Most HIV-positive Americans go without treatment
Advances in scientific research on HIV have helped to develop medication that transformed a once deadly virus into a chronic condition. This has allowed people with HIV to live long and full lives. However, despite the effectiveness of antiretroviral medications, many Americans who have been diagnosed with HIV are not monitored by doctors and don't receive these life-saving drugs.
A new report released on Tuesday by the Centers for Disease Control and Prevention found only 30 percent of 1.2 million Americans living with HIV actually have the disease under control. Additionally, as much as two-thirds of people diagnosed with HIV are not receiving medical care or regularly taking antiretroviral medications that can keep the fatal disease from progressing.
"For people living with HIV, it's not just about knowing you're infected -- it's also about going to the doctor for medical care," Tom Frieden, director of the CDC, said in a press statement. "And for health care facilities, it's not just about the patients in your care -- it's every person diagnosed, and every person whose diagnosis has not yet been made. [The] key to controlling the nation's HIV epidemic is helping people with HIV get connected to -- and stay in -- care and treatment, to suppress the virus, live longer and help protect others."
The CDC report is based on 2011 data from the National HIV Surveillance System and Medical Monitoring Project. In 2011, there were approximately 1.2 million people living with HIV in the U.S., and 86 percent had been tested for the virus. However, only 40 percent of HIV patients were actively receiving medical support to manage the disease. Additionally, only 37 percent of people with HIV were prescribed antiretroviral medications and 30 percent achieved viral suppression with the drugs.
Significantly fewer young people with HIV accessed services to maintain viral suppression. The researchers found only 13 percent of HIV patients aged 18 to 24 had achieved viral suppression, though that percent doubled for people aged 35 too 44. Nearly 40 percent of HIV-positive people over age 65 were able to effectively manage their disease with drugs and other health care services.
When used appropriately, antiretroviral medications can keep HIV viral load at extremely low levels in the body, and significantly reduce the risk of viral transmission. Viral suppression allows HIV-positive individuals to live a near average lifespan. If a person begins antiretroviral drugs after diagnosis, they can extend their life by an average of 51 years, according to the report.
But there are many barriers that prevent HIV patients from receiving care. Though society's perception of HIV has changed -- thanks to better treatment and public awareness campaigns -- many people diagnosed still feel shame and stigma and don't seek help. Despite the Affordable Care Act and Medicaid expansion, many HIV patients don't have health insurance.
Additionally, antiretroviral drugs are still expensive. Patients typically take a cocktail of two or more medications, a treatment plan that can cost several thousand dollars a month. A significant number of federal, state and community programs aim to make treatment less expensive and more widely available, though the report indicates more work must be done to connect HIV patients with medical care.
"Improvements are needed across the HIV care continuum to protect the health of persons living with HIV, reduce HIV transmission, and reach prevention and care goals," the authors write in their report.