The number of people diagnosed with AIDS in Baltimore jumped sevenfold from 1985 through 1990, and the number of infected people in the surrounding counties more than tripled, according to statistics compiled by the state.
"We're seeing a consistent rate of increase" in cases of acquired immune deficiency syndrome in the Baltimore metropolitan area, said Dr. Audrey Rogers, an official with the state AIDS Administration.
The metro area, as defined by the state health department, includes Anne Arundel, Baltimore, Carroll, Harford, Howard and Queen Anne's counties. Separate statistics are kept for Baltimore.
"We need to do some analysis of the [metro area] numbers to see how significant or alarming a trend it is. But on face value, there's steady growth that causes concern," Dr. Rogers said.
In 1985 there were 36 identified cases of AIDS in the metropolitan area, she said, which translates into 25 cases per million residents. The number of identified cases in 1990 jumped to 111 -- 73 cases per million. (The years cited refer to when the cases were first diagnosed.)
Figures for 1991 won't be completed until April, but the number of cases throughout the state is expected to continue rising, Dr. Rogers said.
In contrast to the relatively slower rise in the number of metro-area AIDS cases, the number of cases in Baltimore leaped from 65 in 1985, or 85 cases per million, to 456 cases in 1990, or 612 cases per million.
Nationwide in 1985, 8,388 AIDS cases were reported, a rate of 35 per million. The number of cases rose to 43,339 in 1990, a rate of 170 per million.
Maryland's rate was even higher during that period. In 1985, 201 AIDS cases were diagnosed -- a rate of 47 cases per million. In 1990 there were 865 cases statewide, or 192 per million.
Human immunodeficiency virus, which causes AIDS, "is well-established in Baltimore City but less so in the counties," Dr. Rogers said. "We see this in major metro areas throughout the United States. The epidemic begins in the cities, intensifies, then moves out into the surrounding areas."
In Baltimore in 1990, Dr. Rogers noted, more AIDS cases resulted from people sharing intravenous needles than from sex among gay men. That was the first time any Maryland jurisdiction reported such a finding, she said.
"It's gotten to the point where you can't address AIDS without addressing drugs," said Dr. Rogers, who added that 60 percent of all AIDS cases in the state in 1990 were "drug-associated." That term refers to people infected through their own drug use, the sex partners of drug users or children who had an infected drug user for a parent.
Dr. Rogers said it would be hard to predict whether metro-area rates eventually will catch up to the city's. While IV drug abuse is not as common in the counties as in the city, she said, the sexual practices that transmit the disease are evident in all jurisdictions.
Therefore, she said, a dramatic rise in suburban rates "depends on how wise people in the counties are about their sex lives."
"You really do sleep with everyone your partner has ever slept with," she said. "People have been trusting what their partners say about their past sex lives. But just trusting may not be good enough anymore."