This accounts for 9% and 10% of cases in Utah respectively, and suggests that this is a rising statistic. Of these women, 11% are African Americans and 5% are Hispanic. This is a high rate amongst Utah African American women. In Utah HIV/AIDS women have an overwhelming proportion, 71% of cases being associated with drug use. This includes direct IDU (Intravenous Drug Use) by the affected person and sexual relationships (e.g., with a drug user). Hemophilia accounts for 35 (3%) of AIDS cases and 9 (1%) of cases with HIV. Almost half of these patients have died. No new transfusion cases have been reported in 1994-95. Thus, the incidence in Utah is quite similar to the national epidemic except for the larger proportion falling in the risk group of men having sex with men. The epidemic has disproportionately affected minority groups, with an alarming rate in the African American population. One hundred fifty new AIDS diagnoses were made in Utah in 1994. It is estimated there will be about 150 new cases in 1995 (71 reported through June 16, 1995). University of Utah AIDS Center of the Division of Infectious Diseases The majority of the HIV/AIDS patients reside in the Wasatch Front in Salt Lake, Weber, and Davis counties. Many other Utah residents seek care in Salt Lake City in order to protect their identity and confidentiality From the beginning of the epidemic, the majority of care for patients with HIV/AIDS was provided by Dr. Kristen Ries. The Division of Infectious Diseases at the University of Utah started seeing HIV/AIDS patients in 1988 and opened a special clinic for HIV/AIDS in late 1989. In October 1994, Dr. Ries and Maggie Snyder, PA-C, moved their practice for HIV/AIDS and joined with the University practice at the University of Utah. This could grow into a multidisciplinary center for HIV/AIDS which can provide complex, quality, and cost-effective care for this group of patients. With Utah's Health: An Annual Review 1995 23 |
