Of 1.2 mil­lion with HIV, 156,300 don’t know

CDC also re­ports just four states had met White House goal of 90% aware­ness.

Los Angeles Times - - THE NATION - By Karen Ka­plan karen. ka­plan@ latimes. com Twit­ter: @ LATkarenka­plan

More than 1.2 mil­lion Amer­i­cans are liv­ing with HIV, in­clud­ing about 156,300 who don’t re­al­ize it, ac­cord­ing to a new re­port from the Cen­ters for Dis­ease Con­trol and Preven­tion.

That means 13% of those who are in­fected with the virus that causes AIDS aren’t in a po­si­tion to pro­tect their health, or the health of oth­ers.

The White House has set a goal of mak­ing sure at least 90% of peo­ple in­fected with HIV are aware of their sta­tus.

As of 2012, only four states — Con­necti­cut, Delaware, Hawaii and New York — had cer­tainly met that goal, re­searchers re­ported Thurs­day in the CDC’s Mor­bid­ity and Mor­tal­ity Weekly Re­port. Colorado came very close, with an es­ti­mated 89.7% of its HIV- pos­i­tive pop­u­la­tion hav­ing re­ceived a di­ag­no­sis.

An ad­di­tional seven states — Alaska, Idaho, Maine, Mon­tana, New Hamp­shire, North Dakota and Ver­mont — may well be meet­ing the 90% tar­get set in the Na­tional HIV/ AIDS Strat­egy, the re­searchers said, but these seven states did not have enough new cases of HIV in re­cent years to al­low for a sta­tis­ti­cally re­li­able es­ti­mate.

Na­tion­wide, about 87% of Amer­i­cans with HIV know they are in­fected, ac­cord­ing to the re­port. That f ig­ure is based on data from the 41 states ( plus the Dis­trict of Columbia) where at least 60 peo­ple were di­ag­nosed with HIV each year from 2008 to 2012, on av­er­age.

The state with the low­est rate of HIV- in­fec­tion aware­ness was Louisiana, where only 77% of those with the virus knew that they had it.

It stands to rea­son that peo­ple who are in­fected with the hu­man im­mun­od­e­fi­ciency virus would ben­e­fit from know­ing it.

An in­ter­na­tional clin­i­cal trial re­cently showed that start­ing an­tiretro­vi­ral treat­ment right away in­stead of wait­ing for the im­mune sys­tem to de­te­ri­o­rate can re­duce the risk of death or se­ri­ous ill­ness by 53%. The re­sults of the Strate­gic Tim­ing of An­tiRetro­vi­ral Treat­ment, or START, trial were so con­vinc­ing that the study was stopped early so that all par­tic­i­pants could re­ceive the drugs.

Know­ing one’s HIV sta­tus is also good for the public at large, be­cause peo­ple who have HIV but don’t re­al­ize it are in a prime po­si­tion to spread it to oth­ers. A study pub­lished this spring in JAMA In­ter­nal Medicine found that about 30% of new HIV trans­mis­sions could be traced to peo­ple who were in­fected but un­di­ag­nosed.

To f ig­ure out how many peo­ple in the U. S. were un­aware of their HIV- pos­i­tive sta­tus, re­searchers turned to data from the Na­tional HIV Sur­veil­lance Sys­tem. By look­ing at the num­ber of peo­ple di­ag­nosed with HIV or AIDS, as well as how sick pa­tients were when they were di­ag­nosed, the re­searchers could make a “back- cal­cu­la­tion” to es­ti­mate the true num­ber of new HIV cases in each state each year, the study ex­plained.

Af­ter adding up the an­nual fig­ures and sub­tract­ing out deaths re­lated to HIV/ AIDS, the team could cal­cu­late the over­all preva­lence of HIV in each state in 2012. With those num­bers in hand, they used state data on di­ag­nosed in­fec­tions to f ind the pro­por­tion of all HIV- pos­i­tive peo­ple over the age of 12 who were un­di­ag­nosed.

The team also made es­ti­mates for men who have sex with men, a group that ac­counts for about 60% of new HIV cases per year. Thir­tyeight states plus the Dis­trict of Columbia had enough new cases to al­low the re­searchers to make a re­li­able guess.

Among them, only Hawaii met the 90% thresh­old, though New York came very close at 89.9%, ac­cord­ing to the re­port. Across all 39 ju­ris­dic­tions, an av­er­age of 85.2% of HIV- pos­i­tive men who have sex with men knew of their sta­tus, the re­searchers found.

Alaska, Maine, Mon­tana and Ver­mont ap­pear to be meet­ing the 90% tar­get, but they aren’t among the 38 states with enough new HIV di­ag­noses to say with cer­tainty.

The re­sults were pub­lished two days be­fore to­day’s Na­tional HIV Test­ing Day.

An­to­nio Perez Chicago Tri­bune

ONE AD­VAN­TAGE of know­ing HIV sta­tus is be­ing able to get treat­ment be­fore im­mune dam­age is done.

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