Learn About HIV / AIDS

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HIV Prevention in the 3rd Decade or The Changing Epidemic (Continued)

Examples of CDC Programs and Research for Heterosexual Adults

Research has shown that women, as well as men, benefit from HIV prevention programs. Women benefit from programs aimed at increasing their awareness of their own risk, assertiveness in sexual situations, and coping skills.

In its funding of prevention programs for women, CDC emphasizes

• prevention and treatment services for young women and women of color
• better integrated prevention and treatment services for all women
• recognition of the intersection of drug use and sexual HIV transmission, especially among women who trade sex for drugs or money
• research on effective female-controlled prevention methods for women who are unwilling or unable to negotiate condom use with a male partner
• programs with a proven record of effectiveness for changing risky behaviors and sustaining those changes over time

Interventions found to be effective include

• teaching young heterosexual black women about assertiveness, negotiation, and condom use
• teaching male and female low-income, urban patients at high risk about expectations of outcome, skills, and the belief that one's words and actions will be effective at preventing HIV transmission
• showing videos on assertiveness, negotiation, and planning skills to promote abstinence and safer behaviors among single, innercity pregnant women.

One of CDC's HIV Prevention Strategic Plan objectives for this population is to increase among at-risk sexually active women and at-risk heterosexual men the proportions who consistently engage in behaviors that reduce risk for HIV acquisition or transmission.

Trends among Youth

The HIV/AIDS epidemic has taken a heavy toll on young people in the United States. because it is presumed that young people with HIV were infected fairly recently, scientists believe that HIV infections among youth may indicate trends in the overall HIV/AIDS epidemic. Trends in STDs other than HIV among young persons serve as indicators of risk behaviors for HIV.

AIDS

From the beginning of the epidemic through 2003, an estimated 9,789 young people (aged 15–24 years) with AIDS have died. Fortunately, since the late 1980s (from 1989 through 2003), deaths from AIDS have declined 71% for people in this age group. However, the challenges of addressing disparities in care, preventing secondary transmission of HIV, and meeting the social and medical needs of persons living with HIV or AIDS are especially critical for youth, considering their long-term needs.

HIV

Data from the 25 states with long-standing HIV reporting show that among people aged 25–34 years, the estimated number of new diagnoses from 1994 through 2003 declined by a remarkable 49%. However, in youth aged 13–24, new HIV diagnoses remained stable during this time period.

Trends Among People Worldwide

HIV and AIDS pose one of the greatest challenges to global public health. Worldwide in 2004, more than 3 million people died from AIDS. During that same year, an estimated 5 million people acquired HIV, bringing the number of people living with HIV to 39 million. Especially vulnerable are disadvantaged, marginalized, and unempowered populations such as commercial sex workers, IDUs, MSM, women and girls, and people living in poverty. Many people do not know that they carry the virus. Millions more know nothing or too little about HIV to protect themselves against it. Even those who do know about HIV prevention may not have the power to act on it, especially women and girls, who are often unable to say no to unprotected sex or to negotiate safer behaviors.

Sub-Saharan Africa

Approximately 25.4 million people are living with HIV/AIDS; an estimated 3.1 million were newly infected with HIV in 2004. HIV/AIDS is the leading cause of death in sub-Saharan Africa. In 2004 alone, AIDS killed 2.3 million African people. Without adequate treatment and care, most of those living with HIV will not survive the next decade.

Asia and the Pacific

Approximately 8.2 million people are living with HIV/AIDS; an estimated 1.2 million were newly infected in 2004. New infections increased 8% since 2002. The epidemic claimed over 540,000 lives in 2004. High HIV infection rates in the region are being discovered among IDUs, MSM, and sex workers.

Latin America and the Caribbean

Approximately 2.1 million people are living with HIV/AIDS; an estimated 293,000 were newly infected in 2004. Driving the spread of HIV are unequal socioeconomic development and a highly mobile population. The region, however, has made admirable progress in providing treatment and care.

Western Europe, North America, Australia, and New Zealand

Approximately 1.6 million people are living with HIV/AIDS; an estimated 70,000 were newly infected in 2004. A larger epidemic threatens to develop in high-income countries. Unsafe sex and widespread injection drug use are propelling these epidemics, which are shifting more toward underprivileged communities.

Eastern Europe and Central Asia

Approximately 1.4 million people are living with HIV/AIDS; an estimated 210,000 were newly infected in 2004. Eastern Europe - especially the Russian Federation - continues to experience the fastest growing epidemic in the world. because of high levels of other STDs and injection drug use among young people, the epidemic may grow considerably.

The Middle East and North Africa

Approximately 540,000 people are living with HIV/AIDS; an estimated 92,000 were newly infected in 2004. Poor surveillance systems in several countries hinder accurate assessment of and response to the epidemic.

Adults and Children Estimated to be Living with HIV, 2004

Advancing HIV Prevention: New Strategies for a Changing Epidemic

Advancing HIV Prevention (AHP) is an initiative to reduce barriers to early diagnosis of HIV infection and increase access to quality medical care, treatment, and ongoing prevention services for people living with HIV.

This initiative was created in response to several factors.

• Declines in new HIV infections have leveled off.
• Increases in sexually transmitted diseases and risk behaviors have led to a possible increase in new HIV infections.
• Not enough people know their HIV status.
• People who know their HIV status can protect themselves and their partners.
• A simple, rapid HIV test is available.
• Opportunities for preventing mother-to-child HIV transmission are being missed.

Four strategies are used to advance HIV prevention.

1. Make voluntary HIV testing a routine part of medical care. CDC is working with medical associations to ensure that all health care providers include HIV testing, when indicated, as part of routine medical care.
2. Use new models for diagnosing HIV infections outside medical settings. The use of rapid HIV tests can increase access to early diagnosis and referral for treatment and prevention services.
3. Prevent new infections by working with HIV-infected persons and their partners. CDC published the Recommendations for Incorporating HIV Prevention into the Medical Care of Persons with HIV Infection.
4. Further decrease mother-to-child HIV transmission. CDC promotes routine HIV testing of pregnant women and routine screening of any infant whose mother was not tested.

Data source: Centers for Disease Control & Prevention Website