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Gay, Bisexual Black Men Now Face Greatest AIDS Risk

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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.

Critics of the government's approach to HIV, like Kevin Frost, vice president for clinical research at the American Foundation for AIDS Research, say it's frustrating that Americans still can't talk about sex openly in schools. And it is hard to get federal funding for clean needle programs, even when such programs have been shown to reduce HIV transmission among drug addicts.

Without such changes, Frost tells WebMD, the "future is grim."

Helene Gayle, MD, MPH, who heads the CDC's HIV-prevention effort, worries that some of the benefits from new drugs may have started to plateau. Because the virus mutates, it can become resistant to treatment. Yet other drugs are in the pipeline.

Thus, it appears we'll be living with AIDS for the foreseeable future.

"I don't think that we necessarily have to look back 20 years hence and say ... this is a chronic problem that we are willing to accept like so many others," she says. "I think that what we do for HIV ought to set the stage for other diseases."

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