One in every five HIV positive Amercans is not aware he/she is infected, and only 49% of those who know they are infected receive ongoing medical care and treatment, says a new Vital Signs report issued by the CDC (Centers for Disease Control and Prevention). There are nearly 1.2 million Americans who live with HIV, of whom approximately just 28% have a viral load of below 200 copies of HIV per milliliter of blood (a low viral load).

HIV infected patients with a low viral load have their infection under control – at a level that allows them to stay healthy, and also minimizes their risk of passing it on to other people.

77% of HIV positive Americans who are receiving “ongoing” antiretroviral treatment and care have suppressed levels of HIV. Proper and effective HIV therapy and care improves the patient’s health, and prevents the spread of infection.

The NIH (National Institutes of Health) carried out a study recently on heterosexual couples which demonstrated that ongoing antiretroviral therapy, combined with safety behaviors, can reduce the risk of HIV spreading by about 96%.

CDC Director Thomas R. Frieden, M.D., M.P.H., said:

“While we have known that viral suppression can be achieved with proper HIV treatment and care, today’s new Vital Signs data highlight the challenges our country faces in keeping HIV-positive Americans in the care they need to control the virus.

By improving testing, linkage to care and treatment services, we can help people living with HIV feel better and live longer, and can reduce the spread of HIV dramatically. This is not just an individual responsibility, but a responsibility for families, partners, communities and health care providers.”

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The authors explain that MSM (men who have sex with men) tend to have the lowest awareness of their HIV status, and are the least likely to receive counseling on infection prevention. A recent report showed that 39% of MSM are aware of their HIV status and receive prevention counseling compared to 50% of heterosexual males and females.

The researchers stress that every stage of the treatment and care of HIV in America needs to be improved. More Americans need to be tested, linked to care, given ongoing care, provided with prevention counseling , and treated successfully if viral suppression is to be achieved.

Jonathan Mermin, M.D., director of CDC’s Division of HIV/AIDS Prevention, said:

“Closing the gaps in testing, access to care and treatment will all be essential to slowing the U.S. HIV epidemic. HIV testing is the most important first step toward breaking the cycle of transmission. Combined with effective prevention services, linkage to care and ongoing effective treatment, testing provides a gateway to the most effective prevention tools at our disposal.”

What individual people can do

  • Reduce risky sexual behavior by abstaining from sex, only having sex with one partner who is not infected with HIV, or using a condom for oral, vaginal or anal sex (every time).
  • Go to your doctor and ask for an HIV test.
  • If you are infected with HIV, get medical care ASAP. This will ensure you stay healthier for longer, and help protect others from becoming infected.
  • Have regular HIV tests if you live in an area or community where HIV is common.
  • If you have more than one sexual partner, inject drugs, or are an MSM, get an HIV test at least once every 12 months.

What the federal government can do

  • Create and issue guidelines for health care providers on medical care and testing.
  • Educate the general public as well as health care professionals about the importance of medical care and HIV testing.
  • Fund HIV prevention services and medical care programs.
  • Help the National HIV/AIDS strategy achieve its goals.

What state and local health department can do

  • Fund HIV medical care and HIV prevention programs.
  • Set up programs so that at risk individuals are tested frequently and promptly.
  • Explain to people where they can get tested.
  • Integrate HIV prevention counseling and services as part of standard care.
  • Support programs and community actions aimed at preventing new HIV infections.
  • Help the National HIV/AIDS strategy achieve its goals.

What health care providers can do

  • Offer patients routine HIV tests.
  • Offer STD tests to patients, as well as relevant treatments.
  • Prescribe antiretroviral therapy for HIV-positive patients, and help them keep their viral load down.
  • Ensure that all their HIV-positive patients receive effective HIV medical care.
  • Provide prevention counseling.

Written by Christian Nordqvist