Majority of Americans with HIV Are Not Getting Optimal Care

In a November 29 article in the Washington Post, it was reported that only slightly more than a quarter of HIV-positive Americans are getting the kind of medical care that maximizes their life expectancy, according to a new estimate from the Centers for Disease Control and Prevention (CDC).

The goal of HIV treatment is to suppress the virus until it is no longer detectable in the bloodstream. Only 28% of the 1.2 million people living with HIV in the United States have their viral load controlled to that optimal degree, according to epidemiologists at the CDC.

 “It is time to act even more aggressively,” said Jonathan Mermin, MD, director of the CDC’s Department of HIV/AIDS Prevention. Having such a small fraction of people adequately treated “is not acceptable from a public health, humanitarian, or economic perspective,” he said.

Several years ago, the CDC endorsed universal HIV testing of Americans. With new research showing that treated people are unlikely to transmit the virus to others, the agency is campaigning for physicians and health departments to make sure that people who are found to be HIV-positive get into treatment. For those who enter and stay in care, approximately 77% achieve undetectable viral loads. However, the CDC reports that as many as 50% of those who enter care, end up dropping out.

While high rates of attrition from treatment can be common due to reluctance to take pills, drug side effects, inconvenience, expense, and denial, studies have shown that 32% of Latinos, 21% of blacks and 16% of whites are uninsured, potentially creating an obstacle to HIV treatment. This is not likely to improve with the current political climate and proposed cuts to Medicare and Medicaid.


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