by Mike Andrew -
SGN Staff Writer
Almost three out of four Americans with HIV do not have their infection under control, even though anti-HIV drugs have been available for more than 15 years, according to a study released November 29 by the U.S. Centers for Disease Control and Prevention (CDC).
'That's a very poor rate. We have to do much better than that,' said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and one of the pioneers of HIV/AIDS treatment.
Keeping HIV under control is crucial not only for the 1.2 million people in the United States who carry the infection, but also for their sexual partners. Suppressing the virus decreases the chances it will be transmitted to a sexual partner by more than 95%.
'Treatment is one of the best ways to prevent the spread of HIV infection,' Fauci said.
Of the 1.2 million people living with HIV in the United States, only an estimated 28% have a suppressed viral load, defined as less than 200 copies of the blood-borne virus per milliliter of blood, meaning that the virus is under control and at a level that helps keep them healthy and reduces the risk of transmitting the virus to others.
The authors of the CDC study say that low percentage is because one in five people with HIV do not realize they are infected.
Even more astonishing is the finding that for those who are aware, only 51% receive ongoing medical care and treatment.
Men who have sex with men (MSM), the population most severely affected by HIV in the United States, are least likely to know they are infected, and less likely to receive prevention counseling.
Only 39% of MSM know their HIV status, the CDC says, compared with 50% of men who have sex with women and women who have sex with men.
Of people living with HIV who actually are in ongoing care and on antiretroviral treatment, some 77% have suppressed levels of the virus.
This is an encouraging finding because suppressed levels of the HIV virus dramatically decrease the chances of passing the virus to sex partners.
Results from a recent study of heterosexual couples by the National Institutes of Health showed that consistently taking antiretroviral therapy, in combination with safer behaviors, can reduce the risk of spreading HIV by approximately 96%.
'While we have known that viral suppression can be achieved with proper HIV treatment and care, today's new Vital Signs data highlight the challenges our country faces in keeping HIV-positive Americans in the care they need to control the virus,' said CDC Director Thomas R. Frieden, M.D., M.P.H.
'By improving testing, linkage to care, and treatment services, we can help people living with HIV feel better and live longer, and can reduce the spread of HIV dramatically. This is not just an individual responsibility, but a responsibility for families, partners, communities, and health care providers.'
Since testing is the first step in receiving proper care, the CDC has introduced a new 'Testing Makes Us Stronger' program targeting high-risk groups like African-American Gay and Bi men.
According to the CDC, their research shows that African-American Gay and Bi men do not engage in riskier behaviors than other Gay men, but are at higher risk for HIV infection because of the high prevalence of HIV that already exists in many African-American and Gay communities, increasing the likelihood of becoming infected with each sexual encounter.
'Black Gay and Bisexual men across the country are already doing many of the right things to protect themselves, but more need to make HIV testing a regular part of their lives,' Dr. Kevin Fenton, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, said in a press release.
According to Dr. Fenton, African-American men who have sex with men account for 22% of all current new infections in the United States. Nearly a third who were surveyed were infected with HIV, and nearly 60% living with HIV do not know they are infected.
The website HIVtest.org has been created to help people find testing facilities - including free testing - close to their neighborhoods.
The campaign, which will cost $2.4 million initially, will 'ensure that we are getting the right messages out to Gay men, especially black Gay men,' Fenton said. Many different avenues including social media and disseminating information at Black Pride events will be used.
Regular testing is only the first challenge in controlling HIV, however. Once identified, HIV-positive individuals still require access to effective treatments.
Many can't afford anti-retroviral treatment for their HIV, an expense which can come to $367,000 over a lifetime, according to the CDC.
'Closing the gaps in testing, access to care and treatment will all be essential to slowing the U.S. HIV epidemic,' said Jonathan Mermin, M.D., director of CDC's Division of HIV/AIDS Prevention.
'HIV testing is the most important first step toward breaking the cycle of transmission. Combined with effective prevention services, linkage to care, and ongoing effective treatment, testing provides a gateway to the most effective prevention tools at our disposal.'
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