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Who Will Care for New U.S. AIDS Cases?

Plans to Find 250,000 Hidden U.S. HIV Infections -- but no Plan for Their Care
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 29, 2006 -- Plans to find the 250,000 Americans who don't know they have HIV will bump up against a shortage of funds and care workers to treat them, leading U.S. AIDS experts say.

Experts almost universally praise the CDC's recent recommendation to make the HIV test part of routine annual health care.

The change is part of a major effort to identify the more than 250,000 Americans who have HIV but don't know it.

But there's a big problem. All of these newly diagnosed people would need immediate treatment. Yet AIDS clinics already have too many patients, too few doctors, too few nurses, and far too little money.

"It is unacceptable that we go about the business of finding more people with HIV with lack of a plan of how to treat them," said Phill Wilson, CEO of the Black AIDS Institute, at a news conference.

In an effort to address this and other issues, U.S. AIDS experts this week are holding an "HIV summit meeting" in Washington, D.C. The experts are discussing how the U.S. can improve HIV diagnosis, HIV prevention, and access to HIV care.

The conference comes on the eve of the annual Dec. 1 World AIDS Day.

AIDS a 'Black Disease'

John S. Bartlett, MD, chief of infectious diseases at Johns Hopkins University, strongly supports universal, routine HIV testing.

"The question is: Can the U.S. health care system manage this?" Bartlett asked at the news conference. "Most newly diagnosed patients are on public resource. Most are unemployed. And the number of slots in existing clinics may be limited, where we can't handle the number of new cases."

Bartlett notes that in his Baltimore AIDS clinic, 60% of patients are unemployed, and 45% are uninsured.

"No other disease attacks the disenfranchised population like this one does," Bartlett said. "It is hitting the underserved."

In the 1980s, successful AIDS prevention efforts were targeted to the group that bore the brunt of the epidemic -- gay white men. That was yesterday's AIDS epidemic.

"The face of the epidemic is changing," CDC AIDS chief Kevin Fenton, MD, PhD, said at the news conference. "AIDS is increasingly becoming a black disease in the U.S."

Wilson put the issue more forcefully.

"U.S. AIDS today is a black disease, plain and simple," Wilson said. "Of the 40,000 Americans newly infected with HIV every year, 20,000 are black.

"We have to get black folks and black institutions to take ownership of this disease," Wilson said.

"But that has to be part of a much larger strategy," he added. "We have to demand that we have the tools to make sure people know what the test means, and that we have access to treatment."

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