Despite major advances in human immunodeficiency virus (HIV) medicine, living with HIV infection or acquired immunodeficiency syndrome (AIDS) remains a major challenge. In the United States , HIV/AIDS is disproportionately found in minorities, especially African Americans and Latinos, men who have sex with other men (MSM), injection drug users, those with mental illness, and the poor. Untreated HIV infection is fatal.
In 2003, an estimated 1,185,000 persons in the United states were living with HIV/AIDS, and about one fourth of these were undiagnosed and unaware of their HIV infection. Changes in behavior have radically altered the incidence of the disease throughout the United states, with new infections occurring in fewer than 40,000 persons a year (Glynn, M., 2005. Estimated HIV prevalence in the United states at the end of 2003. National HIV Prevention Conference, Atlanta, Ga.
HIV/AIDS Health Interventions
HIV treatments, when available, may be life sustaining, but are not devoid of complications. A powerful stigma is attached and stymies prevention and treatment efforts.
Fortunately, advances in treatment of the disease have slowed the progression to AIDS and decreased mortality rates (Centers for Disease Control and Prevention. HIV/AIDS surveillance report, 2003, Atlanta : US Department of Health and Human Services, Centers for Disease Control and Prevention, 2004. www.cdc.gov/hiv/).
Antiretroviral drugs are not a cure for HIV/AIDS, but they can prolong and improve the quality of life for an HIV-infected person. More effective antiretroviral drugs are being developed and approved involving fewer pills, once-a-day dosing, and fewer side effects. These meds include: Nucleoside Analogs, Nucleotide Reverse Transcriptase Inhibitor, Non- Nucleotide Reverse Transcriptase Inhibitor, Protease Inhibitors, & Fusion/Entry Inhibitors.
Social Issues & Barriers To Care
Even two and half decades into the epidemic, having HIV/AIDS is associated with great stigma, perhaps considered most shameful in the communities in which it is most prevalent. HIV/AIDS is viewed as an illness that individuals bear direct control over (Schuster, Collins, Cunningham,et al., 2005. Perceived discrimination in clinical care in a nationally representative sample of HIV-infected adults receiving health care. J Gen Internal Med:20(9):807-813). The very factors that put people at risk for contracting HIV also constitute barriers to prevention and optimal care. Neither society nor the health care system has been successful at combating the poverty, low education, recklessness of youth, substance use, or discrimination that underlie the risks of contracting and living with HIV/AIDS.
Other Problems for Care:
Mental illness and substance use are not addressed. Poverty, victimization, and homelessness interfere with treatment. Stigma undermines care. Providers miss chances to screen for HIV, and neglect to educate on transmission of HIV. Providers are inadequately trained to provide complex care, and many health care systems are not optimal care supports. HIV prevention is politically charged.
HIV/AIDS Health Resources
North Central Florida Area HIV/AIDS Patient Care Programs: Ryan White, ADAP, AICP, & HOPWA 800-901-9646 or local: 352-378-2868
Alachua County Health Department: 352-334-7900
By the end of 2005, 40.3 million people were living with HIV/AIDS, including 17.5 million women and 2.3 million children under the age of 15.
4.9 million people became newly infected with HIV in 2005, including 700,000 children. Of these, 3.2 million new infections occurred in Sub-Saharan Africa.
In 2005 alone, a total of 3.1 million people died of HIV/AIDS related causes.
World-wide, only one in ten persons infected with HIV has been tested and knows his/her HIV status.