Apathy Over AIDS Could Prove Deadly

Disease experts worry that a United Nations report that suggests the AIDS epidemic is waning could spark a false sense of security among those most at risk.

Recent numbers from the UNAIDS report hints that the AIDS epidemic may be in its final stage -- that is, it may be beginning to burn out.

However, infectious disease experts across the nation strongly disagreed and warned that that the AIDS epidemic is far from over. They emphasize that the AIDS epidemic is still active.

Their fear is that people who hear of the report will take it as a cue to relax treatment and prevention efforts, which is exactly the opposite of what needs to be done.

"The concern is donors will see these new estimates as reason to relax their response on AIDS," says Christopher Collins, a member of the International Treatment Preparedness Coalition. "That would be a terrible mistake. We are seeing concrete results from prevention and treatment programming -- this is no time to pull back.

"Instead, we need to scale up AIDS prevention and treatment and continue to make progress on what remains a devastating epidemic."

Not Out of the Woods

According to the UNAIDS report, the rate of new infections peaked globally in the late 1990s at more than 3 million per year. Today that rate has declined to about 2.5 million new infections annually. UNAIDS is the Joint United Nations Program on HIV/AIDS, and is the branch of the world body responsible for the organization's AIDS-related programs.

AIDS experts caution against interpreting these figures as a sign that AIDS is becoming relegated to the status of other chronic diseases. Rather, they say that AIDS is not like other diseases -- not only in its magnitude and persistence but also in its nature of infection.

"What makes HIV different from 'other pestilences' is that the persistence for the life of the human host assures that 30 million to 40 million carriers will be infected, in need of care, and potentially [become] transmitters ... for the next decade or so," says Dr. James Curran, professor of epidemiology and dean of the Rollins School of Public Health at Emory University.

Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition agrees.

"While HIV may be behaving like other pestilences, it still has unique features -- not least is the magnitude, and that even with this new data, there are still 32 million people infected," he says.

In addition, AIDS is complicated by other issues, which makes it more difficult to talk about and treat.

"AIDS remains different because it is intertwined with sexuality and drug use, human behaviors that political leaders often have a hard time grappling with honestly and effectively," says Collins. "AIDS is also different because of the deadly stigma involved, in part because many of the groups at highest risk are marginalized in their societies."

And while HIV is similar to other diseases in that it can be transmitted from people who have the virus -- known among researchers as vectors -- to those who don't, its way of disrupting the immune system is different.

"HIV, conceptually, is like other pestilences ... a transmissible disease with known vectors and reservoirs," says Dr. Michael Saag, director of the Center for AIDS Research at the University of Alabama in Birmingham.

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