Health Awarelets: AIDS
AIDS Epidemic Updates - 2000
13th International AIDS Conference. July, 2000. Durban, So. Africa
Eighth Annual Retroviral Conference. February, 2001. Chicago, Illinois
Based on reports by Thomas H. Maugh II. Los Angeles Times.
3000 AIDS researchers met in Chicago for the Eighth Annual Retroviral Conference. The conference ended with little optimism for conquering- or even stalling - the HIV/AIDS epidemic.
While there are some promising drugs in development, none are expected to have the impact that the protease inhibitors have had on extending life for those infected. Several vaccines are also in development, their proponents hoping to be "fast tracked" to determine efficacy. Nonetheless, these potential vaccines would be many years before reaching the general population, and offer little hope of a true, "put an end to it" type of preventative cure.
At the same time, the number of HIV infections appears to have been underestimated in So. Africa, and continues to spread rapidly. In fact, life expectancies in some African countries could drop below 30 because of the increasing spread, most often unabated due to lack of appropriate drug therapy. Recent announcements by drug companies offering meds at "below cost" will hopefully have a positive effect on this situation.
In the U.S., reports indicate risky sexual behaviors that increase HIV transmission are on the rise; resistance to anti-AIDS drugs is increasing; a disproportionate number of African Americans and Latinos are being infected; and there is an alarming rise in the number of infections in heterosexual women. The one bit of good news: recent studies indicate that teenagers in the U.S. appear to be reducing sexual activity and increasing condom use.
Comment: It has been said that HIV/AIDS is really "a number of smaller epidemics, each with its own dynamics." (1) The different faces of this disease, depending to great extent upon geography and demographics, give testimony to that observation.
(1) Campsmith, Michael, DDS, MPH. Update on the Epidemiology of HIV/AIDS in the United States. California Dental Journal. Vol.29, No.2. February, 2001.
AIDS Epidemic Updates - 1999
According to report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization:
For 1999, globally:
- 50 million + people worldwide were infected with HIV
- There were a record 2.6 million AIDS related deaths during 1999
- HIV infections continue unabated.
- It is estimated that 5.6 million adults and children are infected worldwide
- Most of the infected live in sub-Saharan Africa.
- For the first time, HIV-positive women outnumbered men (51%)
- The most rapid increase in infections is in the former Soviet Union.
Reported by Centers for Disease Control (CDC)
The CDC recorded reports of 711, 344 persons with AIDS through June, 1999. It is suggested that AIDS reporting criteria be dynamic, and able to change to incorporate new understanding of the disease. With the advent of effective therapy, population-based data reporting no longer reflects accurate trends in transmission - and consequently, does not accurately represent the continuing need for prevention and care services.
A conclusion is drawn that that HIV and AIDS case surveillance, in contrast to AIDS surveillance alone, provides a more accurate reflection of incidence and magnitude.
Morbidity and Mortality Weekly Report. U.S. Dept. of Health & Human Services.Vol.48, NO. RR-13/ December 1999.
Comment: The decrease in the number of AIDS cases in the US may lead to the mistaken conclusion that the tide has been turned against this disease. In fact, with the new therapy regimens able to extend the period between HIV infection and AIDS diagnosis, AIDS reporting alone no longer tells the whole story. Combining AIDS and HIV surveillance reporting will give a more accurate reflection of progress, or lack of it.