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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

    AIDS a 'Black Disease' continued...

    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."

    Caretakers Struggling to Keep Up

    The problem is evident in the Birmingham AIDS clinic run by University of Alabama researcher Michael S. Saag, MD.

    Saag notes that most of his clinic's patients don't show up for HIV tests until they already have AIDS.

    Such patients' treatment costs are vastly higher than those of patients diagnosed earlier in the disease. Yet their drug costs -- the costs most likely to be reimbursed by government AIDS funds -- are only a fraction of their health care costs.

    "The reimbursement to providers is extremely low," Saag said at the news conference. "We collect $360 per patient per year. Clinics like ours have been flat-funded for years, despite a 60% to 70% increase in patients."

    That means Saag's clinic loses a staggering $1.1 million a year -- before the effects of routine HIV tests are felt.

    Saag said routine testing -- followed by effective treatment -- will cut long-term costs. But treatment, he insisted, has to be part of the equation.

    Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, agreed.

    "It is not what we are doing that is wrong; it is what we are not doing," Fauci said.

    "As we expose this societal lesion -- having more people infected than in care -- I would not slow the momentum of testing," said Fauci. "I hope that is the engine that ignites more activity in getting more people into care."

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