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30 Years of HIV/AIDS

June 2011

30 Years of HIV/AIDS

Thirty years ago this June, an article reporting the first known cases of what we now call AIDS was published in CDC's Morbidity and Mortality Weekly Report (MMWR). Since then, extraordinary progress has been made in treating and preventing HIV, and annual new infections have fallen by more than two-thirds since the height of the epidemic.

Despite this progress, too many people still become infected with and die from HIV in the U.S. Approximately 50,000 new infections occur each year, and more than 1.1 million people are living with HIV. As the number of people living with HIV grows, the potential for increased transmission of HIV to others grows too.

Yet after three decades, the sense of crisis about HIV has waned. Many Americans underestimate their personal risk for infection, or believe HIV is no longer a serious health threat. We can't afford to be complacent. The fact is that HIV is still a deadly disease -- but we have the tools to prevent it.


HIV/AIDS: Progress and Challenges

Figure 1. Estimated Number of New HIV Infections and Persons Living with HIV/AIDS, 1977–2006

Despite continued increases in the number of people living with HIV/AIDS over time, and more opportunities for transmission, HIV prevention efforts have helped to keep the number of new infections stable.

Figure 1. Estimated Number of New HIV Infections and Persons Living with HIV/AIDS, 1977–2006
Source: JAMA 2008; 300(5): 520–529; Campsmith M, et al. CROI 2009

However, this trajectory is likely not sustainable over the long term. If we do not increase the impact of prevention efforts, projections indicate that continued growth in the number of people living with HIV/AIDS will lead to more infections.


HIV/AIDS in America Today

The communities most affected by HIV have been a powerful force behind the country's response to HIV/AIDS. In the early days of the epidemic, the gay community demanded information, research, and resources that have had a major impact. There has also been a groundswell of activity and commitment from African American and Latino communities. And throughout the country, CDC is continuing to raise awareness and mobilize new partners in the fight through its Act Against AIDS campaign.

Gay and Bisexual Men

Figure 2. Estimated New HIV Infections, 2006, by Transmission Category

Figure 2. Estimated New HIV Infections, 2006, by Transmission Category

Injection Drug Users

African Americans

Figure 3: Estimated Rates of New HIV Infections, by Race/Ethnicity and Gender, 2006

Figure 3: Estimated Rates of New HIV Infections, by Race/Ethnicity and Gender, 2006

Latinos/Hispanics

Figure 4. Estimated New HIV Infections in the U.S., 2006, for the Most-Affected Subpopulations*

Figure 4. Estimated New HIV Infections in the U.S., 2006, for the Most-Affected Subpopulations*

*Subpopulations representing 2 percent or less of the overall U.S. epidemic are not reflected in this chart.
** The term men who have sex with men is used in CDC surveillance systems because it indicates the behaviors that transmit HIV than how individuals self-identify in terms of their sexuality.

Factors Contributing to Disparities

Reducing the toll of HIV on communities that are disproportionately impacted requires confronting the complex social and environmental factors that fuel the epidemic in these communities, including:


Reversing the Course of the Epidemic: High Impact Prevention

The National HIV/AIDS Strategy (NHAS), released in July 2010, directs the nation's response to the U.S. HIV/AIDS crisis. Guided by NHAS, CDC is entering the next decade with an aggressive focus on increasing the impact of HIV prevention during a time of limited resources.

With better tools to measure the epidemic and more data about affected populations, CDC is increasing targeted prevention efforts to the hardest hit areas and populations. In addition, new biomedical tools such as pre-exposure prophylaxis (PrEP) for MSM and expanded testing, treatment and linkage to care could have an important impact on infection rates, if used strategically and in combination with other HIV prevention strategies.

With a growing number of effective prevention interventions available, CDC is focusing on "High Impact Prevention" -- prioritizing prevention activities based on their effectiveness, cost, coverage, feasibility and scalability, in order to have the greatest possible impact with available resources.




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