24 Jul 2012

‘Long way to go’ in the battle against Aids

The US Secretary of State, Hillary Rodham Clinton, has promised delegates at this year’s International Aids Conference that the government is working towards an “Aids-free generation”.  In a rousing speech, Clinton said that a blueprint would be put together by World Aids Day in December.

She told the conference:  “The United States is committed and will remain committed to achieving an Aids-free generation.  We will not back off, we will not back down, we will fight for the resources necessary to achieve this historic milestone.”

An Aids-free generation does not mean an HIV-free generation.  Instead it is a commitment that no-one will be born with the virus; second, that as people get older, they will be at a far lower risk of becoming infected than they are today; and third, that if they do acquire HIV, they will get treatment that keeps them healthy and prevents them from transmitting the virus to others.

But there are those who remain sceptical about the ability to achieve this.  They point to Washington DC itself, which has one of the highest HIV and Aids rates in the country.  Figures show that about 2.8 per cent of people are infected but officials believe it is far higher because people are simply not being tested.

Dr Greg Pappas, senior deputy director at the district’s health department, said it was thought that as many as 20 per cent of people with HIV do not know they have the virus.  “That means 4,000 to 5,000 are walking around DC not knowing they are infected,” he said. “We need to get them tested and into treatment.”

Across the United States, the highest rates are among gay African-American men.  In DC it is among African-American heterosexuals.  And recent figures show that there has been a dramatic increase in the numbers of women being infected.  In the poorest districts it is now as high as one in eight.

The figures can partly be explained by women being more willing to be tested.  Health officials say they are struggling to reach the men.

Toni Young, of Community Education Group, an Aids charity, said that the women are being infected by men who refuse to use a condom.  “Many of these women are single heads of households, engaged in a relationship where the male says I don’t want to use a condom.  If that man is paying the mortgage or feeding the household,  how do you negotiate that?  We have to make women understand the risk.”

DC has in many ways been innovative in trying to persuade people to be tested.  They have free HIV testing at the Department of Motor Vehicles so they can renew their licence and find out their HIV status at the same time.

But still, at a time when the disease is treatable and preventable, that is not happening here.  And for all the optimism from the Aids conference and from the American government itself, there is a long way to go.

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