United States HIV/AIDS Epidemic

Why is the Ebola scare such a media focus?   Ebola represents a potential epidemic threat.  HIV/AIDS is here now.  It seems to be the forgotten epidemic.  Not popular to talk about any more.

1 million people are currently infected with HIV/AIDS in the US.  The government estimates 50,000 new cases in the US annually, more than all the total number of Ebola infections worldwide in history

 Mr. Obama joins the scare about a potential Ebola epidemic.

"It is a marathon, but you have to run it like a sprint," Obama said. "How quickly we can contain it is within our control. If we move fast, even imperfectly, that could mean the difference between 10,000, 20,000, 30,000 deaths versus hundreds of thousands or even a million deaths."

This is unsubstantiated hyperbole.  According to WHO statistics, Ebola infection has resulted in less than 1,000 fatalities worldwide in all history.

From the US Government AIDS information page:

U.S. Statistics HIV/AIDS

           

HIV in the United States: At A Glance

Fast Facts

• More than 1.1 million people in the United States are living with HIV infection, and almost 1 in 6 (15.8%) are unaware of their infection.
• Gay, bisexual, and other men who have sex with men (MSM^a), particularly young black/African American MSM, are most seriously affected by HIV.
• By race, blacks/African Americans face the most severe burden of HIV.

CDC estimates that 1,144,500 persons aged 13 years and older are living with HIV infection, including 180,900 (15.8%) who are unaware of their infection¹. Over the past decade, the number of people living with HIV has increased, while the annual number of new HIV infections has remained relatively stable. Still, the pace of new infections continues at far too high a level— particularly among certain groups.
HIV Incidence (new infections): The estimated incidence of HIV has remained stable overall in recent years, at about 50,000 new HIV infections per year². Within the overall estimates, however, some groups are affected more than others. MSM continue to bear the greatest burden of HIV infection, and among races/ethnicities, African Americans continue to be disproportionately affected.
HIV Diagnoses (new diagnoses, regardless of when infection occurred): In 2011, an estimated 49,273 people were diagnosed with HIV infection in the United States. In that same year, an estimated 32,052 people were diagnosed with AIDS. Overall, an estimated 1,155,792 people in the United States have been diagnosed with AIDS³.
Deaths: An estimated 15,529 people with an AIDS diagnosis died in 2010, and approximately 636,000 people in the United States with an AIDS diagnosis have overall³. The deaths of persons with an AIDS diagnosis can be due to any cause—that is, the death may or may not be related to AIDS.

Figure1: Estimated New HIV Infections in the United States, 2010, for the Most Affected Subpopulations

By Risk Group

Gay, bisexual, and other men who have sex with men (MSM) of all races and ethnicities remain the population most profoundly affected by HIV.
In 2010, the estimated number of new HIV infections among MSM was 29,800, a significant 12% increase from the 26,700 new infections among MSM in 2008².
Although MSM represent about 4% of the male population in the United States⁴, in 2010, MSM accounted for 78% of new HIV infections among males and 63% of all new infections². MSM accounted for 52% of all people living with HIV infection in 2009, the most recent year these data are available¹.
In 2010, white MSM continued to account for the largest number of new HIV infections (11,200), by transmission category, followed closely by black MSM (10,600)².
The estimated number of new HIV infections was greatest among MSM in the youngest age group. In 2010, the greatest number of new HIV infections (4,800) among MSM occurred in young black/African American MSM aged 13–24. Young black MSM accounted for 45% of new HIV infections among black MSM and 55% of new HIV infections among young MSM overall².
Since the epidemic began, an estimated 302,148 MSM with an AIDS diagnosis have died, including an estimated 5,909 in 2010³.
Heterosexuals and injection drug users also continue to be affected by HIV.
Since the epidemic began, almost 85,000 persons with an AIDS diagnosis, infected through heterosexual sex, have died, included an estimated 4,003 in 2010³.
New HIV infections among women are primarily attributed to heterosexual contact (84% in 2010) or injection drug use (16% in 2010). Women accounted for 20% of estimated new HIV infections in 2010 and 24% of those living with HIV infection in 2009^{1, 2}. The 9,500 new infections among women in 2010 reflect a significant 21% decrease from the 12,000 new infections that occurred among this group in 2008².
Injection drug users represented 8% of new HIV infections in 2010 and 16% of those living with HIV in 2009^{1, 2}.
Since the epidemic began, nearly 182,000 injection drug users with an AIDS diagnosis have died, including an estimated 4,218 in 2010³.

Followup on comment from Maggie Danhakl, Assistant Marketing Manager at "www.healthline.com".  Their web site offers good current information regarding HIV/AIDS.

Taking the cure

I got a flu shot this week. Mostly because I went to town with my parents, and they believe it is vital. I never want to insult them, but I don't expect them to be so familiar with the science and epidemiology associated with flu epidemics and the theory behind public immunization.

Some people are very sensitive about this issue. I discovered, inadvertently, that our next-door neighbor does not get immunization for his children. They school the children at home,too, so they avoid problems with public health bureaucracy.  Medical studies have resolved this issue, but people still have doubts.

I am afraid I touched on sensitive feelings, spouting off about immunization and the irresponsible parents who fail to participate in public immunization programs.  He came back on the defensive. with some arguments about mercury and autism, and I was taken aback, because it surprised me to realize that he was one of the parents I was talking about.

Suffice it to say that not all who hold their children out of immunization are ignorant simpletons.  There are real issues of concern about immunization safety and problems that may result as side-effects of the vaccine.  Parents are responsible for making this decision about whether or not the children will be exposed to the risk of disease form the shots, or from childhood disease. The threat of widespread epidemic is so much reduced by public immunization, there may be a higher risk for isolated individuals who participate than those who don't.

On the other hand, I understand that some of the reduced risk factor depends on large populations being vaccinated.  Those who don't participate are protected from disease by those around them, who are vaccinated. They benefit from the risk-taking that others are exposed to. That doesn't necessarily paint a very complementary picture of the non-participants. We have to weigh in the realization that in reality, there are no non-participants, and the immunized children protect the others from disease.

I am concerned, too, that today's younger parents do not have the perspective of knowing first-hand the horrifying death and devastating disease that swept through the population, striking so many at random. They have never seen someone with misshapen limbs twisted by childhood polio, for example, or seen their friend locked in an iron lung, struggling just for a free breath. They don't realize what an amazingly effective job public immunization has done of eliminating childhood diseases from our population.

I witness, somewhat bemused at the huge public outrage against Chinese baby milk, contaminated with melamine, and imagine the millions who would have been wiped out without a chance, but for widespread immunizations that have made so many public epidemics a thing of the past -- perhaps a past forgotten too soon. I hope we don't have to re-learn the lessons of epidemics and scourges long-past. Our ancestors paid far too dearly to learn that lesson the first time.

In a long-past time, I remember all the children at the grade school, lining up at the school cafeteria for their shots. I recall how frightened I was at the time. No one bothered to explain to us about the horrible disease they were fighting. At the time, we only knew that the syringe was painful and threatening. Some of the children were sobbing in fear before the vaccine was even injected. But most of us endured the fright, and were thus protected from childhood disease.
 

Dealing with AIDS

In the news yesterday a critical analysis of US policy on dealing with AIDS. Reportedly more than 25 million people in sub-Saharan Africa are already victims of HIV/AIDS, 70 percent of the total worldwide. This supposedly as clear evidence that abstinence is ineffective as a prevention measure for AIDS.

The editorial talks around this issue as grounds for criticism of the US government policy on foreign aid. The current administration apparently established a rule that one third of the AIDS relief funds go support programs that promote moral principles.

The arguments against promoting morality defy logical thinking. Typically they start with the axiom that irresponsible young folks cannot be successfully restrained from sexual promiscuity, no matter what moral teachings they receive. Critics of morality always have numbers to back them up that "prove" how silly it is to believe anything but what they teach. What always seems to be the real reasoning behind their convictions, however, is a burning need to denigrate anything related to religious faith.

As far as I can remember, the idea of promoting any morality based on religion has been objectionable to the liberal-minded. There was a prolonged debate about teaching sex education in public schools when I was young. The argument never really resolved, but the proponents of "alternative" thinking and pluralism eventually won by default, as they dominated in administering public education, and were not accountable to parents of the children they presumed to indoctrinate. Perhaps this was a contributing factor in the subsequent virtual destruction of the traditional family structure of certain social classes.

I could not cast a vote on which plague is worse -- the AIDS crises in Africa, or the loss of a base for morality, and the resultant disintegration of traditional families in western culture.

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Jim Cobabe
jim@cobabe.net
jcobabe@gmail.com
http://www.cobabe.org
http://jcobabe.tripod.com
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