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 The Harm Reduction Act of 1998 allows the lawful exchange of used syringes for clean ones in New Mexico at designated sites.
Better prevention strategies must be developed to reduce sexually transmitted diseases.
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 HIV/AIDS Since 1981, over 2,500 persons have been diagnosed with HIV or AIDS in New Mexico. “HIV infection” means that the virus is present in a person’s body; AIDS is the disease that results from HIV infection. AIDS has been reportable to the New Mexico Department of Health since the early 1980s, and HIV became a reportable condition in 1998. New HIV infections are still occurring. The good news is that newly diagnosed cases of AIDS have declined by approximately one-third each year in 1998 and 1999 (Figure 1). Even more striking is the decline in the number of deaths from AIDS seen in the same period. New combination drug therapies are keeping HIV-infected persons alive longer than ever before.
Since persons who have developed AIDS usually seek treatment, most are easily identified. However, data about HIV infections are undoubtedly incomplete: some HIV-infected persons go untested until they develop AIDS symptoms, years after the initial infection. In 1999, 148 newly recognized HIV infections were reported to the Department of Health. The available data show 1660 persons currently living with HIV or AIDS in New Mexico. Most of them live in Bernalillo or Santa Fe Counties, with the rest scattered throughout the state. Most are adult males; about 9% of infected persons are female, and only eight infected children have been identified in New Mexico. Most (78%) of the New Mexicans diagnosed with HIV or AIDS report that they had been infected through male to male sex (including men who had sex with men and also injected drugs). Strategies to prevent HIV in this population are of prime importance for controlling further spread of the disease in our state. Community programs are encouraging safer sex practices and early testing for infection. Only ten percent report injection-drug use alone as their risk behavior. Studies in selected cities have shown that less than one percent of street-based injection-drug users in New Mexico are infected with HIV. This is much less than in some other states. This is good news, but can also be seen as a warning: the disease could spread rapidly once it appears among our injecting drug users. Syringe exchange programs are managed by community organizations. They are reducing the spread of HIV and other diseases. They have also allowed public health officials to contact hard-to-reach injection-drug users to counsel them about substance abuse, immunize them against certain diseases, and provide other public health and social services. Hepatitis B and C Hepatitis C is a viral disease of the liver spread through blood and possibly other bodily fluids; most cases have been linked to sharing of injection drug equipment. It may be one of the major public health problems of the new century. Already over 16,000 cases of infection have been reported to the New Mexico Department of Health. Based on national data, the total number of infected persons is conservatively estimated at more than 32,000 in New Mexico. The problems that are likely to result are staggering. Even though 90% of persons who acquire hepatitis C have no symptoms when first infected, 50-80% will go on to develop chronic liver disease. Half of those with chronic disease will later develop cirrhosis of the liver or liver cancer. Hepatitis C is already the single leading cause of liver transplantation in the United States. The number of hepatitis C-related transplants is sure to increase even further. The lifetime cost of treating a case of chronic hepatitis C is estimated to be $100,000. If we assume that half of New Mexico’s estimated 32,000 persons with hepatitis C infection go on to develop chronic hepatitis and require treatment, then the treatment costs in New Mexico alone will be $1.6 billion. Some of those persons will go on to require liver transplants, costing about $280,000 per patient.
At this time, New Mexico’s main strategy against hepatitis C is the syringe exchange initiative mentioned above in the discussion of HIV. Educational messages targeted at persons who visit sexually transmitted disease clinics and substance abuse treatment programs warn people about practices that carry a high risk of transmitting the disease, e.g., needle-sharing, non-professional tattoos, and high-risk sexual activity. Other strategies are being used to protect those people who are already infected by the virus against further liver damage. Any disease or substance which damages the liver can have a devastating effect on livers already damaged by hepatitis C. Thus, public-health officials recommend counseling hepatitis C infected persons against alcohol use, and immunizing them against other forms of viral hepatitis. However, substance-abuse treatment opportunities and money for vaccines are in short supply for the huge numbers of hepatitis C infected persons in New Mexico. New Mexico has had one of the highest rates in the country of hepatitis B, another viral disease of the liver that is spread by sexual activity and blood exposure (Figure 2). A mid-school-entry requirement for hepatitis B vaccination may reduce rates among New Mexicans. Funds are also needed to purchase hepatitis B vaccine for high-risk adults. The highest rates of the disease are seen in young adults (age 21-30). Yet, there is currently no federal funding source for vaccinating them and only limited state funds for this purpose. Other Sexually Transmitted Diseases (STDs) Other STDs are still common in New Mexico. Gonorrhea rates in the state are below national rates, even though nearly 1000 cases were reported in 1998 and again in 1999 in New Mexico. However, New Mexico’s rates of chlamydia, another bacterial infection of the reproductive tract of men and women, are among the nation’s highest. The rates are highest among minorities and people 15-24 years old. Both of these diseases are of great public-health concern. First, they can lead to infections that result in hospitalization, surgery and, ultimately, infertility. Secondly, they show that large numbers of people -- especially young people -- are not heeding the public health messages promoting abstinence or “safer” sex. It follows that these same people are at high risk for developing other, more serious infections such as HIV infection and hepatitis B. The numbers of syphilis cases remained steady in the late 1990s. However, the number of cases jumped sharply in Albuquerque in 2000. Reasons for the increase are still being investigated, but the potential consequences are serious. While syphilis is relatively easy to diagnose and treat, many infected persons do not know that they are infected. When pregnant women with syphilis remain untreated, they may pass the infection to their infants, resulting in birth defects and life-long problems.     New Mexico Department of Health Infectious Diseases Bureau
HIV/AIDS/Hepatitis Program
Tuberculosis Program
Sexually Transmitted Diseases (STD) Program
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