World AIDS Day, which was conceived by the World Health Organization to raise awareness and support, is an opportunity to take stock of the epidemic’s scope and the everyday impact of the virus. What better way to do this than by reminding ourselves of the often alarming numbers involved?
On Saturday, December 1, people around the globe who come together to recognize the 25th World AIDS Day will have much to mourn and also much to celebrate. Over the past quarter-century, 25 million lives have been lost to HIV/AIDS, but remarkable strides have also been made in halting the disease's progression.
World AIDS Day, which was conceived by the World Health Organization to raise awareness and support, is an opportunity to take stock of the epidemic's scope and the everyday impact of the virus. What better way to do this than by reminding ourselves of the often alarming numbers involved?
The stories of individuals who have lived with HIV/AIDS, or who have who suffered a loss at its hands, will always have a unique power. But the following statistics, gathered from government data and scientific research, provide a bird's-eye view that brings home the vastness and complexity of the epidemic.
This figure works out to about 1 in every 200 people over the age of 13. What's more, nearly 20% of these people don't know they're infected because they haven't been tested for the virus.
Worldwide, an estimated 34.2 million people are living with HIV/AIDS—two-thirds of them in sub-Saharan Africa. While the rate in the United States may seem low by comparison, it still is one of the highest in the developed world, says Michael Horberg, MD, director of HIV/AIDS at Kaiser Permanente, the nation's largest nonprofit health plan. (In the U.K., for instance, roughly 1 in 650 people are estimated to be HIV-positive.)
This statistic, from 2009 (the most recent year for which solid data is available), is heartbreaking yet also encouraging: It's less than half the number of people who died of HIV/AIDS in 1995, when mortality reached an all-time high.
The sharp decrease is a testament to improved testing, diagnosis, and treatment. "This number, while still too high, shows that quality HIV care, and the potent medications we now have, [have] dramatically improved the lives of HIV-positive Americans and people worldwide," Horberg says.
Young people now account for 1 in every 4 new infections in the United States, according to a report released this week by the Centers for Disease Control and Prevention (CDC).
Even more troubling, 60% of these individuals don't know their status, making transmission easier and treatment harder. Only 35% of 18- to 24-year-olds and just 22% of sexually active high-school students have been tested, according to the report.
This is a startling number, given that African Americans make up just 13% of the population. The burden of disease is even more disproportionate among 13- to 24-year-olds, an age group in which African Americans or blacks (government agencies tend to use the terms interchangeably) account for 57% of new infections.
"HIV is now a disease of minorities—black, Latino, gay men—and people who have been often medically disenfranchised in the past," says Horberg, who is also chair of the HIV Medicine Association, a professional association for doctors and health care providers who specialize in HIV/AIDS.
People can live with HIV for a decade (or longer) before they experience symptoms such as fever, fatigue, and joint pain—a fact that underscores the importance of testing and early detection.
Thanks to virus-fighting drugs (antiretrovirals), this asymptomatic period, known as the "chronic" or "latency" phase of the disease, can essentially be extended indefinitely. "If people are diagnosed early and given effective treatment, and if they stay on their treatment, they won't have any symptoms at all," Horberg says.
The number of people getting tested for HIV rose between 1997 and 2004 but has leveled off since then, according to the 2011 Kaiser Family Foundation survey that produced the above statistic. Black and Latino survey respondents were much more likely than whites to report having been tested.
In the United States, National HIV Testing Day is observed on June 27, but World AIDS Day also features free testing and counseling events around the world.
This guideline, proposed last week by the U.S. Preventive Services Task Force, an independent panel of experts that advises the federal government on preventive care, would strengthen a set of 2005 guidelines that recommend testing only for high-risk adults and adolescents, as well as pregnant women.
The proposed change is aimed at slashing transmission rates and getting more people into treatment sooner. "This new recommendation shows that the evidence is overwhelming," Horberg says. "Not only does treatment help patients…, but it will also greatly prevent others from getting infected."
In July of this year, the antiretroviral Truvada became the first drug approved by the Food and Drug Administration for preventing the sexual transmission of HIV. In one study of heterosexual African couples in which one partner was HIV-positive, the HIV-negative partners who took Truvada had a 75% lower risk of becoming infected compared with those taking placebo.
There are a number of caveats—most notably, people must diligently take the drug every single day in order for it to be effective. But the study results do "show that there are many effective ways to prevent HIV infection," Horberg says. "In certain situations, [Truvada] is going to be very, very useful."
This dramatic decline in low- and middle-income countries is among the many bright spots in this year's World AIDS Day report released by the Joint United Nations Program on HIV/AIDS. Half of the reduction occurred among newborn babies.
In some African countries hardest hit by the epidemic, the numbers are even more encouraging: Over the 10-year span, new infections dropped by 73% in Malawi, 71% in Botswana, and 68% in Namibia. Increasing access to antiretroviral drugs has contributed to these declines, as well as to a concomitant 25% decrease in death rates, according to the report.
This includes donations from governments, corporations, and individuals. Although the amount represents a huge increase from the $300 million spent in 1996, spending has faltered since the global economic crisis began in 2008.
Fighting HIV/AIDS is expensive, but the investment—in addition to saving lives—will ultimately drive down worldwide health care costs, Horberg says. "There will be savings down the line, because you will have fewer newly infected people, people will be generally healthier, [and] they won't be hospitalized," he says.