AIDS care in America is like a set of nested Russian dolls, each figure smaller than the one it’s inside. ¶ About 1.2 million Americans are infected with HIV, the virus that causes AIDS, according to the U.S. Centers for Disease Control and Prevention. Of that total, 80 percent know they are infected; 62 percent have sought medical care after diagnosis; 41 percent have stayed in care; 36 percent are receiving life-extending antiretroviral drugs; and 28 percent have no HIV detectable in their bloodstream as a result of treatment. ¶ “The issue of how to treat patients is a done deal. We know what to do,” said John G. Bartlett, 76, who watched the AIDS epidemic unfold as head of the division of infectious diseases at Johns Hopkins Hospital from 1980 to 2006. ¶ Today, the big issues are how to find the patients, test them, get them into medical care and keep them there, provide them medicines, educate them and follow their progress.
This cascade of challenges reflects both the peculiarities of this disease and medical care in the United States.