06 August 2008

AIDS at Home: Revised Stats Signal Need for Revised Strategy

On Saturday, the Center for Disease Control released a long-awaited report on HIV incidence in the nation. The message it carried was far from good: since the mid-nineties, they’ve severely underreported the number of new HIV infections occurring each year.

The revised annual infection rate is 40 percent higher than previous data suggested. The CDC says it has under-counted the number of new HIV infections by approximately 15,000 people a year, meaning that around 225,000 more people than originally thought are living with HIV. The previous estimate was around 1 to 1.1. million.

While the sheer magnitude of the discrepancy is shocking, its existence is not. As we’ve mentioned before, community-based organizations led by women living with and affected by HIV/AIDS have been calling on the CDC to improve the way in which it tracks new HIV infections and others—from activists to epidemiologists—have criticized the outdated, poorly configured system for years.

The CDC’s surveillance system, which tracks reporting of new HIV cases, hasn’t been changed in more than two decades, leaving many at risk populations under-counted and under-served. This is especially true for women, who frequently acquire HIV differently from men [PDF] and have seen their infection rates rise exponentially since the early years of the epidemic.

CDC surveillance simply isn’t designed to capture how and why more than 50 percent of women get HIV, with grave implications for how prevention programs are designed and funded to address their needs. In fact, because they aren’t thought to be “at risk,” women are sometimes turned away from federally funded testing sites.

The most recent revelation, then, of the underreporting of new HIV cases, is just the tip of the iceberg. Still, it does underscore the urgent need for a much more cohesive, reality-based, well-funded U.S. AIDS strategy.

As the Black AIDS Institute drove home last week in the release of a new report, the current U.S. Administration’s AIDS policy has focused more on combating the epidemic outside the U.S. than within it. This willful neglect has taken a particularly ruthless toll on people of color, especially African Americans.

The Institute’s research starkly reveals how HIV/AIDS rates among certain populations in the U.S. compare to those in developing countries—and consequently, why they should be causing nearly as much alarm:

  • If African Americans represented a country unto themselves, it would rank 16th in the world in the number of people living with the AIDS virus.

  • More African Americans were living with the AIDS virus than the infected populations in Botswana, Ethiopia, Guyana, Haiti, Namibia, Rwanda or Vietnam—seven of the 15 countries that receive support from the Administration’s anti-AIDS program.
Let’s also not forget that today, despite extraordinary improvements in HIV treatment, AIDS is the leading cause of death among African American women between the ages of 25-34 and the second leading cause of death among African American men between the ages of 35-44.

Clearly, from failing to accurately assess the hard numbers and true scope of the U.S. AIDS epidemic, to lacking a national strategy grounded in today’s reality to address it—we're faced with a broken system. What’s needed, our Women and AIDS Fund grantees continue to say, is a strategic overhaul that puts affected communities’ unique experiences and leadership squarely at the center of policymaking decisions, and their specific needs at the very heart of treatment and prevention.

Let’s hope the next Administration gets it right.

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