The growing HIV/AIDS epidemic in Berks County, PA

Dawn Day, Ph.D.
December 1999

In 1998 there were over 380 persons living with HIV or AIDS in Berks county, Pennsylvania, and the number can be expected to expand in coming years, with the majority of new infections coming directly or indirectly from infected needles. 

Berks county had the fifth highest AIDS rate in Pennsylvania in 1996.(1)

Since 1995, the advances in AIDS treatment have reduced AIDS deaths dramatically in Berks county as well as elsewhere in the United States. In Berks, AIDS deaths have been reduced from a high of 49 in 1995 to 31 in 1997.  But with falling AIDS deaths and a continuing steam of people progressing from HIV to AIDS, each year there are growing numbers of persons living with AIDS in Berks, as can be seen in Figure 1.

Looking at Figure 2, we can see the progression in number of persons living with AIDS in the years 1995 to 1998, and also get some sense of the wider epidemic, which includes both persons living with AIDS and with HIV. In 1998, over 380 persons living with HIV or AIDS were receiving services in Berks.(2) (See Attachment 1.)

Thirty eight percent of persons with HIV/AIDS receiving services in Berks county during the period 1988 to 1998 had been infected through dirty needles. Over the period, the number served who were injecting drug users grew gradually until in 1998, persons infected through dirty needles were 45 percent of all persons receiving HIV/AIDS services in Berks. 

Persons infected through heterosexual sex grew from an average of 27 percent of all persons served in 1988 through 1998 to 31 percent of all persons served in 1998. Most persons infected through heterosexual sex were infected because they were the wives, husbands or significant others of current or former injecting drug users.(3)

Sixty five percent of the injecting drug users receiving services in Berks county in 1998 were white. (See Attachment 2.)


High priority in Berks: Prevention of drug-related HIV
With substantial numbers of persons infected either directly or indirectly through the use of HIV-infected needles, AIDSNET Coalition, the regional planning group for AIDS in Berks and surrounding counties, has made HIV prevention among injecting drug users and their sexual partners is a high priority.(4)  An HIV prevention technique that could be very effective in Berks county is needle exchange.

Secretary of Health and Human Services, Donna E. Shalala has pointed to the careful scientific research showing that needle exchange programs successfully slow the spread of HIV and do not increase drug use. The American Medical Association and other major health organizations have called for needle exchange programs as part of HIV prevention.(5)


The low cost of clean-needle programs
Preventing the spread of HIV through needle exchange costs much less than treating HIV/AIDS after a person is infected. Using sophisticated mathematical models, a University of California team of investigators estimates that, over a five-year period, it costs between $4,000 and $12,000 in needle-exchange program expenses for each HIV infection averted.(6)  The cost of medicine for antiretroviral therapy for that same five-year period would be $60,000. One recent estimate puts the cost of antiretroviral therapy at over $17,000 for a single year!(7)  If we add in doctors' fees and hospitalization, the cost difference between prevention and treatment would be even greater.

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