From Our 2011 Archives
Most Americans With HIV Don't Have Infection Under Control
Medications Can Help Suppress the Virus, but Many Don't Take Them
By Brenda Goodman, MA
Reviewed by Laura J. Martin, MD
Nov. 29, 2011 -- Nearly three-quarters of Americans with HIV don't have their infection under control. That's in large part because they may not know they have HIV or because they aren't taking drugs that suppress the virus, according to a new study from the CDC.
The study is published in the Morbidity and Mortality Weekly Report. It is being released in advance of World AIDS Day, Thursday, Dec. 1.
The report reveals that 1.2 million people in the U.S. are living with HIV, but only 28% take drugs to keep the amount of the virus in their bodies low.
A low "viral load" helps people with HIV stay healthy and reduces the chance they'll transmit the virus to others. Untreated HIV infection can lead to AIDS.
The virus can be suppressed by antiretroviral drugs, sometimes for decades.
But the study's authors say that one in five people who are infected with HIV do not know it. Of those who are aware of their HIV-positive status, slightly more than half receive ongoing treatment.
Testing and Treatment for HIV Lags in U.S.
"The HIV crisis in America is far from over," Jonathan Mermin, MD, director of the Division of HIV/AIDS Prevention at the CDC in Atlanta, said in a news briefing.
"Closing the gaps in testing, care, and treatment will all be essential to slowing or reversing the U.S. AIDS epidemic," he says.
Many people drop out of treatment because they struggle to afford health insurance or medication, or because they have mental health or substance abuse problems that make it difficult for them to take care of themselves, Mermin says.
The good news is that regular medical care and antiretroviral drugs work for most people with HIV.
More than three-quarters of those on regular drug regimens had suppressed the amount of virus circulating in their blood.
A previous study has shown that when people with HIV start treatment early and keep their viral loads low, they are 96% less likely to infect their partners.
"Treatment for HIV can prevent spread of HIV to others," says CDC Director Thomas Frieden, MD, MPH.
"We have substantial work ahead to fully realize the potential benefit of treatment in the U.S.," he says.
Racial Gaps in HIV
The study also found racial differences in HIV care.
Compared to whites, African-Americans and Hispanics were less likely to get antiretroviral drugs, and even if they were prescribed the medications, were less likely to achieve low viral loads.
The report also found that many people who are HIV-positive do not get information about how to prevent the spread of the disease to others.
Only about half of heterosexual men and women with HIV are counseled about precautions they should take to keep from infecting others, while only 39% of gay men with HIV get that information.
To help stem the tide of new infections, the CDC also launched a new awareness campaign aimed at gay and bisexual African-American men, who account for nearly one-quarter of all new HIV infections in this country.
The campaign, "Testing Makes Us Stronger," will encourage these men to learn their HIV status.
"The need for this new campaign could not be clearer," says Kevin Fenton, MD, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, at the CDC.
He points to a recent 21-city study that found that nearly two-thirds of gay and bisexual African-American men who tested positive for HIV did not know they were infected.
The CDC recommends that all Americans be tested for HIV at least once during their lifetimes.
Those at high risk, such as those who have more than one sex partner, inject drugs, or are men who have sex with men, should be tested more frequently -- at least once a year.
SOURCES: Cohen, S. Morbidity and Mortality Weekly Report, published online Nov. 29, 2011.News release, CDC.Thomas R. Frieden, MD, MPH, director, CDC, Atlanta.Kevin Fenton, MD, director, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, CDC, Atlanta.Jonathan Mermin, MD, director, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, CDC, Atlanta.