There have been many well-documented and successful strategies employed in the United States and throughout the world that have shown promise in slowing the devastating expansion of the AIDS epidemic. The United Nations Millennium Development Goals (MDG) and U.S. National HIV/AIDS Strategy have focused attention and funds on the HIV epidemic. The MDG (listed at the beginning of this course) represent the commitment by 193 countries to reach certain target and elimination goals by 2015.
The U.S. National HIV/AIDS Strategy represents the commitment of state, local, and tribal governments, businesses, faith communities, philanthropy, the scientific and medical communities, educational institutions, and people living with HIV to reduce new HIV infections, increase access to care, improve health outcomes for people living with HIV, and reduce HIV-related health disparities.
But despite these and other global efforts to eradicate HIV, the cost in lives and lost productivity remains a staggering problem. In the United States there are 50,000 new infections each year, and worldwide there are about 2.3 million new infections annually. Although more men are infected with HIV, women are becoming infected at higher rates than any other group of people and are increasingly becoming the face of the epidemic.
Good progress has been made in certain areas in reducing the sexual and bloodborne transmission of HIV. Use of male condoms, increased availability and use of female condoms, early testing and counseling, and keeping people with HIV in care have all contributed to a decrease in the rate of new HIV infections in the United States. Aggressive and early use of antiretroviral therapy has decreased the risk of transmitting HIV to another person.
Persistent problems remain, however, with only 25% of people diagnosed with HIV remaining in care consistently enough to reach viral suppression—the point at which the virus is effectively suppressed in an individual. Viral suppression is critical because it dramatically reduces the risk of transmitting the virus to another person. Retaining people in care is a point of focus of public health departments throughout the country.
As healthcare workers, we can help to reduce the spread of AIDS by engaging in safe sex and encouraging behavior change and prompt treatment of sexually transmitted infections. We can also support distribution and use of clean injection drug equipment, encourage routine HIV testing, provide good-quality patient education and counseling, and encourage consistent male and female condom use. The goal is to eliminate new HIV infections entirely in Kentucky, in the United States, and throughout the world. We all play a vital role in accomplishing this goal.