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    U.S. AIDS Epidemic Worse Than Thought

    40% Higher HIV Infection Rate; 56,300 Americans Infected Each Year

    Who Gets HIV in America? continued...

    "It is a very large and disturbing disparity," Wolitski says.

    Race itself is not the risk. Wolitski points to factors and situations that disproportionately affect black Americans' HIV risk.

    "Poverty, stigma, misperceptions of risk, disparities in rates of sexually transmitted diseases, and the destabilizing effects incarceration has on individuals, families, communities, and substance use -- all may be playing a role here," he says.

    Black men who have sex with men are at particularly high risk. A 2005 CDC study showed that in some U.S. cities, 46% of black gay/bisexual men were infected with HIV. That's twice the 21% infection rate seen for white gay/bisexual men, and far higher than the 17% rate for gay/bisexual Hispanic men.

    Drug Users -- Clue to AIDS Prevention Success?

    The CDC's new figures aren't all gloom and doom.

    A ray of light comes, of all places, from intravenous drug users. Since the mid-1990s, fewer and fewer Americans have been getting HIV from intravenous drug use. That's due not to a decrease in drug use, but to prevention success among those who continue to use illicit drugs.

    "It is exciting to see the continued declines in new infections among intravenous drug users," Wolitski says.

    What makes this so exciting is that drug users are a hard-to-reach population that obviously ignores mainstream health messages. Yet prevention efforts succeeded in dropping new HIV infections from a high of about 35,000 per year in the late 1980s to fewer than 6,000 per year in 2003-2006.

    "It underscores the importance of a comprehensive approach that included a focus on individuals' needs, and includes needle and syringe exchanges that have been implemented in many communities around the country," Wolitski says. "Here it shows why we really need a comprehensive approach to HIV prevention. No single strategy is going to be a solution to the epidemic."

    The Future of AIDS in America

    Often lost in discussions of new HIV treatments is the fact that nobody has to get HIV. It's a 100% preventable infection. But prevention means dealing with sexual issues in a practical, forthright manner.

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