E-Mail This Article to a Friend HIV/AIDS Massachusetts can’t slow the death rate BY DAVID S. BERNSTEIN

In combating such preventable causes of death as heart disease, sudden-infant-death syndrome, and child asthma, Massachusetts has already reached or neared its target objectives, which were inspired by the national "Healthy People 2010" initiative. But one figure remains stubbornly and depressingly far from the goal: HIV/AIDS deaths. According to a new state report, HIV/AIDS accounts for 3.5 deaths per 100,000 residents — five times the target of 0.7.

Massachusetts is still ahead of the US average, but has made little progress in lowering the figure over the past five years. Even more troubling, deaths from the disease are actually increasing slightly among the state’s Hispanic population. In fact, HIV/AIDS remains the leading cause of death among Massachusetts Hispanics aged 25 to 44, according to the Massachusetts Deaths 2002 report released by the state Department of Public Health earlier this week.

Nearly half of all HIV-positive Hispanics in the state have contracted the disease through intravenous-drug use, as compared to just over a quarter of non-Hispanic AIDS/HIV patients. IV-drug users face an increased risk of contracting other blood-borne diseases, such as hepatitis C, that can become lethal in combination with HIV, says Edward Rewolinski, executive director of the Boston AIDS Consortium. Hispanics are also disproportionately located in the western part of the state, according to DPH statistics. "How well are our prevention messages working there?" Rewolinski asks. "What kind of access do they have to high-quality medical attention outside of the Boston area?"

"I can’t say we shouldn’t be seeing any deaths at all," says Cathy Morales, executive director of Boston Living Center, an AIDS-outreach program. "But we’re still seeing a lot of deaths we shouldn’t, because we have people who do not receive proper care."

Rebecca Haag, executive director of AIDS Action Committee, concurs. But she also points to good news in the state’s report. In particular, she says, patients are living longer with the disease — for the first time, an AIDS death was most likely to occur at age 45 or older. Haag attributes that in part to state-provided medication. "This says that things are good because we are providing people with these drugs," she says.

That’s why she’s worried about a projected shortfall in funding for the drug program next year. Rewolinski and Morales also point to the mortality figures as evidence of the need for AIDS-treatment resources in the state’s 2005 budget. "The budget is on the governor’s desk right now," says Rewolinski. "It has two line items for AIDS in it. We’ll see what happens."