World AIDS day highlights awareness gaps
The number of HIV infections has stabilized at about 50,000 new cases every year since the 1990s, but researchers at the National Minority Aids Council, also known as NMAC, say more needs to be done to increase health literacy around the disease that suppresses immune systems.
NMAC researchers note that there needs to be a particular emphasis on high-risk groups, such as young black men who have sex with other men, a population the council says carries “a sharply disproportionate burden of new HIV infections.” Researchers from the coalition of local and faith-based organizations, which received funding from drugmakers including Merck and Gilead for its “Continuing the Advance Against HIV/AIDS”report, also noted that “the proportion of undiagnosed people living with HIV remains stubbornly fixed.”
The concern dovetails with statistics the Centers for Disease Control and Prevention released last week that highlighted what is behind the stability: while 30% of HIV-positive patients “had the virus under control in 2011” 66% of HIV-positive patients whose disease was not being managed “were no longer in care.” The stasis and continuing infection rates mean 50,000 diagnosed patients add to the current count of approximately one million HIV cases nationwide. Further, the agency said that about 20% of patients who fall in the “uncontrolled” category are not aware they are infected. NMAC researchers noted that the undiagnosed patients are a prevention linchpin of sorts, estimating that almost 50% of new infections are caused by just 20% of infected patients.
The CDC noted that viral suppression tracks with age — the older the patient group, the greater the number of controlled HIV cases. The agency said the percentages break down as follows: 13% of infected 18-to-24-year-olds qualified as “virally suppressed,” compared to 23% of infected 25-to-34-year-olds and 37% of patients 65 and older.
“There is untapped potential to drive down the epidemic through improved testing and treatment, but we're missing too many opportunities,” the CDC's Jonathan Mermin, who heads up the agency's HIV/AIDS, viral hepatitis, STD and tuberculosis prevention division, said in a statement.
The CDC's Eugene McCray said in a statement that increasing infection status awareness could make the control statistics move upwards among younger patients. FDA Commissioner Margaret Hamburg and Health and Human Services's Assistant Secretary Jimmy Kolker reinforced this point on the FDA Voice blog, writing “We can truly see in our future an AIDS-Free generation because of the wide availability of prevention and treatment tools.”
The sentiment highlights a gap NMAC says lies between what is available and what is deployed: for example, the organization's researchers, note that although the CDC recommends routine HIV testing for patients 13-to-15, the data “suggest a wide variation in the extent to which these guidelines are followed.” Among the data points that caught their attention: 16% of the 7,271 surveyed males who have sex with men and who had not been tested before the 2008 National HIV Behavior Surveillance survey had not been previously tested, and tested positive for HIV, while 29% had been tested for HIV in the last six months.