We Haven’t Yet Won the HIV War
By James W. Curran, Gerald Schochetman
“It has been more than 30 years since the two of us began working together at the Centers for Disease Control and Prevention (CDC) in Atlanta in the collective war against HIV and AIDS.
During the past three decades, we have witnessed tremendous advances in preventing, diagnosing and treating HIV/AIDS around the world. Yet despite all of the progress made since then, we continue to find ourselves facing new challenges, frustrations and a continual need for more action.
Last week, the Obama administration launched an updated strategy to fight HIV/AIDS that echoes many of the themes and best practices we have advocated and discussed for years. It’s a big step forward.
Among the many encouraging parts of this plan are renewed focuses on increasing access to widespread testing and linkage to care, particularly focusing on populations that are disproportionately impacted by HIV. We also were encouraged to see that, as the president said, “it seizes on the rapid shifts in science and policy, as we’ve learned more about this disease.”
In 1983, people in San Francisco had a 1-in-90 chance of getting HIV from infected blood. In 1985, the year after Abbott launched the first FDA-approved test to screen blood donors for HIV, the number went down to 1-in-40,000. Now that number sits at about 1-in-2,000,000. In addition, new drug treatments available since the mid-1990s have accomplished what was unthinkable in the early 1980s: changing a diagnosis of HIV from a terminal disease to a chronic, manageable one for millions of HIV-positive people.
Because of all of these advances, the disease has somewhat fallen off the general public’s radar, creating, in our view, an extremely dangerous situation for those at greatest risk of contracting this virus. We believe the president’s call to action last week will help reinvigorate enthusiasm for wiping out this disease.
More than 1.2 million people in the United States are living with HIV, and almost 1 in 8 don’t know that they have it. We are seeing a resurgence in HIV infections in adolescents and young adults — and more than 50 percent of these individuals do not know they are infected. This lack of awareness means that young adults or other high-risk groups may not receive treatment until the virus has caused irreparable damage.
The earlier people get tested and know their status, the sooner they can begin treatment. Early treatment is key in fighting this disease. In May, the National Institutes of Health (NIH) came out with the first study that clearly shows that those with HIV who received immediate treatment significantly reduced their risk of serious, adverse health outcomes.
But in order to know whether someone has contracted HIV at a very early stage, people must make sure they are being tested with the most accurate methods.
Last year, the CDC recommended that laboratories use the latest HIV testing technology to better identify early cases of the virus.
Called fourth-generation tests, or HIV Combo, these tests can screen for both antibodies to the virus and antigen (a protein of HIV), and can detect HIV infection earlier than the older antibody-only tests. These tests are widely available in the United States and can detect the virus sooner after infection than traditional, antibody-only tests. Knowing your status can get you started on treatment early. It can also reduce the chance of transmitting HIV to others.
We believe the president’s plan will be enormously beneficial and that it has identified critical outcomes and goals, including improving access to testing and treatment, continuing to improve treatment options for those already infected, and focusing on populations that are disproportionately impacted by HIV.
After more than 30 years on the forefront of the fight against HIV, we now know so much more than when we started. Scientific breakthroughs have saved and prolonged the lives of millions in the United States and throughout the world. While the war is not over, we know that, with the right information about HIV status at the right time, we can turn the tide against HIV.
So, do your part. Talk to your doctor, get tested and learn all of your options at the earliest stage possible.
Dr. James W. Curran (firstname.lastname@example.org) is dean of public health at the Rollins School of Public Health at Emory University and co-director at the Emory Center for AIDS Research; he was with the CDC from 1971-1995 and led the CDC HIV/AIDS Task Force. Dr. Gerald Schochetman (email@example.com) is senior director of diagnostic research for Abbott.”- The Baltimore Sun August 6, 2015