By Thomas R. Frieden, M.D., M.P.H.
Director, Centers for Disease Control and Prevention
Today marks 30 years since the first report of a mysterious and deadly new syndrome that would come to be known as AIDS was published in CDC’s Morbidity and Mortality Weekly Report (MMWR). At the time, no one could have predicted the enormous toll the disease would take—claiming the lives of more than 500,000 Americans and many millions worldwide. Today we remember those we have lost, and honor them by recommitting ourselves to the fight against this deadly yet preventable disease.
Over the last three decades, prevention efforts have helped reduce new infections and treatment advances have allowed people with HIV to live longer, healthier lives. But as these improvements have taken place, our nation’s collective sense of crisis has waned. Far too many Americans underestimate their risk of infection or believe HIV is no longer a serious health threat, but they must understand that HIV remains an incurable infection. We must increase our resolve to end this epidemic.
CDC released data today showing that the number of Americans living with HIV continued to increase by more than 71,000 people between 2006 and 2008, mainly due to treatments which allow those infected with HIV to live longer, healthier lives. Currently, more than 1.1 million people in the United States live with HIV, and as this number increases, so does the risk of HIV transmission.
Today, the most infections are among people under 30—a new generation that has never known a time without effective HIV treatments and who may not fully understand the significant health threat HIV poses. Groups that have historically borne a disproportionate burden of HIV continue to see more than their share of devastation from this disease:
· Gay men: Gay and bisexual men of all races remain the group most affected by this epidemic. Men who have sex with men (MSM) account for just 2 percent of the U.S. population but represent more than half of all new infections in the United States. White MSM continue to account for the largest number of new infections, but MSM of color are disproportionately impacted. And a CDC analysis released today found high levels of HIV infection even among those MSM who get tested regularly. Approximately 7 percent of MSM in the 21 cities surveyed tested positive for HIV in the study, even though they reported having a negative HIV test result during the past 12 months.
· African-Americans and Latinos: The rate of new HIV infections for black men is about 6 times as high as that of white men, and about 3 times that of Hispanic men. The HIV incidence rate for black women is nearly 15 times as high as that of white women, and nearly 4 times that of Hispanic women. Among Hispanics, the rate of new HIV infections among men is more than double that of white men, and the rate among women is nearly 4 times that of white women.
Reducing HIV rates in the United States is not only possible—it is imperative. A recent analysis of the epidemiological and economic impacts of HIV estimates that if infection continues at its current rate, it could cost more than $200 billion to treat those who become newly infected over the next decade.
Advances in HIV prevention hold promise for reducing new infections and avoiding this high burden on lives and medical costs. More people know their HIV status and protect others from infection. New prevention interventions have been identified, such as pre-exposure prophylaxis (PrEP) for MSM. And new data confirm that early testing and treatment for HIV-infected heterosexuals in relationships in which one person is HIV-positive and the other is not could contribute to declines in HIV in the United States.
At CDC, we are entering the next decade of HIV/AIDS with an aggressive focus on increasing the impact of prevention. Guided by the National HIV/AIDS Strategy, we are prioritizing prevention activities based on their effectiveness, cost, coverage, feasibility and scalability—to have the greatest possible impact with every dollar. Further, with support from the U.S. Department of Health and Human Services and the White House Office of National AIDS Policy, CDC is implementing 12 demonstration projects in hard-hit areas across the country. The goal is to identify and implement a combination approach to enhance effective HIV prevention. And we are continuing to keep HIV on the radar of all Americans, through our national Act Against AIDS communication campaign. But government alone cannot end this epidemic. It’s up to all of us to get the facts about HIV, get tested, and take control to protect ourselves and our loved ones.
On this 30th commemoration of AIDS, our resolve to end the epidemic cannot falter. It is possible to greatly reduce new HIV infections. Working together, we can break through complacency, save lives, and end HIV as a threat to the health and well-being of all Americans.
For more information on the 30 years of HIV, please visit http://www.cdc.gov/nchhstp/newsroom/HIV30thCommemoration.html. For more information on HIV, please visit www.actagainstaids.org; to find an HIV testing site in your local area, visit www.HIVTest.org.