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US underestimated country's HIV epidemic

Agence France-Presse - August 3, 2008
Laurent Thomet

WASHINGTON, Aug 3, 2008 (AFP) - US health authorities acknowledged that they had substantially underestimated the number of new HIV infections in the country, in a study showing that the epidemic is worse than previously thought.

About 56,300 people were infected with the virus that causes AIDS in 2006, a figure 40 percent higher than the previous estimate of 40,000 new infections a year, the Centers for Disease Control and Prevention (CDC) said Saturday.

"This new picture reveals that the HIV epidemic is -- and has been -- worse than previously known and underscores the challenges in confronting this disease," Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The revised assessment came on the eve of a six-day international AIDS conference in Mexico City, which is expected to be attended by some 22,000 scientists, policymakers and grassroots workers.

The CDC said new technology allowed it to establish a more precise estimate of the epidemic.

"These data, which are based on new laboratory technology developed by CDC, provide the clearest picture to date of the US HIV epidemic, and unfortunately we are far from winning the battle against this preventable disease," said CDC Director Julie Gerberding.

"We as a nation have to come together to focus our efforts on expanding the prevention programs we know are effective," she said.

The study found that the annual number of new infections was never as low as 40,000. While new infections increased in the last 1990s, they have been roughly stable since then.

"While the level of HIV incidence is alarming, stability in recent years suggests that prevention efforts are having an impact," said Richard Wolitski, acting director of the CDC's Division of HIV/AIDS Prevention.

The study also found that gay and bisexual men as well as and African American men and women are the groups most affected by HIV.

The new estimate found that 53 percent of new infections occurred in gay and bisexual men, while heterosexuals accounted for 31 percent of them and injection drug users for 12 percent.

African Americans, who make up 13 percent of the US population, accounted for 45 percent of the new infections in 2006. The infection rate among blacks was seven times higher than among whites -- 83.7 out of 100,000 people compared to 11.5 out of 100,000.

The study found some encouraging signs of progress as new infections have dropped among both injecting drug users and heterosexuals.

The CDC said the new estimate will be published in a special HIV/AIDS issue of the Journal of the American Medical Association that was to be released in Mexico City on Sunday. The agency released them Saturday because news organizations broke the embargo.

Anti-AIDS groups said the revised estimate showed that the HIV infection rate was not dropping and may be increasing significantly, and that it highlighted the need for a comprehensive national strategy to combat AIDS.

"HIV/AIDS continues to be a public health emergency that has not received adequate nor appropriate attention as a nationwide priority," said Julie Davids, Executive Director of the Community HIV/AIDS Mobilization Project (CHAMP).

"To make measurable progress against HIV, we need to know whether infection rates are going up, which groups are becoming infected, and which prevention activities reduce new infections," said Mark Cloutier, chief executive officer of the San Francisco AIDS Foundation.

"We need a comprehensive National AIDS Strategy with measurable outcome targets, a timeline for action, increased funding and a particular focus on those most at risk, including racial and ethnic minorities."

Joseph Interrante, chairman of the AIDS Action Council's board of directors said the revised figures represented "an unacceptable level of new HIV infections for a preventable disease."

"The revised estimate underlines the need for a national AIDS strategy with measurable outcomes, reliance on evidence-based programs, and sufficient funding," Interrante said in a statement.

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