THE NATION

HIV, AIDS Cases in U.S. Said to Top 1 Million

By Thomas H. Maugh II
Times Staff Writer

June 14, 2005

The number of Americans living with HIV or AIDS has passed the 1-million mark for the first time, reflecting an increasing success in prolonging survival with treatments and a continuing failure in controlling the spread of new infections, government researchers said Monday.

Three-quarters of those infected are males and nearly half of them are black, according to data from the Centers for Disease Control and Prevention presented Monday at the National HIV Prevention Conference in Atlanta.

"This is a heartbreaking milestone," said Craig E. Thompson, executive director of AIDS Project Los Angeles.

Men having sex with men account for 45% of the cases, according to the new data. About 25% do not know they are infected.

The number of those infected represents a sharp increase from the figures released in December; it was estimated then that between 850,000 and 950,000 Americans were living with HIV at the end of 2002.

The new figures, for the end of 2003, represent a best estimate of between 1,039,000 and 1,185,000 people.

In part, the new data reflect better reporting by the states, indicating that previous estimates were low. But the numbers also reflect a continued increase in infections, about 40,000 new cases per year and 18,000 deaths, for a net gain of 22,000 cases each year.

That 40,000 figure has remained constant for more than a decade, despite a 2001 pledge by the CDC that it would strive to halve the rate.

"It is clear that we have not achieved that goal," Dr. Ronald O. Valdiserri, deputy director of the CDC's national center for the prevention of HIV, sexually transmitted diseases and tuberculosis, said at a news conference Monday.

Dr. Carlos del Rio of Emory University in Atlanta presented new data indicating that the infection rate may actually be increasing and may now be as high as 60,000 new cases per year.

Researchers believe that a large fraction of the new cases, if not most of them, are caused by people who do not know they are infected.

Separately, at a news briefing Monday with the presidents of Botswana, Ghana, Mozambique, Namibia and Niger, President Bush announced that more than 200,000 people in sub-Saharan Africa were receiving anti-HIV therapy under the President's Emergency Plan for AIDS Relief, putting the program ahead of its milestones for reaching a goal of 2 million people in treatment by the end of 2008.

In a follow-up news conference, Dr. Mark Dybul, deputy U.S. global AIDS coordinator, said that as of the end of March, 230,000 people in Africa and 5,000 people in the Caribbean and Vietnam were receiving treatment under the program, commonly known as PEPFAR.

The program's short-term goal was 200,000 people in treatment by the end of this month, "so we are very much on target," Dybul said.

"These numbers prove that PEPFAR has been strong out of the gate," said Mark Isaac, vice president for policy at the Elizabeth Glaser Pediatric AIDS Foundation. But "this is only a beginning, and the toughest stretches still lie ahead."

An estimated 38 million people worldwide are living with HIV or AIDS. The United Nations AIDS program estimates that nearly 6 million of them - mostly in Africa - will die in the next two years if they do not receive antiretroviral drug treatment. The most recent figures from UNAIDS, released in January, indicate that about 700,000 people are receiving the drugs.

About 54% of all AIDS funding in the region comes from the United States, Dybul said.

"We really need the rest of the world to respond if we are going to get the full numbers in treatment," he said.