Just 30 percent of Americans with HIV have it under control, a new report finds, even though most of them know they are infected.
It’s a frightening problem because drugs can control the AIDS virus, keep people healthy and greatly reduce the odds they’ll infect someone else. But people with untreated HIV will get sicker and can die — and are much more likely to spread the virus.
“When you have an infection, you treat it,” Centers for Disease Control and Prevention director Dr. Tom Frieden told reporters.
“People with HIV who achieve viral suppression aren’t just healthier — they’re also less likely to infect others,” Frieden added. “Today’s study shows too many people with HIV aren’t getting the care they need.”
The study doesn't look at why people are not getting treatment, but navigating the red tape of the U.S. healthcare system may be one major factor. CDC says providers need to work harder to make sure people not only get diagnosed, but treated for HIV.
The numbers come from CDC’s latest look at HIV in the U.S. In 2011, it found, 1.2 million Americans had HIV and 86 percent of them knew it.
But only 40 percent were seeing a doctor or other provider about it — even though HIV has no cure and it’s a lifelong infection that requires a lifetime of medical attention.
Just 37 percent had a prescription for the drugs that can keep the virus under control, and only 30 percent actually had the virus controlled. That means 840,000 Americans have uncontrolled HIV in their bodies.
Even more startling, only 13 percent of people ages 18 to 24 who were infected were taking an effective dose of HIV drugs.
Getting HIV treatment should be a no-brainer. There are more than two dozen HIV drugs, many available as combinations in a single pill. CDC guidelines say everybody who has HIV should be getting drugs, and long waiting lists for programs to help pay for the drugs are a thing of the past.
“We’ve got such great treatment of HIV now that people living with HIV can have an almost normal lifespan,” Frieden said.
The human immodeficiency virus or HIV is usually transmitted sexually but also in blood, via shared needles or from mother to child at birth. It attacks the immune system, so if it isn’t treated, people can develop infections or cancer and die. The drug cocktails keep the virus from replicating and circulating in the blood, so patients stay healthy and don’t infect others.
"Treatment is crucial. It is one of our most important strategies for stopping new HIV infections,” said Dr. Jonathan Mermin, who heads CDC’s AIDS branch.
CDC officials said they were alarmed by the findings and say it’s clear people with HIV need help getting and staying in care.
“Some people may not know where to go, or they may have trouble accessing care,” Frieden said.
“Taking treatment for an infection that may have no symptoms and that you need to take for life is not easy,” he added. “That is why it is so important that services for people living with HIV be easy (to access).”
Taking HIV drugs can also protect people who are at high risk of infection.
There was some good news in the report. The great majority of people with HIV — 86 percent — have been tested and know they have it. The epidemic was spreading out of control before testing became so common. The annual rate of diagnosis with HIV fell by more than 30 percent in the US between 2002 and 2011.
And there aren’t any clear disparities when it comes to going without treatment — blacks, whites, gays, men and women were equally likely to be skipping care.
“I think it’s clear that accessing HIV care can be difficult, particularly for people who lack health insurance or who have difficulty navigating what can sometimes be a complex health care system,” Mermin said.
Doctors and clinics treating patients may need help holding on to them, Mermin added. “It’s not enough to diagnose patients. You have to take accountability and responsibility for every patient,” he said.