Petrelis Files

Dear Friends:

Today's snail mail brought the San Francisco Department of Public Health's first quarterly report for 2004, full of tables and charts showing the decline of full-blown cases continues.

To me, the most crucial table in the report is always number five because it's for AIDS cases by year and transmission route.

The current report shows in the first three months this year, only eight new AIDS diagnoses were reported. [1]

The number of new AIDS cases for America's AIDS model city, in the first quarter of 2004, has dropped into the single digits.

During this period, there were six gay male cases and 2 gay men who contracted AIDS through IV drug use.

Let's examine just the totals in table five from the past six year's worth of first quarter reports:

2004 = 8

2003 = 14

2002 = 40

2001 = 56

2000 = 49

1999 = 62

[2, 3, 4, 5, 6]

Dare I ask, what will next year's first quarterly surveillance report show? Less than eight? Certainly hope so, and that the same quarterly report for 2006 documents a further drop. Damn, it would be such a great thing for me to live to see the day when zero new AIDS cases are reported in even a single first quarter report for San Francisco.

But I digress.

So San Francisco has not turned into a sub-Saharan village decimated by HIV and AIDS, as widely predicted by the health department and the Centers for Disease Control in 2000, right before the launch of that year's global AIDS conference in Durban, South Africa.

In a July 1, 2000, front-page, above the fold story in the New York Times, Lawrence K. Altman, M.D., reporting from Manhattan's W. 43rd Street, informed readers of the following:

"A small but sharp rise in new infections with the virus that causes AIDS has been detected among gay men in San Francisco over the last three years, San Francisco health officials said yesterday.

"The estimated number of new infections in San Francisco nearly doubled to 900 last year from about 500 three years ago after having stabilized following aggressive prevention campaigns.

"The rise is deeply troubling because it was seen in San Francisco, one of the principal centers of the AIDS epidemic that was first detected in 1981. Thus, the rise could signal a new wave of infections there and elsewhere, San Francisco health officials said. San Francisco, New York and Los Angeles were the three cities where AIDS was first recognized. An estimated 6,000 new infections with H.I.V., the virus that causes AIDS, occurred in San Francisco at the peak of the epidemic there in 1982," the Times said. [7]

As if his editors require it, Altman turned to a researcher for analysis from the CDC, an agency with which Altman has a current relationship, and where he once worked as editor of Weekly Morbidity and Mortality Report.

Altman went to Dr. Ronald O. Valdiserri, an AIDS expert at the federal Centers for Disease Control and Prevention in Atlanta, who admitted his agency had not reviewed the San Francisco data.

"But, if confirmed, the findings 'are very serious and important,' Dr. Valdiserri said in an interview,'" with the Times.

Why let something as trivial as actually having read the findings deter the Times from giving the CDC one more chance sound an alarm?

The article was just one more example of how Altman skews the news to only include the opinions of CDC researchers, and omits any voices that differ from federal health officials.

If only for argument's sake, I'll assume the dire predictions back in 2000 from CDC for San Francisco, and the entire country, were true.

That means CDC-funded HIV prevention groups, using CDC-designed methodologies and research, in San Francisco and elsewhere were failing to stop HIV and new full-blown AIDS cases.

I'd think if only for the journalistic requirement of providing balance to a story, the Times would insist on voices critical of CDC efforts at HIV prevention.

Since federal health authorities were not meeting the agency's promised goal of reducing HIV transmissions and AIDS diagnoses, including the views of citizens and researchers skeptical of CDC and its local partners in the Times story, would have made for well-rounded journalism.

But that's asking just too much of Altman, the CDC's de facto mouthpiece at the paper of record.

My suggestion to the Times about the data in six years of first quarter AIDS surveillance reports is that it's worth looking at, especially in terms of updating the July 1, 2000, article. Almost four years after that gloomy piece ran, what's happened to the messages from CDC targeting gay men? Is CDC HIV and STD prevention effective and worth supporting? The Times should assign a reporter to answer these and other questions.

And if the science editors decide it's time to look critically at HIV and AIDS statistics from San Francisco's health department for a story, I ask that the story is not assigned to Altman and that the writer reports from here.

That's not asking too much.


Sources:
1. First quarter, 2004
2. First quarter, 2003
3. First quarter, 2002
4. First quarter, 2001
5. First quarter, 2000
6. First quarter, 1999
7. NY Times; July 1, 2000