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Why the U.S. Has Not Stemmed HIV
An international AIDS conference in Toronto this week will focus on global progress against HIV and, perhaps, the lack of progress in the United States.
(By Nathan Denette -- Associated Press)
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"I think it's fair and certainly honest to say that over the past several years we've gotten more stringent with our funding," Valdiserri, of the CDC, said last week.
Men of Color Motivational Group was a 14-year-old organization of gay black men in Detroit with two missions: outreach to teenagers and outreach to adults. It had a $1.2 million budget, with $650,000 provided by the CDC.
Last year, it lost that funding and closed.
"Over the years, there were ups and downs," said Mark J. McLaurin, a New York AIDS activist who sat on the group's board. "But I don't think there was any question that dealt the deathblow."
The strategy for reducing new infections many experts consider most overlooked is needle exchange for drug addicts.
The CDC estimates that 17 percent of new infections each year come from contaminated needles. Evidence suggests that 65 percent of those could be prevented if every addict had access to a clean needle. However, federal law prohibits using federal money for that purpose.
Nevertheless, there are 150 needle-exchange programs around the country, including one in the District, supported by local budgets and contributions. They have had dramatic effects.
In Baltimore, 60 percent of new infections came from drug use in 1994, the year before the city offered needle exchange. In 2003, 41 percent of new infections came from needle use -- and over that period the total number of new infections, from all causes, declined.
Exchanging 2.2 million needles a year, Seattle is not just protecting addicts. Most heterosexual transmission occurs between male drug users and their female partners. In Seattle, very few women are becoming infected that way, which in turn means that few pregnant women are HIV-positive. That is part of the reason the city hasn't had a baby born with the virus since 1997, said Robert W. Wood, the physician who heads HIV-control efforts in the Seattle health department.
"Is prevention effective? We've spent a lot of money and a lot of effort toward IV drug users, and I hope that's not for naught," he said.
