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Gay, Bisexual Black Men Now Face Greatest AIDS Risk

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"When the CDC investigated the first cases of AIDS in 1981, no one could have foreseen the enormous toll that AIDS would have within 20 years, both in the United States and throughout the world," said Satcher at a news conference marking the occasion.

The initial MMWR report of five rare pneumonias in previously healthy gay men suggested to the disease detectives at the CDC that the problem could be a "cellular-immune dysfunction ... acquired through sexual contact." Within 18 months, CDC scientists had discovered that HIV was transmitted through blood, sexual activity, or intravenous drug use.

At its peak, more than 150,000 Americans were being infected with HIV annually, but with the advent of antiviral therapies, the rate has stabilized at about 40,000. Experts say, however, that people should not be lulled into a false sense of security.

"People look at HIV now as a conquered disease, and they need to realize it's not a conquered disease ... because people think 'if I get HIV, there's cocktails [of different combinations of medicines] I can take,'" says Bruce Rausbaum, MD, a Washington internist who specializes in HIV and is himself infected with the virus. "People have a false sense of reassurance," he tells WebMD.

Since the MMWR's first report, nearly 450,000 Americans have died from the disease, which relentlessly destroys the immune system. Almost 1 million are living with HIV and AIDS here, but the number worldwide who are living with HIV or AIDS now is a staggering 36 million.

"We made many advances in our knowledge in both our knowledge about HIV and also about the treatment and prevention, but we still don't have that quick fix," said Martha Rogers, MD, one of first at the CDC assigned to crack the HIV puzzle.

She tells WebMD that so little was known about the deadly virus at the time, that she stored autopsy samples from an AIDS patient in her home refrigerator.

Even though CDC officials are confident a crucially important vaccine will be developed, a new and aggressive commitment to prevention is a must. "This disease is becoming concentrated in marginalized populations ... people who are generally outside the system," says Satcher. He's concerned that perhaps one-third of Americans carrying the virus may have no idea they're infected.

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