How Serious Is It?
The HIV/AIDS epidemic has taken a tremendous toll on people
in the United States. From the beginning of the epidemic in 1981
through 2003, an estimated 1.3–1.4 million people in this country
have been infected with HIV/AIDS. Of these, about one third (more
than 500,000) have died.
Despite declines in new infections in the early 1990s, more people
are living with HIV/AIDS than ever before. CDC estimates that
about 1 million people in the United States are living with HIV
or AIDS. About one quarter of these people are unaware of their
infection, which puts them and others at risk. Those who do not
know that they are infected cannot take advantage of treatment and
may unknowingly transmit HIV to others. And even of the three
quarters who know that they are HIV-infected, one third may not be
receiving ongoing care. About half of all HIV-infected people may be
untested, untreated, or both.
AIDS
New AIDS cases and deaths have declined dramatically since the
beginning of the epidemic. However, this decline began to stabilize
in 1999 and may not drop further unless new HIV infections also
decrease or new treatments are developed. The decline in AIDS
cases should not be confused with a decline in new HIV infections or
an end to the epidemic. It can mean that fewer HIV infections are
progressing to AIDS.
HIV
New HIV infections have also declined but have
remained stable for several years. At an estimated
40,000 new HIV infections per year, this number is
unacceptably high. It represents the spreading of the
epidemic into new, vulnerable populations.
Although effective treatment will ensure that fewer
HIV infections progress to AIDS, it means that more
and more people will be living with HIV, producing
a wellspring of potential new infections. It is also important to
note that treatment does not cure HIV infection. And no one knows whether treatment may produce long-term adverse effects or
whether the drugs will remain effective. These realities underscore
the importance of tracking the epidemic and using scientifically
proven prevention programs to protect the people who are most at
risk.
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How is it Changing? The epidemic is changing in terms of how many people are living
with HIV, where they are living, who is most vulnerable, and how
we track the epidemic.
- More people are living with HIV. because of treatment
advances, people with HIV are living longer. As a result, more
people are living with HIV today than at any other time during
the history of the epidemic. Along with this growing population
of HIV-infected persons, chances for transmission are increasing.
- The epidemic keeps moving. The HIV/AIDS epidemic varies
considerably across the country, not only by region, but within
regions and states, and even within communities. Currently (as
well as for the past several years), many people with AIDS live in
rural areas or small cities in the South.
- Populations affected are changing. In addition to the
groups who have been at highest risk since the beginning of the
epidemic—MSM and IDUs—other groups are also at risk for
HIV.
- Racial and ethnic minorities. The epidemic has expanded
from primarily affecting white people to primarily affecting
people of color.
- Women. More than half of heterosexually acquired HIV
infections occur in women.
- Youth. New generations are replacing those who benefited
from early prevention strategies.
- Tracking the epidemic is more complex. Early on, CDC
tracked the epidemic by monitoring new AIDS cases. Today,
trends in the epidemic are better reflected by new HIV infections,
which are more difficult to track. New HIV infections cannot be
measured directly because many newly infected people do not get
tested and because a positive test result alone does not indicate
whether the infection is recent.
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