The HIV/AIDS epidemic has taken a tremendous toll on people in the United States.
Despite declines in new infections in the early 1990s, more people are living with HIV/AIDS than ever before. From 1,039,000 to 1,185,000 people in the United States are estimated to be living with HIV or AIDS, as of 2005. About one quarter of these people are unaware of their infection, which puts them and others at risk.
Get Tested and Treated
"It's simply unacceptable that 40,000 people in this country become infected with HIV each year, and it's intolerable that about one fourth of those infected with HIV don't know they're infected and therefore are not receiving appropriate medical care," said Julie Gerberding, M.D., M.P.H., director of the Centers for Disease Control and Prevention (CDC).
To increase testing and awareness of HIV infection so people can receive appropriate medical care, the CDC urges healthcare providers to make HIV testing a routine component of medical care. The CDC is not recommending mandatory testing of any group of people under any circumstances. The HIV test is offered like any other standard medical test, but can be declined.
In addition to being available in a medical setting such as a hospital or a doctor office, a rapid HIV test is available in community settings including STD (sexually transmitted disease) clinics, drug treatment centers, shelters, and correctional facilities.
The CDC hopes to prevent new infections by working with diagnosed HIV people. Historically, much of the prevention efforts have focused on uninfected people. That emphasis will continue, and be expanded to include prevention counseling and other management services to those who are already infected.
Finally, the CDC recommends routine HIV testing for all pregnant women, and as a safety net, for any infant whose mother was not screened, to reduce perinatal HIV transmission. Again, the test is not mandatory, just routine and recommended.
Populations at Greatest Risk
Throughout the last decade, an estimated 40,000 people became newly infected with HIV annually. In addition to the two groups that have been at highest risk since the beginning of the epidemic — men having sex with men, and IV drug users — other groups are now at increasing risk for HIV.
Racial and ethnic minorities. The epidemic has expanded from primarily affecting white people to primarily affecting people of color.
Women. Heterosexual transmission is occurring more frequently, especially from men to women.
Youth. New generations are replacing those who benefited from early prevention strategies.
More People Living with HIV
During the mid-to-late 1990s, advances in treatment slowed the progression of HIV infection to AIDS and led to dramatic decreases in AIDS deaths. There was an eight percent decrease in the estimated number of AIDS deaths from 2000 through 2004.
Although effective treatment will ensure that fewer HIV infections progress to AIDS, it means that more people will be living with HIV, producing a wellspring of potential new infections. From 2000 through 2004, the estimated number of people in the United States living with AIDS increased from 320,177 to 415,193 — an increase of 30 percent.
Still No Cure
It is important to note that treatment does not cure HIV infection. And no one knows if treatment will produce long-term adverse effects or if the drugs used will remain effective. These realities underscore the importance of tracking the epidemic and using scientifically proven prevention programs to protect the people who are most at risk.
Globally…
HIV and AIDS also have a large presence outside of the United States. At the end of 2006, an estimated 39.5 million people worldwide were living with HIV, and 4.3 million became newly infected with the virus that year.
A recent UNAIDS report found increases in China, Indonesia, Papau New Guinea, and Vietnam. There are signs of HIV outbreaks in Bangladesh and Pakistan. South Africa remains the global epicenter of the AIDS epidemic, with no signs of slowing down.
A report by the National Intelligence Council forecasts that HIV/AIDS cases are about to climb steeply in five populous nations – China, India, Ethiopia, Nigeria and Russia. The report predicts that the number of HIV/AIDS cases in the five countries could increase from around 14 to 23 million currently to an estimated 50 to 75 million by 2010.
The rise of HIV/AIDS in the next-wave countries is likely to have significant economic, social, political, and military implications. The next-wave countries are likely to seek greater U.S. technical assistance in tracking and combating the disease.
Glimmer of Hope for Prevention
When looking at the data of several studies on AIDS, scientists saw an undeniable pattern: Circumcised men consistently had a significantly lower risk of acquiring AIDS from women – up to 60% lower risk – than did uncircumcised men.
In light of this, the World Health Organization has declared that male circumcision is an effective intervention for heterosexual HIV prevention. But that declaration carries with it some warnings, including:
- Male circumcision should never replace other known methods of HIV prevention (abstinence, using condoms correctly, reducing the number of sexual partners, and HIV testing), but should be part of a comprehensive prevention package.
- Because circumcision is not completely protective, it might give men a false sense of security and lead to high-risk sexual behaviors – which would undermine the protection provided.
Circumcision has not been proven effective in preventing transmission of HIV from men to women or from men to men. |
