HIV in the U.S.: No time to rest on our laurels

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With the introduction of highly effective antiretroviral drugs to combat HIV and AIDS over the past 17 years, the infection has taken a back burner to other health maladies in the U.S. But a new study presented at the Conference of Retroviruses and Opportunistic Infections finds that among black women in America, HIV is still a major concern.

The latest data come from the ISIS study, which analyzed nearly 2,100 at-risk women in six urban areas who had never tested positive for HIV. A team led by a researcher at the Emory University School of Medicine found that, after one year, 0.24 percent of the women tested positive for the disease. Though that may not sound like a significant figure, it s actually comparable to HIV infection rates among the general population in many sub-Saharan African countries, including Kenya (0.53 percent) and the Democratic Republic of Congo (0.28 percent).

In fact, the latest figures are five times greater than the Centers for Disease Control and Prevention s previous estimate for black U.S. women. Over 40 percent of the study participants had a household income of $10,000 or less, demonstrating that HIV still thrives in many impoverished areas of the country.

As Dr. Carlos Del Rio, principal investigator for the Atlanta area of the study, points out, poverty, food insecurity, and substance abuse are all confounding factors for HIV risk among this cohort of women. So we can t just say, Here s some information on AIDS and here are some condoms, he says. We re talking about structural interventions that are needed ¦this epidemic is the face of the forgotten people.

ACSH s Dr. Gilbert Ross agrees. This crisis is not amenable to simple public health interventions, he says. We need to focus on better access to health care, screenings, and education.

ACSH s Dr. Josh Bloom notes that it has been shown in studies in Africa that treating HIV positive men with antiretroviral drugs can cut the rate of transmission to women by 96 percent. Expanding access to this treatment is clearly a major part of the approach we should be taking here.