COMMENTARY
Living with AIDS
| • | The battle isn't over, so Hawai'i needs to step up |
By Julie Gerberding
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Twenty-five years ago, the U.S. Centers for Disease Control and Prevention published the first official notice of a new, nameless and deadly syndrome that had affected a handful of gay men in New York and Los Angeles.
Although we didn't know it at the time, similarly mysterious illnesses were turning up in Uganda, and soon in other African nations. This was to be the beginning of the global HIV epidemic.
A generation later, HIV/AIDS has become one of the deadliest epidemics in human history. Around the world, more than 25 million people have died of AIDS, and 40 million are infected with HIV.
Among the dead are more than 500,000 of our fellow Americans. In the 1980s, as a physician at San Francisco General Hospital, I witnessed the epidemic firsthand.
On this somber June anniversary, many of us will review the accomplishments and the missed opportunities over the past 25 years. But this also is a time to look ahead: How can we ensure that far fewer of our sons and daughters, families and communities will suffer the pain and grief of this disease?
While powerful treatments have caused HIV/AIDS deaths to plummet in many countries, today's treatments are no panacea. The drugs are expensive; sometimes ineffective, particularly over time; and can cause significant side effects.
The simple and inescapable truth is that to defeat AIDS, we need to reduce the number of people who become infected. While we strive to develop an effective vaccine, the fact is that we already have the means to stop this epidemic.
In the United States, annual HIV infections declined sharply from an estimated 150,000 at the height of the epidemic to about 40,000 in recent years. New statistics suggest that we may be beginning to show progress in lessening the HIV/AIDS burden among blacks and repeated studies have shown a downward trend among injection drug users. The near-elimination of mother-to-child transmission of HIV in the United States is perhaps the best reminder of what's possible.
As we look ahead, there are several key strategies that will help us reduce the suffering from this entirely preventable disease:
HIV prevention is complex, and requires a continued commitment from people at risk, people infected, and society as a whole. Prevention efforts also need to keep pace with a constantly changing epidemic. For example, while white gay men were the first to bear the brunt of the epidemic early on, half of all new HIV diagnoses are now among black men and women. And rising rates of sexually transmitted diseases, such as syphilis, among gay men suggest a resurgence of risk behavior in that community. Finally, new generations of Americans, who may not remember the deadly, early days of the epidemic, continually need to be reached with basic prevention messages.
HIV remains a serious, lifelong infection. Our commitment to prevention must be just as long and just as strong as the disease itself. At this 25th commemoration of AIDS, let's remember those lost to this terrible disease by stopping its spread.
Dr. Julie Gerberding is director of the U.S. Centers for Disease Control and Prevention in Atlanta.
