New HIV Cases Are Down, but Patients Fail to Take Advantage of Therapy

It’s been 30 years since the CDC reported the first cases of AIDS, and 20 years since legendary basketball player Magic Johnson revealed he had contracted HIV—an announcement that left both sports fans and the general public stunned. Today, Johnson is one of 33 million people living with HIV.

During the past few decades, advances in medicine have helped increase understanding of the disease and have resulted in vast improvements in treatment. The number of HIV infections and AIDS-related deaths has continued to decrease and the number of individuals receiving treatment has risen to nearly 50% of those eligible. However, awareness is still too low among those who have HIV, which is a trend that experts want to see reversed, particularly given the fact that early detection is critical to prevent disease progression.

The goal of increasing awareness is reflected in the theme of this year’s World AIDS Day: “Getting to Zero,” meaning no new HIV infections, no discrimination against those with the disease, and no AIDS-related deaths, according to the United Nations. In a speech delivered at the US National Institutes of Health in Bethesda, Maryland on November 8, US Senator Hillary Clinton (D-NY) echoed these sentiments as she called on the world to join the United States in working to achieve the goal of an AIDS-free generation.

Trends in HIV

As Clinton pointed out, improvements in terms of both effectiveness and affordability of antiretroviral therapy (ART) have helped make significant headway in terms of the mortality and overall health of those with HIV.

The 2011 UNAIDS World AIDS Day report stated that 2.7 million individuals were newly infected with HIV in 2010, marking a reduction of 21% since 1997. It also found that 6.6 million individuals now have access to ART drugs, which is an increase of 1.35 million since 2009.

“Even in a very difficult financial crisis, countries are delivering results in the AIDS response,” said Michel Sidibé, executive director of UNAIDS, in a statement. “We have seen a massive scale-up in access to HIV treatment which has had a dramatic effect on the lives of people everywhere.”

Declines in new HIV infections are attributed to a number of factors, including more individuals taking (and staying on) treatments, changes in sexual behavior that include fewer sexual partners and increased use of contraceptives, and more women accessing prevention of mother-to-child transmission.

Raising awareness

Despite these improvements, the CDC estimates that there are still about 240,000 individuals living with HIV who don’t know that they are infected. Each year, about 50,000 people in the United States become infected with HIV. Those who receive antiretroviral therapy can lower the level of the virus in the body and improve their chance to live a longer and healthier life while decreasing the risk of transmitting the disease to others.

However, only 28% are getting the care they need to manage the disease and keep the virus under control, according to a CDC Vital Signs report. All health care professionals—including physicians, nurses, and pharmacists—are urged to take the following steps, particularly with at-risk patients:

• Offer patients an HIV test as a regular part of medical care.
• Offer patients STD testing and treatment services.
• Prescribe ART as needed for patients with HIV and make sure the amount of virus is as low as possible.
• Make sure people with HIV continue getting proper care.
• Provide HIV prevention counseling to patients on how to protect their health and avoid passing the virus on to others and refer to other prevention services such as partner counseling as needed.

For more information, click on the links below:

• Pharmacists: partners in health care for HIV-infected patients
• Antiretroviral Therapy Adherence, Medication Use, and Health Care Costs During 3 Years of a Community Pharmacy Medication Therapy Management Program for Medi-Cal Beneficiaries with HIV/AIDS (Journal of Managed Care Pharmacy)
• Maternal, Infant Antiretroviral Therapy Decreases Mother-to-Child Transmission of HIV
• Evaluation of Pharmacy-Implemented Medication Reconciliation Directed at Antiretroviral Therapy in Hospitalized HIV/AIDS Patients (Annals of Pharmacotherapy)