Dec. 1 – World AIDS Day (12-01-2005)  

THURSDAY, December 1 is World AIDS day. Human Immunodeficiency Virus (HIV) is the agent of AIDS or Acquired Immunological Deficiency Syndrome.

Still no cure, still no vaccine, and a host of new challenges. As the world commemorates the 18th annual World AIDS Day on Dec.1st, it might seem that little has changed since the epidemic began 25 years ago. The prospect of an AIDS vaccine is still elusive, but effective preventive measures and treatments still find formidable barriers to their diffuse implementation.

While all our attention has been recently focused by media on the potential of a bird flu pandemic, few seem to realize that a huge epidemic is already unfolding worldwide under our eyes: already, 3.1 million adults and children will die of AIDS this year out of about 40 million individuals who are already infected, NOW, with HIV.

In the tiny South African nation of Lesotho, almost one out of every three adults is now HIV-positive; in nearby Swaziland, that number is four in 10. In South Africa, 20 percent of people 15 to 49 years old have HIV, up from 1 percent in 1990. Asia, too, is beginning to see increasingly high numbers of HIV/AIDS cases.

But this idea that this epidemic is somebody else's problem –an issue of stigmatized countries, and populations - is part of the barrier to its solution in terms of a comprehensive public health approach.

Counter to HIV exceptionalism it should be known that in the United States alone HIV has killed already more than half a million people in two decades. (New England Journal of Medicine, Dec.1, 2005). Yet a comprehensive public health approach that has stopped other epidemics has not been used to address this one. In particular, prevention and treatment programs haven't stopped the spread of illness among minorities.

Would you fight a flu pandemic with ideology, and superstition or rather rely on evidence based health science? AIDS is unfortunately and essentially a sexually transmitted disease. Unlike cough etiquette for flu, sexual hygiene is a taboo that prevents education and prophylaxis to be evidence based. While prevention cannot unfold because of all sorts of cultural barriers, even treatment suffers from substantial obstacles.

Although HIV infection remains incurable, AIDS is now treatable and has become a chronic disease for those fortunate enough to afford and receive effective treatment. Still, only about 1 million people in the developing world are taking AIDS drugs -- there are 25.8 million people infected with HIV in Africa alone-- and access to care is an issue for the underdeveloped world as much as the minorities in developed countries.

At least Knowing a bit more about it would go a long way.

Learn more about HIV and AIDS at the link below.
U.S. Department of Veterans Affairs

Alberto M. Colombi, MD, MPH
Corporate Medical Director
Pittsburgh General Office