HIV Infections Rising In U.S.
About 900,000 Americans are infected with the AIDS virus, and a quarter of them do not know it, the U.S. Centers for Disease Control and Prevention said Monday.
Another 25 percent are not getting any kind of care for their disease, the CDC told an AIDS conference. That means more than 400,000 people are going untreated for HIV, and may be spreading it through unprotected sex or shared needles.
"We estimate that roughly half of all people living with HIV either don't know that they are infected, or they are not in care, or both," Dr. Harold Jaffe, acting director of the National Center for HIV, Sexually Transmitted Diseases and Tuberculosis Prevention at the CDC, told reporters.
"The proportion is improving, but we have a long way to go," said Dr. Constance Benson of the University of Colorado.
The United States does not keep national records on who has HIV and AIDS, so the CDC used computer programs and information available from 25 states that do keep track to make its projections.
The data suggest that 50,000 more people are living with HIV or AIDS than two years ago, a testament to the power of AIDS drugs that have vastly improved treatment over the past six years the CDC's Dr. Pat Fleming told the Ninth Annual Conference on Retroviruses in Seattle.
"That then gives us an estimated total of between 850,000 and 950,000 currently living in the United States with HIV infection," Jaffe said.
Survival increased almost overnight when drug combinations that included medicines called protease inhibitors transformed HIV from a death sentence to a chronic treatable illness.
The government estimates that 40,000 Americans catch HIV each year, a figure that has remained roughly stable for over a decade. However, until the turnaround in AIDS therapy, this figure was nearly offset each year by AIDS deaths, so the total number of
Americans carrying the virus stayed level.
Now, AIDS deaths have plunged from around 40,000 annually to about 15,000. As a result, new infections are outstripping deaths.
This is a small number compared to the global epidemic. Worldwide 3 million people die of AIDS every year and 40 million are infected -- most of them in Africa.
More people are alive with HIV in industrialized countries than ever before because of good drug treatments that do not cure the disease but that can keep it at bay.
But far too few in the United States are getting these drugs, Jaffe said.
"A major part of what we are trying to do at CDC is to get people tested," he said, adding that the agency was starting a new public information drive to educate people about testing.
He said a big help would be approval of rapid tests that would allow people to get a one-stop answer to whether they are infected, instead of having to come or call back into a clinic to find out the results of a blood test.
Several are being considered by the U.S. Food and Drug Administration and Jaffe said he hoped they would be approve soon. "I am not making any accusations," he said.
Dr. Benson, who heads the scientific committee of the meeting, said she has seen people's penchant to be tested wax and wane.
"Some of the trends that we observed in treatment have made an influence on the willingness of individuals to be tested," she said. In other words, people get tested if they feel there is hope but see no point in testing if they feel they will die regardless.
"One of the things we noticed, at least in many areas of the country -- the overall swings in optimism or pessimism in therapy have had influences on patients wanting to come into care and wanting to get tested."
But now people are hearing about some of the adverse effects of treatment, such as high blood cholesterol, diabetes and osteoporosis.
"That really resulted in people feeling maybe they don't want to be on therapy and there is no reason to be tested," Benson said.