Damned Heretics

Condemned by the established, but very often right

I am Nicolaus Copernicus, and I approve of this blog

I am Richard Feynman and I approve of this blog

Qualified outsiders and maverick insiders are often right about the need to replace received wisdom in science and society, as the history of the Nobel prize shows. This blog exists to back the best of them in their uphill assault on the massively entrenched edifice of resistance to and prejudice against reviewing, let alone revising, ruling ideas. In support of such qualified dissenters and courageous heretics we search for scientific paradigms and other established beliefs which may be maintained only by the power and politics of the status quo, comparing them with academic research and the published experimental and investigative record.

We especially defend and support the funding of honest, accomplished, independent minded and often heroic scientists, inventors and other original thinkers and their right to free speech and publication against the censorship, mudslinging, false arguments, ad hominem propaganda, overwhelming crowd prejudice and internal science politics of the paradigm wars of cancer, AIDS, evolution, global warming, cosmology, particle physics, macroeconomics, health and medicine, diet and nutrition.

HONOR ROLL OF SCIENTIFIC TRUTHSEEKERS

Henry Bauer, Peter Breggin , Harvey Bialy, Giordano Bruno, Erwin Chargaff, Nicolaus Copernicus, Francis Crick, Paul Crutzen, Marie Curie, Rebecca Culshaw, Freeman Dyson, Peter Duesberg, Albert Einstein, Richard Feynman, John Fewster, Galileo Galilei, Alec Gordon, James Hansen, Edward Jenner, Benjamin Jesty, Michio Kaku, Adrian Kent, Ernst Krebs, Thomas Kuhn, Serge Lang, John Lauritsen, Mark Leggett, Richard Lindzen, Lynn Margulis, Barbara McClintock, George Miklos, Marco Mamone Capria, Peter Medawar, Kary Mullis, Linus Pauling, Eric Penrose, Max Planck, Rainer Plaga, David Rasnick, Sherwood Rowland, Carl Sagan, Otto Rossler, Fred Singer, Thomas Szasz, Alfred Wegener, Edward O. Wilson, James Watson.
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Many people would die rather than think – in fact, they do so. – Bertrand Russell.

Skepticism is dangerous. That’s exactly its function, in my view. It is the business of skepticism to be dangerous. And that’s why there is a great reluctance to teach it in schools. That’s why you don’t find a general fluency in skepticism in the media. On the other hand, how will we negotiate a very perilous future if we don’t have the elementary intellectual tools to ask searching questions of those nominally in charge, especially in a democracy? – Carl Sagan (The Burden of Skepticism, keynote address to CSICOP Annual Conference, Pasadena, April 3/4, 1982).

It is really important to underscore that everything we’re talking about tonight could be utter nonsense. – Brian Greene (NYU panel on Hidden Dimensions June 5 2010, World Science Festival)

I am Albert Einstein, and I heartily approve of this blog, insofar as it seems to believe both in science and the importance of intellectual imagination, uncompromised by out of date emotions such as the impulse toward conventional religious beliefs, national aggression as a part of patriotism, and so on.   As I once remarked, the further the spiritual evolution of mankind advances, the more certain it seems to me that the path to genuine religiosity does not lie through the fear of life, and the fear of death, and blind faith, but through striving after rational knowledge.   Certainly the application of the impulse toward blind faith in science whereby authority is treated as some kind of church is to be deplored.  As I have also said, the only thing ever interfered with my learning was my education. My name as you already perceive without a doubt is George Bernard Shaw, and I certainly approve of this blog, in that its guiding spirit appears to be blasphemous in regard to the High Church doctrines of science, and it flouts the censorship of the powers that be, and as I have famously remarked, all great truths begin as blasphemy, and the first duty of the truthteller is to fight censorship, and while I notice that its seriousness of purpose is often alleviated by a satirical irony which sometimes borders on the facetious, this is all to the good, for as I have also famously remarked, if you wish to be a dissenter, make certain that you frame your ideas in jest, otherwise they will seek to kill you.  My own method was always to take the utmost trouble to find the right thing to say, and then to say it with the utmost levity. (Photo by Alfred Eisenstaedt for Life magazine) One should as a rule respect public opinion in so far as is necessary to avoid starvation and to keep out of prison, but anything that goes beyond this is voluntary submission to an unnecessary tyranny, and is likely to interfere with happiness in all kinds of ways. – Bertrand Russell, Conquest of Happiness (1930) ch. 9

(Click for more Unusual Quotations on Science and Belief)

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NYC’s urgent search for more AIDS patients

Today (May 24 Tues) we read in our favorite public relations organ for the AIDS-HIV paradigm, the world’s greatest and, some might say, most scientifically gullible newspaper, the New York Times, a posting of the latest pronouncement from the local servants of the global AIDS orthodoxy.

The story allows us to assess the current thinking of that self-important species, whose cries of alarm and calls to arms are as predictable as the underlying science for their recommendations is questionable, according to the experts who have reviewed it.

Specifically, Andrew Jacobs has reported, in a routinely supine story on the bottom right of page B5, on the draft report and recommendations presented today by the City Health Department’s New York City Commission on HIV/AIDS: Proposes Measures to Slow the Spread of AIDS.

The entire draft report can be found as a pdf at the NYC Department of Health. Visit here to download a copy of the draft report.

Or leave a comment. If you download the report you will see it has “DRAFT” emblazoned in huge letters on every page. Apparently the Commission members are sensitive to the excruciating politics of their topic, and want the project to be a community work. As their press release states:




The public is invited to provide written comments on the draft report’s contents and recommendations beginning today through Monday, June 13.

Though probably not the kind that the Commmission welcomes, here are a few comments that occur to us, based on the press release (click to see the full press release).

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City

FOR IMMEDIATE RELEASE

Press Release # 053-05

Monday, May 23, 2005

Sandra Mullin/Sid Dinsay/Andrew Tucker

(212) 788-5290; (212) 788-3058 (after hours) NYC COMMISSION ON HIV/AIDS PRESENTS DRAFT REPORT FOR PUBLIC COMMENT

NEW YORK CITY May 23, 2005 The New York City Commission on HIV/AIDS today released for public comment a draft of a report with recommendations on drastically reducing the spread of HIV, significantly improving control of the epidemic in New York City, and further strengthening the City’s position as a national and global model for HIV/AIDS prevention, treatment, and care.

The public is invited to provide written comments on the draft report’s contents and recommendations beginning today through Monday, June 13. Visit http://www.nyc.gov/html/doh/html/ah/ah-nychivreport.shtml to download a copy of the draft report. Comments can be sent to the Commission via email at comments@health.nyc.gov. People can also request copies of the report through 311 and mail comments to HIV/AIDS Commission Report, 125 Worth Street, CN 28, New York, NY 10013.

New York City continues to be the epicenter of the HIV/AIDS epidemic in the United States. There are more than 100,000 people living with HIV/AIDS (PLWHA) in the City today, representing approximately 1 out of 6 people living with HIV/AIDS in the United States.

Many of these people have not been diagnosed. Each year in New York City, there are still approximately 4,000 people newly diagnosed with AIDS and 1,700 deaths from AIDS. About 1,000 people each year – 3 people every day – first learn they are HIV-positive at the time they receive an AIDS diagnosis, up to a decade after they become infected. In the 25 years since the emergence of HIV/AIDS, the epidemic has changed dramatically. Today, more than 80% of new AIDS diagnoses and deaths are among African Americans and Hispanics, who comprise half of the CityÂ’s population. Black men are nearly 3 times more likely to be living with HIV/AIDS than other New Yorkers, with black men age 40-54 about 7 times more likely. A third of new HIV and AIDS diagnoses in NYC are among women, more than 90% of whom are black or Hispanic.

“HIV/AIDS prevention and care continue to be among our most critical public health priorities,” said New York City Health Commissioner and Co-Chair of the Commission, Thomas R. Frieden, MD, MPH. “More needs to be done to expand voluntary HIV testing, distribute condoms more widely, expand harm reduction, and improve treatment outcomes. We thank the Commission for putting together these critical recommendations.”

Recommendations include:

Improve Prevention

1. Make condoms much more widely available

2. Expand harm reduction programs

3. Expand drug treatment programs and facilitate referrals

4. Expand Prevention With Positives initiatives

5. Improve HIV prevention among HIV-negative people with continued risk-taking behaviors

6. Expand social marketing programs that work

7. Improve HIV/AIDS health education in schools

8. Reduce HIV-related stigma in order to improve HIV prevention, testing, and treatment

9. Evaluate prevention programs and expand those that work

Expand Voluntary Testing and Linkage to Care

10. Increase voluntary HIV testing and linkage to care of those who test HIV-positive

1. Advocate for making HIV testing an integrated part of normal medical care

2. Ensure that reimbursement schedules maintain the existing testing and counseling infrastructure

3. Increase citywide availability of HIV testing, especially rapid tests

4. Support a high-visibility social marketing and media campaign

11. Monitor HIV testing closely

12. Evaluate testing programs and expand those that are effective

Improve Treatment Outcomes

13. Preserve and strengthen treatment, case management, and support services to further improve patient outcomes

14. Increase housing opportunities and improve allocation based on client needs

15. Expand mental health, behavioral health, and harm reduction services and co-locate them with HIV/AIDS care

16. Increase access to care by:

1. Further improving health care worker and community staff training;

2. Enhancing patient education and empowerment; and

3. Disseminating information on service availability to PLWHA and service providers

Scott E. Kellerman, MD, MPH, Assistant Commissioner for HIV/AIDS Prevention and Control, added: “The Commission’s draft recommendations will significantly strengthen our response to the epidemic. We welcome input from the community to ensure that we are addressing the needs of New Yorkers living with HIV/AIDS and are doing everything we can do to stop the spread of HIV and control the epidemic.”

About the Commission

The Commission, a panel of 21 individuals who serve as key policy advisors on HIV/AIDS issues, was created in December 2003. The Commission includes individuals from diverse backgrounds, including executive directors of AIDS service organizations, HIV prevention researchers, and persons who are living with HIV/AIDS. Each member has more than a decade of experience in HIV/AIDS work.

The Commission provides guidance on how New York City can improve prevention, diagnosis, treatment, and control of HIV/AIDS. It supplements the work of the New York City Department of Health and Mental HygieneÂ’s (DOHMH) Bureau of HIV/AIDS Prevention and Control, which manages and coordinates the agencyÂ’s HIV/AIDS activities. It also complements the work of the New York City Prevention and Planning Group, as well as the HIV Health and Human Services Planning Council, which determines how the City disburses funds received under the federal Ryan White Title I CARE Act.

Comments by Commission Members

Spencer Cox, Founder and Executive Director of the Medius Institute for Gay Men’s Health, and a person living with HIV/AIDS said, “This report makes clear that, with the best of intentions, weÂ’ve made HIV testing inaccessible and difficult to administer. Almost a quarter of people with HIV in New York City donÂ’t get diagnosed until theyÂ’re already seriously ill. For most of those people, earlier treatment could have prevented progression to full-blown AIDS. We havenÂ’t been protecting HIV-positive people from discrimination, but abandoning them to disease progression. Now there is finally a consensus that weÂ’ve got to make HIV testing universally available, easy to access, and fully integrated into routine medical care.”

Don C. Des Jarlais, PhD, Director of Research, Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, and a world-renowned researcher in the field of HIV prevention among injection drug users and syringe exchange programs, said, “New York has had dramatic success in reducing HIV transmission from sharing needles and syringes. We have reduced the rate of new infections among drug injectors by 75%. We now need to urgently address sexual transmission, which is often associated with the use of a variety of different drugs.”

Jay Dobkin, MD, Associate Attending Physician, Department of Infectious Diseases, Columbia-Presbyterian Hospital, said, “Since many aspects of HIV and AIDS have changed over 25 years, it is important to reassess what we do to prevent, diagnose, and treat this potentially devastating infection. The Commission report highlights the enormous progress we have made but also points to areas where much remains to be done. The steps needed to decrease new HIV infections, diagnose cases earlier, and ensure that the full benefit of modern treatment is achieved are not easy and not free of controversy. If fully implemented, the Commission’s recommendations should enable many more New Yorkers to avoid needless infection, illness and death. This makes it imperative that we not accept the status quo.”

Debra Fraser-Howze, President/CEO, National Black Leadership Commission on AIDS, said, “We are pleased with this report, but it is impossible for one document to capture all that needs to be done to fight this epidemic. We welcome community comments and we acknowledge the Department of Health and Mental Hygiene for furthering our efforts.”

Mathilde Krim, Chairperson, American Foundation for AIDS Research (AmFAR), said, “HIV/AIDS is a dark and growing cloud looming over our city. No medical treatment can as yet cure it nor is there as yet – if ever there will be – a vaccine to protect from it. However, much has been learned over the last two decades. HIV’s spread in a population can be hindered by a combination of different approaches and progression of disease from HIV infection to AIDS can be much slowed by antiretroviral therapies. Our city authorities are to be commended for having searched what new or improved means could be applied towards the better control of HIV/AIDS. The interventions recommended here would certainly hasten the day when New York City’s AIDS epidemic can effectively be held in check.”

Frank Oldham, Director of the Harlem Director’s Group, said, “The Commission’s report is the first bold step toward ending the high rates of HIV infection and death in communities like Harlem. The report reflects the Mayor’s and Commissioner’s strong commitment to making New York City the national model for improving HIV services, treatment, and care and, most importantly, improving the lives of people living with HIV/AIDS. As a person living with HIV, I am confident in the report’s findings and commend the Bloomberg administration for moving with such decisiveness on this issue.”

Ana Oliveira, Executive Director of the Gay MenÂ’s Health Crisis, said, “As a member of the Commission, I want to encourage members of the community to read the report and provide feedback so New York City can move to a more advanced level of commitment in the fight against HIV and AIDS. It is only through community participation and collaboration that we will win this battle.”

Tokes Osubu, Executive Director, Gay Men of African Descent, said, “The work of the Commission is a testament of the City’s commitment, under the leadership of the Health Department, to remain at the forefront of the battle to combat the spread of HIV. My hope is that this report will be used as a reference guide by service providers and everyday New Yorkers alike regarding what needs to be done.”

Commission Members

Dennis Walcott, NYC Deputy Mayor for Policy, Co-chair

Thomas R. Frieden, MD, MPH, Commissioner, NYC Dept. of Health and Mental Hygiene, Co-chair

Moisés Agosto-Rosario, Vice President & Managing Director, Community Access

Allan Clear, Executive Director, Harm Reduction Coalition

Spencer Cox, Founder and Executive Director of the Medius Institute for Gay Men’s Health

Humberto Cruz, Executive Deputy Director, Div. of HIV Health Care, NYS Department of Health, AIDS Institute

Don C. Des Jarlais, PhD, Director of Research, Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, Specialist in HIV prevention among injection drug users

Jay Dobkin, MD, Director, AIDS Center; Physician, Infectious Diseases, Columbia-Presbyterian Hospital

Verna Eggleston, Commissioner, NYC Human Resources Administration

David D. Ho, MD, Director and CEO, Aaron Diamond AIDS Research Center

Debra Fraser-Howze, President/CEO, National Black Leadership Commission on AIDS

Mathilde Krim, PhD, Chairperson, American Foundation for AIDS Research (AmFAR)

Kim Nichols, ScM, MS, Co-Executive Director, African Services Committee

Frank Oldham Jr., Executive Director, Harlem Directors Group

Tokes Osubu, Executive Director, Gay Men of African Descent

Ana Oliveira, MA, Executive Director, Gay Men’s Health Crisis

Jairo Enrique Pedraza, Director of International Programs, Cicatelli Assoc., Inc.

Elaine E. Reid, CSW, Co-Chairperson-Elect, NYC Prevention Planning Group

J. Edward Shaw, Co-Chair, NYC Prevention Planning Group, People Living With AIDS Committee

Terry Troia, Executive Director, Project Hospitality

Rona M. Vail, MD, Clinical Director, HIV Services, Callen-Lorde Community Health Center

###

#053

Apparently the working premise of the Commission is that there is a looming shortage of HIV/AIDS patients, and much must be done to expand business.

For according to its report this little group of poo-bahs sees in AIDS a continuing cloud looming as darkly as ever over the future of New York City, since the city is the “epicenter” of the epidemic in the US, and the word epicenter is not one to be used lightly, after all. Evidently they can easily imagine that the virus’s stealthy penetration of the entire population of the metropolitan area will be accomplished in short order.

New York City continues to be the epicenter of the HIV/AIDS epidemic in the United States. There are more than 100,000 people living with HIV/AIDS (PLWHA) in the City today, representing approximately 1 out of 6 people living with HIV/AIDS in the United States. Many of these people have not been diagnosed. Each year in New York City, there are still approximately 4,000 people newly diagnosed with AIDS and 1,700 deaths from AIDS. About 1,000 people each year – 3 people every day – first learn they are HIV-positive at the time they receive an AIDS diagnosis, up to a decade after they become infected.

At this point we cry out, Huh? Hold that statistic!



No, we are not calculating the time that a rate of 4,000 new infections per year would take to penetrate a population of some 8 million.



We are wondering, If there are 100,000 in NYC, and 500,000 in the country, where are the missing 200,000 to 400,000 people with HIV in the US, where the total has always been supposedly one million HIV positives more or less, a level which has held throughout the supposed epidemic? Is it possible that business is dwindling?

That would certainly fit with the statistics last time we looked, which showed that AIDS began to tail off in the city as in the country in the nineties. Supporters of the present religion interpret this as evidence of the effectiveness of the new drug cocktails, but the heretics object that the timing better fits the use of lower doses of AZT.

That business is no longer brisk is certainly the impression one gets from one measure they advise to head off disaster. The Commission suggests (in the only novelty in the report) that anyone who shows up in an ER for treatment should be tested for HIV.

This continues a theme that has been seen for some time now in national HIV-AIDS ideology, which is that testing must be expanded in as many groups as possible to capture numerous potential patients who are apparently walking about entirely unaware of their dangerous predicament, one which might bring them down in an average of ten, and certainly not longer than twenty years, with a sudden diminution of their T cells, not something which has proved out as a cause for alarm in the latest studies.

Particular efforts should be made, the Commission suggests, to root out such innocents among the homeless and among blacks and Hispanics, who form half the city’s population and who are already proving a fertile resource for keeping the AIDS wheels spinning with new recruits. A third of them are women, contrary to the long time rule in America and Europe, in which the AIDS epidemic has been almost entirely gay and IV drug user based.

Today, more than 80% of new AIDS diagnoses and deaths are among African Americans and Hispanics, who comprise half of the CityÂ’s population. Black men are nearly 3 times more likely to be living with HIV/AIDS than other New Yorkers, with black men age 40-54 about 7 times more likely. A third of new HIV and AIDS diagnoses in NYC are among women, more than 90% of whom are black or Hispanic.

Presumably such people will be subjected to the twin impact of being told they suffer from a dread, and still incurable disease, and some helpful medications which will give them buffalo lumps, and other unpleasant side effects such as liver replacement, but all this will be counted a triumph of medical intervention.

Meanwhile, the high proportion of women leads one to go and see exactly how many people are represented by these numbers. So often in the past, a trumpeted “doubling” of numbers among women and similar claims have proved to be based on a few dozen, rather than the thousands one easily imagines.

Anyway, the Commission’s enthusiasm for expanded testing is unrestrained:

Expand Voluntary Testing and Linkage to Care

10. Increase voluntary HIV testing and linkage to care of those who test HIV-positive

1. Advocate for making HIV testing an integrated part of normal medical care

2. Ensure that reimbursement schedules maintain the existing testing and counseling infrastructure

3. Increase citywide availability of HIV testing, especially rapid tests

4. Support a high-visibility social marketing and media campaign

11. Monitor HIV testing closely

12. Evaluate testing programs and expand those that are effective.

Turning to measures to contain the epidemic, which is word-painted as a raging viral forest fire but in fact has been tailing off since the mid nineties as far official statistics show, we are once again talking condoms To prevent the spread of HIV among the sexually active, the Commission suggests shipping condoms into prisons, schools and nightclubs, and giving every nodding IV drug user a clean needle for his next shoot up.

They also ask the city to publicize the dangers of crystal meth among gay men, reduce the stigma of AIDS among blacks and let HIV positives know how they can stop spreading the virus. The former draws attention to a factor, supercharged speed, which in and of itself must knock the immune system out of the park as a result of its systemic effects, ruining sleep, digestion and heart rhythm, not to mention paranoid psychosis. The latter two proposals add up to more testing, it is fairly easy to see.

All very well and good, if you have never read a scientific review of the unscientific ideology of HIV-AIDS, and have not seen the studies that prove one basic fact in the peer reviewed literature that vitiates some of this advice and renders it nonsensical: HIV is not infectious, to any significant extent if at all, in heterosexual coupling. In fact, it is the least infectious disease culprit ever identified. It is pretty much never conveyed in heterosexual couples, studies show.



We wonder if there is any meaning in evidence that gay sex transmits the virus, or at least, “positivity”, but that is another story. There is also the fact that a rise in condom sales over the years has not correlated in the past with a decline in the prevalence of STDs, which reportedly have climbed in recent years regardless.

Of course, the same expert scientific reviews (described in the early posts of this blog) say that HIV is effectively inert and does no harm of any kind to anybody, like every other one of the 96,000 other retroviruses floating around our bodies, not even HTLV-1, pace Robert Gallo, who we hear continues to enjoy royalties from the tests for that retrovirus applied to all US blood used in transfusions.

(I recall once asking the genial if rogueish Gallo at one of his exclusive Washington conferences to which he invited me with the evident hope of snowing me under a six foot drift of scientific jargon and expertise, what the chances were of HTLV-1 giving leukemia to a human carrier, since there is famously a large area in Japan where that retrovirus is ubiquitous, but no added incidence of leukemia is observed.

“About one in a hundred carriers, ” he smiled. “Well, how often? ” I asked him. “Oh, once in fifty years!” he replied with one of his giant grins. “Isn’t that a rather weak correlation to prove causation?” I asked him innocently. “Oh really, you are such a boy scout!” he joked, giving me one of his patented elbow squeezes and going off to talk shop with his colleagues.)

But who are we to turn the world view of the highup Commission members completely upside down? After all, they include both Mathilde Krim and David Ho, scientific and social champions of the battle against HIV and well versed in every scientific and political justification of the AIDS=HIV banner they fight under. All 21 members boast of more than a decade of experience in AIDS, which makes it by definition impossible that they should have any interest in alternative views of the scientific foundation of the field. There is no political admissibility for even raising the topic.

Meanwhile according to Andrew Jacobs in his Times story,


The report, 18 months in the making, comes at a time of renewed urgency among public health officials, who say the fight against AIDS has been losing steam even as infection rates remain steady. The growing apathy, they say, may be partly responsible for the appearance of a rare and possibly virulent strain of H.I.V. that was reported last February by the city’s health department.

Yes, it is difficult to feel that the feeling of horrified alarm with which the AIDS Cassandras once imbued the public has not now degenerated into apathy. Private fundraising here has dropped in effectiveness even as AIDS has become something of a cash cow for foreign nations willing to apply US federal and private aid in AIDS in the officially sanctioned manner.

But is this due to rampant ignorance, or an example of The Wisdom of Crowds, as James Surowiecki of the New Yorker might have it? For twenty years now the prediction of a heterosexual epidemic of AIDS in America has failed to come about, Isn’t it likely that the mainstream public would lose interest in a danger that as time passes seems to be confined to active club gays and IV drug users in the US, and otherwise be spreading only in far flung foreign countries?

(Click below for the full Times story).

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May 24, 2005

New York Proposes Measures to Slow the Spread of AIDS

By ANDREW JACOBS

A commission appointed by the city’s health department has proposed a set of measures to increase condom distribution vastly in prisons, schools and nightclubs, expand needle exchange for intravenous drug users and make H.I.V. testing a routine part of every emergency room visit.

The draft report, issued by the New York City Commission on H.I.V./AIDS, also calls on the city to pay for public awareness campaigns that would address crystal meth abuse among gay men, the strong stigma that AIDS has among African-Americans and the role that people infected with H.I.V. can play in stopping the spread of the virus.

“This report outlines the direction we need to take if we want to halt the epidemic,” said Ana Oliveira, the executive director of Gay Men’s Health Crisis and one of the commission’s members. “The proof of the pudding, however, will be in the implementation.”

Although dollar figures do not accompany its recommendations, many of the commission members said the report, if adopted in its current form, would transform the way the city deals with H.I.V. and AIDS. The panel, whose 21 members included doctors, researchers and advocates for people with AIDS, also calls for increased access to treatment and housing for people with H.I.V. and AIDS.

Dr. Thomas R. Frieden, New York City’s health commissioner, said he was pleased by the proposed recommendations, calling them “a blunt assessment of where we are and a message of optimism.”

If financed and put into effect, the proposals would drastically reduce the spread of H.I.V., he said, and “make New York City a national and global model of how to stop the epidemic.” The report will be formally adopted on June 13 after a public comment period.

The report, 18 months in the making, comes at a time of renewed urgency among public health officials, who say the fight against AIDS has been losing steam even as infection rates remain steady. The growing apathy, they say, may be partly responsible for the appearance of a rare and possibly virulent strain of H.I.V. that was reported last February by the city’s health department.

Although additional cases of that strain have not been documented, panel members said they were concerned that more than 4,000 New Yorkers test positive for H.I.V. each year. More worrisome, they said, is that a quarter of them learn their status only when they are found to have full-blown AIDS.

The report’s most potentially contentious proposals involve ways to increase H.I.V. testing, especially among minorities, the homeless and intravenous drug users. In addition to encouraging more people to get tested, the commission endorsed new state rules governing how data on H.I.V. and AIDS is gathered.

The regulations, which go into effect on a temporary basis next week, streamline H.I.V. testing consent forms and allow health officials to collect detailed information about a patient’s viral load and whether he or she is showing resistance to AIDS medications. Several commission members privately said their willingness to embrace the changes had encouraged the state to adopt the new regulations.

But Tracy L. Welsh, executive director of the H.I.V. Law Project, said she was worried the new rules would chip away at long-established safeguards on the privacy of those infected with H.I.V. “My concern is that this sets the stage for government involvement in private medical decisions,” said Ms. Welsh, who was not a commission member.

While they acknowledged public concerns over privacy, many of the panel’s members said they felt the benefits outweighed the costs. “I’m tired of folks coming through our doors who test positive and who were infected years earlier,” said Tokes Osubu, executive director of Gay Men of African Descent and one of the commission members. “Chances are, they may have been unknowingly infecting other people, and this is something we have to stop.”

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