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
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
"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
"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."