World AIDS Day, December 1, 2009
Margo Kerrigan, M.P.H., Area Director
Indian Health Service California Area Office
December 1, 2009 is World AIDS day, marking its 20th anniversary. The concept of a World AIDS Day originated at the 1988 World Summit of Ministers of Health on Programs for AIDS Prevention. Since then every year UN agencies, governments and all sectors of civil society worldwide join together to campaign around specific themes related to AIDS. This year's theme for World AIDS Day is "Lead - Empower - Deliver", building on last year's theme of "Take the Lead". Designating leadership as the World AIDS Day theme for 2007 and 2008 provides an opportunity to highlight both the political leadership needed to fulfill commitments that have been made in the response to AIDS and to celebrate the leadership that has occurred at all levels of society.
Since 1988, efforts made to respond to the epidemic have produced positive results. However, the latest UNAIDS report on the global AIDS epidemic indicates that the epidemic is not yet over. According to that report, internationally 33 million people are living with HIV, with nearly 7,500 new infections occurring each day.
In the United States, CDC estimates that about 1.1 million people are living with HIV. These numbers are likely to increase over time, as antiretroviral drug treatments extend the lives of those with HIV and more people become HIV infected. As the number of people living with HIV grows, so does the opportunity for those with HIV to pass on the virus to others.
HIV/AIDS is a growing problem among American Indians and Alaska Natives. Even though the numbers of HIV and AIDS diagnoses for American Indians and Alaska Natives represent less than 1% of the total number of HIV/AIDS cases reported to CDC's HIV/AIDS Reporting System, when population size is taken into account, American Indians and Alaska Natives in 2005 ranked 3rd in rates of HIV/AIDS diagnosis, after blacks (including African Americans) and Hispanics. American Indians and Alaska Natives make up 1.5% (4.1 million people) of the total US population. The rate of AIDS diagnosis for this group has been higher than that for whites since 1995.
CDC currently estimates that approximately one in five persons living with HIV in the United States is unaware of his or her infection and may unknowingly transmit the virus to others. Since anyone can be at risk for HIV, CDC recommends that adults and adolescents between the ages of 13 and 64 years of age be routinely screened for HIV infection in healthcare settings. Pregnant women in the U.S. should be screened for HIV infection as part of their routine prenatal testing.
The Indian Health Service has had a Government Performance and Results Act measure that tracks HIV screening of pregnant women since 2005. Over the past 4 years that screening rate has increased from 54 percent in 2005 to 75% in 2008. While this increase is significant, we need to do more. Studies have shown transmission rates of less than 2% among HIV infected mothers who started antiretroviral treatment during pregnancy; those who did not begin treatment until labor or after birth had transmission rates of 12-13%, and those who received no treatment had rates of 25%. Routine prenatal HIV testing of all pregnant women is the best way to avoid transmission of HIV from mother to infant.
On this World AIDS Day 2009, we all need to commit to expanding the reach of effective prevention efforts to those at risk and those living with HIV in order to stop the further spread of HIV in the United States. Here are some steps this year's organizers recommend that each of us take:
- Get tested for HIV. To find a testing site center near you, visit www.hivtest.org or, on your cell phone, text your zip code to Know IT (566948).
- Stand up against stigma, racism, and other forms of discrimination associated with HIV/AIDS.
- Donate time and money to HIV/AIDS organizations.
The World AIDS Campaign has produced a wide variety of campaign materials to be used by individuals and organizations that want to campaign on World AIDS Day and host commemorative events on December 1 and throughout the month. These materials as well as a calendar of events are available on the World AIDS Campaign web site at www.worldaidscampaign.org.
For more information about HIV/AIDS or World AIDS Day, please visit www.AIDS.gov.