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The number of new HIV infections in Minnesota rose 13 percent in 2009, the biggest increase in 17 years, signaling the return of a health scourge that public health experts had hoped was under control.
After holding steady for several years, the number of new HIV cases in the state rose from 326 in 2008 to 368 last year.
The largest cluster of new cases was among gay and bisexual men aged 15 to 24 -- 77 cases, compared to 42 in the previous year.
In an unusual move, the Minnesota Department of Health released the annual numbers more than two months ahead of schedule, a reflection of officials' concern about the unexpected increase.
"This tells us that HIV/AIDS remains a significant health threat in Minnesota, and we need to take steps to strengthen our prevention efforts," said Dr. Sanne Magnan, Minnesota Commissioner of Health.
Peter Carr, manager of HIV and Sexually Transmitted Diseases for the Health Department, said the causes are complex. But they appear to include a growing complacency and ignorance about the disease among teenagers and young adults, combined with the efficiency of the Internet and social networking sites as a means for connecting gay men who are seeking casual sex. He said the increase was not the result of increased testing.
"It could be that people are not taking it seriously," Carr said.
That's what Darin Rowles hears from teenagers and young adults when he teaches the HIV 101 class for the Minnesota AIDS Project (MAP), an advocacy group.
"Kids will say things like 'HIV can be cured,'" said Rowles. "That if they get HIV they only have to take a pill from time to time."
After all, experts said, the face of HIV for that age group is former basketball great Earvin (Magic) Johnson. He has spoken publicly about his HIV, but years after his diagnosis he still appears healthy and vibrant, thanks to the antiviral treatments that today make HIV/AIDS a chronic illness rather than the death sentence it once was.
"What they don't see in the media are the ones who are not the glamorous side of the story," Rowles said.
The Internet and the rise of social networking sites also are fueling the spread of the infection, experts say. Research has shown that gay men who use the Internet to find partners are not likelier to engage in risky sex, but they do tend to have more sexual encounters, which increases the risk of infection.
"That may be contributing to greater levels of anonymous sex," Carr said.
MAP and other advocacy groups try to spread prevention messages through gay websites and chat rooms, but the internet is vast and changes rapidly.
"It's very hard to keep up," Rowles said. "As soon as we get our heads wrapped around one [site], there's another."
Public funding for HIV prevention has declined in recent years as well. Lorraine Teel, executive director of MAP, said funding from the U.S. Centers for Disease Control and Prevention has dropped by 20 percent since 2002. Today, only 4 percent of federal AIDs spending is dedicated to prevention. The rest is earmarked for treatment and research, she said.
Others said the increase in HIV, as well as the epidemic of sexually transmitted diseases, both of which are occurring nationally, are also related to the decline in funding for comprehensive sex education in schools and communities.
"We lost a lot with abstinence-only education" said Fred Evans, who runs a sex education outreach program for teens through the Fremont Community Clinics in Minneapolis.
The Bush administration emphasized funding for abstinence-only sex education -- programs that encouraged teenagers to not have sex until marriage, but which provided no information about birth control or safe sexual practices.
The Obama administration eliminated more than $150 million in abstinence-only funding, though the Senate's health care overhaul would reinstate $50 million of it. The administration is also launching a $110 million sex education initiative focused on programs that have proven effective, but has left open the possibility of funding abstinence programs as well.
But sex education is not enough, said Brigid Riley, executive director of the Minnesota Organization on Adolescent Pregnancy, Parenting and Prevention, an advocacy group for adolescent sexual health. She pointed out that other countries, from Thailand to Denmark, have consistently funded successful public health campaigns that focus on HIV prevention.
"Those places that have placed public health above the politics of morality have had much better success at reaching young people," she said.
Josephine Marcotty • 612-673-7394