HIV and AIDS – Changing All the Time…Still!
Written by admin on August 14th, 2008
by Joshua Love, Director of Metropolitan Community Churches Global HIV/AIDS Ministry
As I left the 2008 International AIDS Conference in Mexico City last week, I felt in awe once again at the complexity of HIV and AIDS in the lives of people around the world. The impact of this virus has been anything but simple. It complicates the body, mind, and spirit of people living with HIV (PLHIV). I wanted to share a few of the ways time has evolved our understanding.
On August 3, 2008, during the days and weeks many people around the world were preparing for and arriving at 2008 International AIDS Conference a press announcement was released by the United States Centers for Disease Control and Prevention (CDC), which stated the following: “New Technology Reveals Higher Number of New HIV Infections in the United States than Previously Known.” This was serious news to those of us working on the frontlines of HIV and AIDS in the United States, and potentially around the world.
I visited the Centers for Disease Control and Prevention to gather their latest definitions and statistics on HIV and AIDS…wondering what language are the experts using to explain this multi-layered pandemic. I then went back to a publication, ALERT, circulated by Metropolitan Community Churches starting in 1987. Rev. Steve Pieters worked with a team to gather all the information available at the time and send out updates to the community. I an including for comparison the 2008 CDC definitions and the 1987 news item from Alert on the definitions of HIV and AIDS. First you will find the August 3 Press Release from the CDC, then a few excerpts from the CDC website and finally the synopsis by Rev. Steve Pieters of Metropolitan Community Churches AIDS Ministry in 1987.
Press Release
For Immediate Release
August 03, 2008
Contact: National Center for HIV/AIDS,
Hepatitis, STD and TB Prevention
404-639-8895
New Technology Reveals Higher Number of New HIV Infections in the United States than Previously Known
The Centers for Disease Control and Prevention (CDC) announced today that an estimated 56,300 HIV infections occurred in the United States in 2006. That estimate differs from the agency′s previous estimate of 40,000 because CDC is now using a more precise method for estimating annual HIV incidence, which is the number of individuals who become newly infected with HIV in a given year. The new estimate is published today in a special HIV/AIDS issue of the Journal of the American Medical Association, released at the XVII International AIDS Conference in Mexico City.
“These data, which are based on new laboratory technology developed by CDC, provide the clearest picture to date of the U.S. HIV epidemic, and unfortunately we are far from winning the battle against this preventable disease,” said CDC Director Dr. Julie Gerberding. “We as a nation have to come together to focus our efforts on expanding the prevention programs we know are effective.”
The new estimate is derived from the first national surveillance system of its kind that is based on direct measurement of new HIV infections and builds on a new laboratory test (the BED HIV-1 Capture Enzyme Immunoassay) that can distinguish recent from long-standing HIV infections. CDC′s prior annual HIV incidence estimate was based on indirect and less precise methods available at the time.
A separate CDC historical trend analysis published as part of today′s study suggests that the number of new infections was likely never as low as the previous estimate of 40,000 and has been roughly stable overall since the late 1990s.
“It′s important to note that the new estimate does not represent an actual increase in the number of new infections, but reflects our ability to more precisely measure HIV incidence and secure a better understanding of the epidemic,” said Kevin Fenton, M.D., director of CDC′s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “This new picture reveals that the HIV epidemic is - and has been - worse than previously known and underscores the challenges in confronting this disease.”
Burden Greatest Among Gay and Bisexual Men of All Races and African Americans
CDC′s new surveillance system also provides more precise estimates than previously possible of new infections in specific populations. Results confirm that the impact of HIV remains greatest among gay and bisexual men of all races and among African American men and women. In 2006, men who have sex with men (MSM) accounted for 53 percent of those with new infections (28,700), heterosexuals for 31 percent (16,800), and injection drug users (IDU) for 12 percent (6,600). Infection rates among blacks were 7 times as high as whites (83.7/100,000 people versus 11.5/100,000) and almost 3 times as high as Hispanics (29.3/100,000 people), a group that was also disproportionately affected.
“Too many Americans continue to be affected by this disease,” stressed Fenton. “These new findings emphasize the importance of reaching all HIV-infected individuals and those at risk with effective prevention programs.”
Separate Trend Analysis Sheds New Light on History of U.S. Epidemic
In addition to the 2006 HIV incidence estimates, CDC conducted a separate, historical analysis that provides new insight into HIV incidence trends over time - overall and for specific populations. Results confirm dramatic declines in the number of new HIV infections from a peak of about 130,000 in the mid-1980s to a low of roughly 50,000 annual infections in the early 1990s. However, findings also indicate that new infections increased in the late 1990s, but have remained roughly stable since that time (with estimates ranging between 55,000 and 58,500 during the three most recent time periods analyzed).
“Prevention can and does work when we apply what we know,” said Richard Wolitski, Ph.D., acting director of CDC′s Division of HIV/AIDS Prevention. “While the level of HIV incidence is alarming, stability in recent years suggests that prevention efforts are having an impact. In this decade, more people are living with HIV and living longer than ever before due to advances in treatment. Even though this could mean more opportunities for transmission, the number of new infections has not increased overall. ”
The analysis revealed some other encouraging signs of progress as well as significant challenges among specific groups. Findings indicated reductions in new infections among both injecting drug users and heterosexuals over time. Yet, the findings also indicate that HIV incidence has been steadily increasing among gay and bisexual men since the early 1990s, confirming a trend suggested by other data showing increases in risk behavior, sexually transmitted diseases and HIV diagnoses in this population throughout the past decade. The analysis also found that new infections among blacks are at a higher level than any other racial or ethnic group, though they have been roughly stable, with some fluctuation, since the early 1990s.
“These data confirm the critical need to revitalize prevention efforts for gay and bisexual men of all races and to build upon the growing momentum in the African American and Hispanic communities to confront HIV,” said Wolitski. “We must all remember that we are dealing with one of the most insidious infectious diseases in history. Reducing this threat will require action from everyone - individuals at risk, community leaders, government agencies and the private sector.”
For more information on HIV prevention, visit www.cdc.gov/hiv or www.aids.gov.
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Content Source: Office of Enterprise Communication
Note: Links to a non-governmental sites does not necessarily represent the views of the CDC
Page last modified: August 03, 2008
Page Located on the Web at http://www.cdc.gov/media/pressrel/2008/r080803.htm
Brief History of HIV in the United States
Centers for Disease Control and Prevention
http://www.cdc.gov/hiv/topics/basic/index.htm#hiv
HIV was first identified in the United States in 1981 after a number of gay men started getting sick with a rare type of cancer. It took several years for scientists to develop a test for the virus, to understand how HIV was transmitted between humans, and to determine what people could do to protect themselves.
In 2008, CDC adjusted its estimate of new HIV infections because of new technology and developed by the agency. Before this time, CDC estimated there were roughly 40,000 new HIV infections each year in the United States. New results shows there were dramatic declines in the number of new HIV infections from a peak of about 130,000 in the mid 1980s to a low of roughly 50,000 in the early 1990s. Results also shows that new infections increased in the late 1990s, followed by a leveling off since 2000 at about 55,000 per year.
AIDS cases began to fall dramatically in 1996, when new drugs became available. Today, more people than ever before are living with HIV/AIDS. CDC estimates that about 1 million people in the United States are living with HIV or AIDS. About one quarter of these people do not know that they are infected: not knowing puts them and others at risk.
2008
Centers for Disease Control and Prevention
http://www.cdc.gov/hiv/topics/basic/index.htm#hiv
HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. HIV is different from most other viruses because it attacks the immune system. The immune system gives our bodies the ability to fight infections. HIV finds and destroys a type of white blood cell (T cells or CD4 cells) that the immune system must have to fight disease.
AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection. It can take years for a person infected with HIV, even without treatment, to reach this stage. Having AIDS means that the virus has weakened the immune system to the point at which the body has a difficult time fighting infections. When someone has one or more of these infections and a low number of T cells, he or she has AIDS.
1987
ALERT: News from the UFMCC on Legislation, Education, Research and Treatment
Written by Rev. Stephen Pieters, Rev. Elder Don Eastman, and Gary McClelland, M.D.
“It has been recognized ever since the discovery of the Human Immunodeficiency Virus (HIV) as the cause of AIDS and of sensitive, accurate tests to determine its presence that the original case definition of AIDS was far too narrow to include all the manifestations of the disease. As a result, the statistics which are quoted so frequently in tracking the progress of AIDS have not been truly reflective of the full extent of the disease. In response to this awareness, the Centers for Disease Control in Atlanta, Georgia in its August 14, 1987 newsletter presented a new broader definition of AIDS which is expected to increase the counts by more than 15%…
“While the primary goal of the CDC in introducing this expanded definition is for its own benefit – to reflect a more accurate picture of how widespread AIDS is – there is, a much more significantly beneficial impact of the definition on the AIDS patient and that is socioeconomic. Up to this point there have been large numbers of people with significant illness, disability, and even death who were never classified as AIDS because of the narrow criteria which previously existed. Because these patients did not fit the AIDS definition they were excluded from many of the benefits which AIDS patients received (i.e disability, SSI, MediCare, benefits from AIDS organization, etc…) With the more realistic definition of AIDS untold thousands will become eligible for these benefits and will no longer be living their lives in the grey zone – that limbo of disability in the absence of diagnosis.

