The Promised Land is in sight—though the view is somewhat hazy—for HIV/AIDS activists, victims, government and others who hope for an end to the epidemic.
“We are at a very important juncture in the trajectory of the AIDS epidemic. We now have the tools to end this disease,” said Phill Wilson, founder, president and CEO of the Black AIDS Institute.
Major strides in prevention technologies and approaches, including scientific breakthroughs in treatment, has brought the United States closer to defeating the scourge of HIV/AIDS, experts said.
“Prevention has really helped us rethink what we can do to end this disease,” said Michael Kaplan, CEO, AIDS United, a nonprofit advocacy group dedicated to ending the epidemic.
Among the proven HIV prevention methods, experts said, were increased HIV testing and linkage to care, access to condoms, prevention programs for people with high risk of HIV infection and those who are already HIV-positive, substance abuse treatment and access to sterile syringes. Screening and treatment for sexually transmitted infections such as gonorrhea, which increase the chances of acquiring and transmitting HIV, have also proven effective.
Most promising is the impact of HIV medications such as antiretrovirals, which have proven effective in reducing mother-to-child transmissions and reducing the HIV viral loads in infected persons, which reduces the chances of transmission to someone else by 96 percent, according to data from the Centers for Disease Control and Prevention.
When taken immediately after exposure to the virus, antiretrovirals also reduce the risk of infection (post-exposure prophylaxis). And, when taken by HIV-negative individuals who are at high risk of infection, such medications have proven effective in reducing that risk (pre-exposure prophylaxis).
Campaigns to educate the public about HIV—how it can be prevented and treated—has also proven effective in mitigating the disease’s impact, experts said.
“You have to salute the Department of Health and Human Services and state health departments who did a great job of marketing this information,” said Dr. Sohail Rana, who treats pediatric HIV/AIDS patients and is a professor of pediatrics at Howard University College of Medicine.
Due to those efforts, since the height of the epidemic in the mid-1980s, the annual number of new infections in the U.S. has dropped by more than two-thirds from about 130,000 to 50,000, according to the CDC’s “National HIV Prevention Progress Report,” which was released this month.
More recently, from 2008 to 2010, new HIV infections decreased 15 percent among heterosexuals, 21 percent among African-American women, and 22 percent among injection drug users.
Also promising was a decline in the HIV transmission rate, which decreased about 9 percent from 2006-2010. And testing efforts succeeded in increasing the percentage of people living with HIV who know their status from 80.9 percent to 84.2 percent, which means that 5 out of 6 people living with HIV in 2010 knew their status.
While the nation has taken strides toward reaching the 2015 benchmarks established in the Obama administration’s National HIV/AIDS Strategy, however, many challenges remain.
The number of new infections has “flatlined” at about 50,000 per year over the past decade or so, Kaplan said.
Additionally, while more people are aware of their HIV status, there are an estimated 180,000 people in the U.S. living with an undiagnosed HIV infection.
Racial/ethnic disparities persist—African Americans, particularly Black women, continue to bear the brunt of the epidemic, accounting for almost half of new infections (44 percent) and almost half (44 percent) of those living with HIV, and they lack access to treatment.
Also, new infections remain dauntingly high among gay, bisexual, and other men who have sex with men (MSM), who account for 63 percent of all new infections. From 2008 to 2010, there was a 12 percent increase in new infections among MSM and a 22 percent increase among young MSM aged 13-24 years.
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