November 29, 2004
From the time that AIDS
was first being diagnosed in 1981,
"The estimated number
of diagnoses of AIDS through 2002 in the United States is 886,575.
Adult and adolescent AIDS cases total 877,275 with 718,002 cases
in males and 159,271 cases in females. Through the same time period,
9,300 AIDS cases were estimated in children under age 13."
Please note: These numbers
are estimates, only through 2002, and only refer to cases with
an AIDS diagnosis--not a diagnosis of HIV.
So, how many people have
HIV in the United States?
"[As of the year
2000], [t]he Centers for Disease Control and Prevention (CDC)
estimate that 850,000 to 950,000 U.S. residents are living with
HIV infection, one-quarter of whom are unaware of their infection.
"Approximately 40,000 new HIV infections occur each year
in the United States, about 70 percent among men and 30 percent
among women. Of these newly infected people, half are younger
than 25 years of age."
While HIV is the virus
that causes AIDS, not everyone with HIV has had the disease progress
to the point of AIDS.
"The AIDS case definition
used for surveillance in the United States was updated by the
CDC in 1992. Initially, the definition was based almost exclusively
on the diagnosis of one or more "defining illnesses,"
i.e., opportunistic infections that were unique to AIDS. However,
advocates argued that this resulted in undercounting of women,
whose AIDS-related illnesses were not unique to AIDS (e.g., cervical
cancer and chronic dysplasia). This was particularly problematic
because many government programs based their eligibility on an
AIDS diagnosis; thus, many women were dying of AIDS without qualifying
for any AIDS-related services. The new definition added CD4 T-cell
counts, a common marker for assessing AIDS-related immune system
damage. The formal AIDS diagnosis now includes all HIV-infected
adults and adolescents with a CD4 T-cell count below 200 or who
have been diagnosed with pulmonary tuberculosis, invasive cervical
cancer, recurrent pneumonia, HIV encephalopathy, chronic isosporiasis,
disseminated histoplasmosis, wasting syndrome, or other conditions."
Early treatment is key
in slowing the progression of HIV to AIDS; but early treatment
requires that people know that they have the disease and that
they begin to take action.
"With the advent
in the late 1990s of powerful new AIDS treatments, called highly
active anti-retroviral therapy (HAART), the limits of AIDS reporting
became even more pronounced. With increasing numbers of people
receiving early treatment for HIV and forestalling progression
to AIDS, reporting of AIDS cases became an increasingly imprecise
representation of the epidemic. In response, many states began
moving toward reporting HIV diagnoses in addition to AIDS case
While (with early diagnosis
and the help of powerful medications) people are living longer
with HIV, AIDS is still a reality. There is not yet a cure for
HIV or AIDS. We still have an epidemic. Those in the US are clearly
not exempt, but AIDS has been far more devastating globally than
what most U.S. residents have observed in our neighborhoods.
11 of every 1000 adults aged 15 to 49 are HIV-infected. In Sub-Saharan
Africa, about 7.5 percent of all adults in this age group
are HIV-infected. Women account for nearly half of all people
worldwide living with HIV/AIDS."
How many people are in
your school? How many adults (and teens) are in your city or state?
Work with the global numbers. What if you lived in Sub-Saharan
Africa? How would this affect your neighborhood? Work with the
numbers for the United States listed earlier. How does this compare?
To put some of these statistics in perspective, you can find current
local, national, and global population estimates at:
However the numbers work
out for your community (keeping in mind that each community is
different, and some areas--even in the U.S.--have higher HIV/AIDS
population densities than others), the global numbers are tragic.
"At the global level,
the number of people living with HIV continues to grow - from
35 million in 2001 to 38 million in 2003.
"An estimated 5 million people acquired the human immunodeficiency
virus (HIV) in 2003, the greatest number in any one year since
the beginning of the epidemic.
"In 2003, almost three million were killed by AIDS; over
20 million have died since the first cases of AIDS were identified
Worldwide, the decision
still must be made: When does an HIV diagnosis become AIDS?
"Outside of the
United States, many countries use one of two World Health Organization
(WHO) case definitions for AIDS. The WHO "AIDS surveillance
case definition" is recommended in cases where there is limited
access to HIV serology testing. It defines AIDS (for adults or
adolescents over 12 years of age) as having at least two of the
"major signs" and at least one of the "minor signs"
of the disease."
The bottom line:
"AIDS is the worst
epidemic humankind has ever faced. The virus infects 14,000 people
every day, leaving millions of people suffering and having a devastating
effect on the world's most vulnerable:
"More than 14 million children worldwide have been orphaned
because of AIDS. That's the equivalent of every child under five
in America with no one to watch over them.
"Nearly six million children have been killed by AIDS. That
number is more than every child in every grade school and high
school in New York, Los Angeles, Chicago, Washington, Miami and
HIV does not discriminate:
male, female, young, old, and if you are between the ages of 15
"Today, more than
half of those newly infected with HIV/AIDS are between the ages
of 15 and 24, and in some countries, one out of every four people
is infected with the disease. ... Sadly, if nothing is done, countries
all over the globe will face ever-increasing death rates that
will decimate workforces, economies, life expectancy rates, and
living standards, and even more tragically, leave millions of
young children without parents. Eventually, every country will
be severely affected by a global disaster of this magnitude."
Progress can be made
if the disease is taken seriously.
"In Uganda, HIV
infection rates have fallen for the eighth straight year from
29.5 percent in 1992 to only 11.25 percent in 2000. This is a
direct result of communication programs that reach down to the
While 11.25 percent is
still a devastating number, it is certainly a drastic improvement
showing strides in the right direction.
To contrast, in the United
"The estimated number
of new adult/adolescent AIDS diagnoses in the United States was
43,225 in 1998, 41,134 in 1999, 42,239 in 2000, 41,227 in 2001,
and 42,136 in 2002."
... things have pretty
much stayed the same.
Questions of the Week:
How severe will the problem have to get here in the U.S. before
it is taken seriously by more people? What is the difference between
an HIV diagnosis and a diagnosis of AIDS? How can a patient benefit
from finding out they have HIV in it's early stages? With an estimated
hundreds of thousands of people (in the U.S. alone) unaware that
they have AIDS, what can teens (and adults) do to protect themselves
and reduce their risks of acquiring the disease? Look over the
numbers. Work with the math. How could HIV and AIDS be affecting
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum