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The number of gay and bisexual men diagnosed with HIV, the virus that causes AIDS, climbed for the third consecutive year in the United States in 2002, fueling fears the disease might be poised for a major comeback in this vulnerable group.

Overall AIDS diagnoses rose 2.2 percent to 42,136 last year, the Centers for Disease Control and Prevention also said on Monday at the 2003 National HIV Prevention Conference in Atlanta.

"These findings suggest that the dramatic progress against AIDS following the introduction of highly active antiretroviral treatment in the 1990s is beginning to plateau," Dr. Ron Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention, told a news conference.

Some 850,000 to 950,000 Americans have the AIDS virus. The disease killed 16,371 people across the nation last year, about 6 percent fewer than in 2001, according to the CDC.

Although U.S. health officials have been preaching HIV prevention to all Americans, they have become particularly concerned in recent years by an apparent resurgence of HIV and other sexually transmitted diseases in gay and bisexual males.

HIV diagnoses among men who have sex with men surged 7.1 percent last year, according to data collected by the CDC from 25 states that have long-standing HIV reporting. New diagnoses in this group have increased 17.7 percent since 1999, while remaining stable in other high-risk communities.

CDC officials cautioned, however, that the jump in HIV diagnoses could have been caused by more gay and bisexual males being tested for the virus and was not proof that this group was being infected at a faster rate.

The data also did not include New York, California and other states with large HIV-infected populations.

Standard tests
Standard HIV tests cannot tell when a person was infected, leaving open the possibility that HIV was contracted many years earlier.

But the CDC plans in the coming months to implement a new HIV tracking system, based on a blood test that it says can determine whether infection occurred in the previous six months.

Officials at the Atlanta-based agency said the new surveillance strategy was prompted by a need for more precise data. About 40,000 new HIV infections are reported in the United States each year.

Since the AIDS virus first surfaced in 1981, estimates of new HIV cases have been based on the predictable length of time -- usually 10 years -- that elapsed between an initial infection and the onset of AIDS symptoms.

But the development of antiretroviral drugs has slowed the progression of AIDS and made it more difficult to determine when a person contracted HIV.

"It will provide us timely information on HIV transmission that is occurring now," Dr. Robert Janssen, who directs the CDC's HIV prevention programs at the Atlanta-based agency, said in a conference call late last week.

"What it will do is allow us to target our prevention programs to those areas and populations among whom HIV is being currently transmitted," Janssen added.

The CDC plans to have the system in place in 35 areas that account for 93 percent of annual U.S. HIV infections by 2004. The agency has allocated $13 million in supplemental funding to state health departments for the program in fiscal 2004.

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