United Press International - June 13, 2005
Ed Susman

"The Centers for Disease Control and Prevention now estimates that by the end of 2003 between 1.039 million to 1.185 million HIV-infected persons are living in the United States," said Dr. Alan Greenberg, acting director for science in the CDC's Division of HIV/AIDS Prevention.

Greenberg told the 2005 National HIV Prevention Conference the new figures were calculated using a mix of HIV surveillance data and statistical models. In 2002 the CDC estimated the prevalence of HIV infection at the end of 2000 ranged between 850,000 and 950,000 people in the United States.

HIV, the human immunodeficiency virus, is the retrovirus that causes AIDS.

At the end of the millennium about one in four people infected with HIV were unaware of their status, Greenberg said, and little has changed since. The CDC now estimates 24 percent to 27 percent of people infected do not know they carry the virus.

In his address, Greenberg said statistics from surveillance projects in 32 states indicate an overall stable infection prevalence, but there also appear to be increases among men who have sex with men and slight decreases in persons infected through injected drug use. Infections among high-risk heterosexuals and other risk groups remained unchanged.

"We believe that the reason there are more people living with HIV is due to the contribution from people who are living longer," said Dr. Ron Valdiserri, deputy director of the CDC's National Center for HIV, STD (sexually transmitted diseases) and TB (tuberculosis) Prevention.

Valdiserri acknowledged that the 2001 stated goal of the CDC to cut HIV infections by 50 percent had "clearly not been achieved."

"The duration of survival is definitely a component of the increase in people living with HIV," Dr. Sindy Paul of the New Jersey Department of Health and Senior Services told United Press International. She said the advent of anti-retroviral drug cocktails allow people with HIV to control their disease and survive years longer.

"We have also learned how to prevent opportunistic infections and better how to treat those infections," she said. Opportunistic infections include pneumonia, brain infections, diarrhea and other ailments that occur when HIV destroys a person's immune system.

"The new figures give us the clearest picture of the HIV epidemic," said Kate Glynn, a CDC epidemiologist who will present details of the prevalence data Tuesday at the conference. "Our ability to monitor the HIV epidemic is central to our efforts to reduce the HIV burden in the United States. Understanding the size and scope of the epidemic helps us direct testing, prevention and treatment services where they are most urgently needed."

Finding people who do not know they are HIV-positive is being made easier as rapid-testing kits becoming widely used. Paul presented data Monday showing use of the kits in emergency rooms identified 2.3 percent of persons admitted there as HIV-positive -- with 60 percent of them unaware they were infected.

Those patients then are directed to appropriate care, Paul said. Her researchers are following those patients to determine if they receive proper treatment.

Valdiserri said the need to identify people who are not aware of their HIV status is critical to controlling the epidemic; most new infections occur because the virus is spread by people who do not know they are infected.

AIDS activists said the new prevalence figures represent evidence of a lack of government funding.

"Frankly, we are not shocked that the potent mix of a decade of insufficient funding for science-based HIV prevention and an overdose of ideologically driven policy has pushed us over the million mark," said Julie Davids, executive director of the Community HIV/AIDS Mobilization Project, in New York City.

Valdiserri said "government cannot do it all" and called for government and community partnerships to intensify efforts to control the epidemic.

Ed Susman covers medical research and health issues for UPI Science News. E-mail: sciencemail@upi.com

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