AIDS in America: Where we are today

AIDS in America: Where we are today

New HIV infection rates remain steady in the United States, which means there’s still a lot of work to be done on AIDS awareness and HIV prevention.

By Chris Iliades, MD

Medically reviewed by Niya Jones MD, MPH

To get a sense of where the United States stands in regards to transmission of HIV/AIDS, consider this statistic: In 2009, the prevalence of HIV among people over the age of 12 in Washington, D.C. was so high that it was similar to some regions of sub-Saharan Africa.

“Where we are today with HIV and AIDS in America is about where we have been,” notes Robert Grossberg, MD, medical director of the Center for Positive Living and the Infectious Disease Clinic at Montefiore Medical Center in the Bronx in New York City. “More people are living with HIV and AIDS in America, and our awareness and prevention programs have not lowered the number of people that are being diagnosed every year.”

What the Stats on AIDS in America Tell Us

More people are living with HIV and AIDS, and fewer are dying from AIDS, Dr. Grossberg says. Why? Among other reasons, says Grossberg, “AIDS awareness and needle exchange programs have resulted in less HIV being diagnosed in intravenous drug users.” Statistics from the Centers for Disease Control and Prevention (CDC) show that annual infections peaked in the mid-1980s at 130,000, fell to 50,000 in the early 1990s, and have increased to 56,300 since then.

Some other statistics:

· More than one million people are living with HIV and AIDS in the United States today.

· Between 2005 and 2008, HIV transmission between intravenous drug users decreased while HIV transmission due to sexual encounters increased — both among men who had sex with men and among men and women exposed to HIV through heterosexual contact.

· AIDS awareness and HIV prevention have resulted in routine testing for pregnant women in many states, dramatically reducing HIV transmission from mother to baby.

Who Becomes Infected With HIV?

According to the CDC, men still account for the majority of HIV-infected individuals in America. In recent years, just over 50 percent of newly infected individuals got the HIV virus from male-to-male sexual contact, 30 percent from heterosexual contact, and about 10 percent from intravenous drug use.

Grossberg also points out that racial differences exist in HIV transmission — people newly diagnosed with HIV/AIDS are more likely to be black or Latino than white. These differences in HIV transmission appear to be due, at least in part, to a lack of consistent access to health care.

How the United States Compares to the Rest of the World

North America has about 1.2 million reported cases of HIV/AIDS. Compared to areas like sub-Saharan Africa with 22 million cases and Southeast Asia with 4.2 million cases, the United States has substantially fewer cases, but considerably more than in Western and Central Europe, which report about 730,000 cases.

“In America and other developed countries, AIDS is a chronic, treatable disease. In the rest of the world, AIDS is a devastating epidemic,” notes Grossberg. In underdeveloped countries, AIDS affects more women and children and it continues to spread at an alarming rate. Here are some of the reasons why:

· Lack of access to HIV/AIDS medications

· Untreated genital lesions that increase the risk of HIV transmission

· Strains of HIV that are more likely to be resistant to medications

· Poor overall health and nutritional status

Building HIV Awareness

The development of successful HIV/AIDS treatment has contributed to what Grossberg calls “the unsafe sex” problem. “Because we have been able to treat AIDS in America so successfully, the fear of AIDS … has decreased. The HIV/AIDS prevention message has suffered from message fatigue,” he notes.

Evidence that the importance of HIV prevention needs to be reinforced includes the finding that 40 percent of gay men in a recent survey reported not using a condom with their last sexual partner. Additionally, the estimation that about 20 percent of HIV-positive Americans have never been tested, and may be unknowingly spreading the virus, also highlights the fact that the HIV prevention message has to be reaffirmed. Encouraging people to get tested can increase HIV awareness and help prevent the further spread of HIV.

More HIV and AIDS Prevention Strategies

Other HIV prevention strategies include

· Increasing the availability of HIV/AIDS treatment for those who are uninsured or underinsured

· Increasing the use of rapid HIV tests that provide results in 20 minutes

· Avoiding abstinence-only education and including information about condoms and teenage sexual relationships

· Increasing the availability of needle exchange programs

The panic and hysteria that once characterized the media’s response to AIDS in America has now been replaced by “message fatigue.” Despite decreased HIV transmission due to intravenous drug use and childbirth, HIV/AIDS continues to increase among certain groups. Although we have made some progress in AIDS awareness and HIV prevention, America is home to more people living with HIV than any other industrialized country. What do these numbers tell us about AIDS in America? We need to do much better.

Some other statistics:

•   More than one million people are living with HIV and AIDS in the United States today.

•   Between 2005 and 2008, HIV transmission between intravenous drug users decreased while HIV transmission due to sexual encounters increased — both among men who had sex with men and among men and women exposed to HIV through heterosexual contact.

•   AIDS awareness and HIV prevention have resulted in routine testing for pregnant women in many states, dramatically reducing HIV transmission from mother to baby.

Who Becomes Infected With HIV?

According to the CDC, men still account for the majority of HIV-infected individuals in America. In recent years, just over 50 percent of newly infected individuals got the HIV virus from male-to-male sexual contact, 30 percent from heterosexual contact, and about 10 percent from intravenous drug use.

Grossberg also points out that racial differences exist in HIV transmission — people newly diagnosed with HIV/AIDS are more likely to be black or Latino than white. These differences in HIV transmission appear to be due, at least in part, to a lack of consistent access to health care.

How the United States Compares to the Rest of the World

North America has about 1.2 million reported cases of HIV/AIDS. Compared to areas like sub-Saharan Africa with 22 million cases and Southeast Asia with 4.2 million cases, the United States has substantially fewer cases, but considerably more than in Western and Central Europe, which report about 730,000 cases.

“In America and other developed countries, AIDS is a chronic, treatable disease. In the rest of the world, AIDS is a devastating epidemic,” notes Grossberg. In underdeveloped countries, AIDS affects more women and children and it continues to spread at an alarming rate. Here are some of the reasons why:

•   Lack of access to HIV/AIDS medications

•   Untreated genital lesions that increase the risk of HIV transmission

•   Strains of HIV that are more likely to be resistant to medications

•   Poor overall health and nutritional status

Building HIV Awareness

The development of successful HIV/AIDS treatment has contributed to what Grossberg calls “the unsafe sex” problem. “Because we have been able to treat AIDS in America so successfully, the fear of AIDS … has decreased. The HIV/AIDS prevention message has suffered from message fatigue,” he notes.

Evidence that the importance of HIV prevention needs to be reinforced includes the finding that 40 percent of gay men in a recent survey reported not using a condom with their last sexual partner. Additionally, the estimation that about 20 percent of HIV-positive Americans have never been tested, and may be unknowingly spreading the virus, also highlights the fact that the HIV prevention message has to be reaffirmed. Encouraging people to get tested can increase HIV awareness and help prevent the further spread of HIV.

More HIV and AIDS Prevention Strategies

Other HIV prevention strategies include

•   Increasing the availability of HIV/AIDS treatment for those who are uninsured or underinsured

•   Increasing the use of rapid HIV tests that provide results in 20 minutes

•   Avoiding abstinence-only education and including information about condoms and teenage sexual relationships

•   Increasing the availability of needle exchange programs

The panic and hysteria that once characterized the media’s response to AIDS in America has now been replaced by “message fatigue.” Despite decreased HIV transmission due to intravenous drug use and childbirth, HIV/AIDS continues to increase among certain groups. Although we have made some progress in AIDS awareness and HIV prevention, America is home to more people living with HIV than any other industrialized country. What do these numbers tell us about AIDS in America? We need to do much better.