What Needs To Happen
The challenges in the years ahead are clear: we need to reach the 25% of people who have HIV and dont know and support them to test and link to treatment. We need to increase access to prevention to condoms, to voluntary medical male circumcision, to harm reduction and to PrEP. We need to prioritize HIV services for vulnerable and hard-to-reach groups such as people in prisons, people who inject drugs, men having sex with men, transgender people and sex workers. These key populations continue to be left behind, not benefiting from the huge advances in HIV testing, prevention and treatment made over the past 30 years says Dr Baggaley.
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Impact Across The Country
- Although HIV has been reported in all 50 states, the District of Columbia, and U.S. dependencies, the impact of the epidemic is not uniformly distributed.
- Ten states accounted for about two-thirds of HIV diagnoses among adults and adolescents in 2019 .31 Regionally, the South accounted for more than half of HIV diagnoses in 2019.32
- Rates of HIV diagnoses per 100,000 provide a different measure of the epidemicâs impact, since they reflect the concentration of diagnoses after accounting for differences in population size across states. The District of Columbia has the highest rate in the nation, compared to states, nearly 3 times the national rate and Georgia was the state with highest rate , twice that of the national rate.33,34 Nine of the top 10 states by rate are in the South.35
- New HIV diagnoses are concentrated primarily in large U.S. metropolitan areas , with Miami, Orlando, and Atlanta topping the list of the areas most heavily burdened.36
|Table 1: Top Ten States/Areas by Number and Rate of New HIV Diagnoses , 2019|
|CDC. HIV Surveillance Report, Diagnoses of HIV Infection in the United States and Dependent Areas, 2019 vol. 32. May 2021.|
How Did Hiv Cross From Chimps To Humans
The most commonly accepted theory is that of the ‘hunter’. In this scenario, SIVcpz was transferred to humans as a result of chimps being killed and eaten, or their blood getting into cuts or wounds on people in the course of hunting.5 Normally, the hunter’s body would have fought off SIV, but on a few occasions the virus adapted itself within its new human host and became HIV-1.
There are four main groups of HIV strains , each with a slightly different genetic make-up. This supports the hunter theory because every time SIV passed from a chimpanzee to a human, it would have developed in a slightly different way within the human body, and produced a slightly different strain. This explains why there is more than one strain of HIV-1.6
The most studied strain of HIV is HIV-1 Group M, which is the strain that has spread throughout the world and is responsible for the vast majority of HIV infections today.
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Impact On Gay And Bisexual Men
- While estimates show that gay and bisexual men comprise only about 2% of the U.S. population, male-to-male sexual contact accounts for most new HIV infections and most people living with HIV .58
- Annual new infections among gay and bisexual men declined overall between 2015 and 2019 but remained stable among Black and Latino gay and bisexual men.59
- Blacks gay and bisexual men accounted for the largest number of new diagnoses among this group in 2019, followed by Latino gay and bisexual men .60 Additionally, according to a recent study, Black gay and bisexual men were found to be at a much higher risk of being diagnosed with HIV during their lifetimes compared with Latino and white gay and bisexual men.61 Young Black gay and bisexual men are at particular risk â Black gay and bisexual men ages 20-29 accounted for 51% of new diagnoses among that age group and 13% of all diagnoses.62
Key Points: Hiv Incidence
HIV incidence declined 8% from 2015 to 2019. In 2019, the estimated number of HIV infections in the U.S. was 34,800 and the rate was 12.6 .
, the annual number of HIV infections in 2019, compared with 2015, decreased among persons aged 1324 and persons aged 45-54, but remained stable among all other age groups. In 2019, the rate was highest for persons aged 25-34 , followed by the rate for persons aged 35-44 .
, the annual number of HIV infections in 2019, compared with 2015, decreased among persons of multiple races, but remained stable for persons of all other races/ethnicities. In 2019, the highest rate was for Blacks/African American persons , followed by Hispanic/Latino persons and persons of multiple races .
, the annual number of new HIV infections in 2019, as compared to 2015, decreased among males, but remained stable among females. In 2019, the rate for males was 5 times the rate for females .
, the annual number of HIV infections in 2019, compared with 2015, decreased among males with transmission attributed to male-to-male sexual contact, but remained stable among all other transmission categories. In 2019, the largest percentages of HIV infections were attributed to male-to-male sexual contact
For more details on recent HIV incidence statistics, see Estimated HIV Incidence and Prevalence in the United States, 2015-2019.
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Was Hiv Created In A Lab
No. HIV is a virus that has evolved over time and though it became a global pandemic only recently in human history, its origins are much older and found in nature.How can I tell if I’m infected with HIV?
The only way to know if you are infected is to be tested for HIV infection. You cannot rely on symptoms to know whether or not you are infected. Many people who are infected with HIV do not have any symptoms at all for 10 years or more.
The following may be warning signs of advanced HIV infection:
- rapid weight loss
- recurring fever or profuse night sweats
- profound and unexplained fatigue
A Note About Treatment
While theres currently no cure for HIV, treatments have come an incredibly long way since the virus was first identified. Due to advances in treatment, people living with HIV can have long, healthy lives.
There are now many types of antiretroviral drugs available to treat HIV. According to the National Institutes of Health , taking antiretroviral medications each day as directed can reduce viral load to undetectable levels in 6 months or less .
Not only can having an undetectable viral load keep the immune system healthy, but it can also prevent transmission of HIV to others. People with an undetectable viral load have no risk of transmitting HIV to their partners via sex.
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Where Did Hiv Come From
The earliest known case of infection with HIV-1 in a human was detected in a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of the Congo. Genetic analysis of this blood sample suggested that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s.
We know that the virus has existed in the United States since at least the mid- to late 1970s. From 19791981 rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of male patients who had sex with other men. These were conditions not usually found in people with healthy immune systems.
In 1982 public health officials began to use the term “acquired immunodeficiency syndrome,” or AIDS, to describe the occurrences of opportunistic infections, Kaposi’s sarcoma , and Pneumocystis jirovecii pneumonia in previously healthy people. Formal tracking of AIDS cases began that year in the United States.
In 1983, scientists discovered the virus that causes AIDS. The virus was at first named HTLV-III/LAV by an international scientific committee. This name was later changed to HIV .
For more information on this discovery, visit the NIH National Institute of Allergy and Infectious Diseases press release. For information on the theory that HIV originated in polio vaccines, visit the CDC Vaccine Safety site.
Pop Culture Opens Up Conversations About Hiv
Actor Rock Hudson was the first major public figure to acknowledge he had AIDS. After he died in 1985, he left $250,000 to set up an AIDS foundation. Elizabeth Taylor was the national chairperson until her death in 2011. Princess Diana also made international headlines after she shook hands with someone with HIV.
Pop culture icon Freddie Mercury, singer for the band Queen, also passed away from AIDS-related illnesses in 1991. Since then many other celebrities have revealed that theyre HIV-positive. More recently, Charlie Sheen announced his status on national television.
In 1995, the National Association of People with AIDS founded National HIV Testing Day. Organizations, conventions, and communities continue to fight the stigmas attached to this infection.
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A Brief History Of The Epidemic In America
HIV was first identified in 1981 and is the cause of one of the most deadly and persistent epidemics in human history.
The identification of the virus began with rare lung infections and rare and unusually aggressive cancers in young gay men in New York and California. By December 1981, doctors found these same symptoms in five infants whose mothers were drug users and sex workers.
In 1992, AIDS became the number one cause of death for men in the U.S. aged 2544. By 1995, there were 500,000 reported cases of AIDS in the country. However, in 1996 the number of new AIDS cases declined for the first time since the epidemic began.
Did Hiv Start In Africa
Using the earliest known sample of HIV, scientists have been able to create a ‘family-tree’ ancestry of HIV transmission, allowing them to discover where HIV started.
Their studies concluded that the first transmission of SIV to HIV in humans took place around 1920 in Kinshasa in the Democratic Republic of Congo .10
The same area is known for having the most genetic diversity in HIV strains in the world, reflecting the number of different times SIV was passed to humans. Many of the first cases of AIDS were recorded there too.
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Impact On Communities Of Color
- Racial and ethnic minorities have been disproportionately affected by HIV/AIDS since the beginning of the epidemic, and represent the majority of new HIV diagnoses, people living with HIV disease, and deaths among people with HIV.37,38
- Black and Latino people account for a disproportionate share of new HIV diagnoses, relative to their size in the U.S. population .39,40 Black people also account for more people living with HIV than any other racial group â an estimated 479,300 of the 1.2 million people living with HIV in the U.S. are black.41
- Black people also have the highest rate of new HIV diagnoses, followed by Latino people â in 2019, the rate of new HIV diagnoses per 100,000 for Black people was about 8 times that of white people Latino people had a rate 4 times that of white people.42
- Black people accounted for close to half of deaths among people with an HIV diagnosis in 2019.43,44
- Survival after an AIDS diagnosis is lower for Black people than for most other racial/ethnic groups, and Black people have had the highest age-adjusted death rate due to HIV disease throughout most of the epidemic.45 HIV ranks higher as a cause of death for Black and Latino people, compared with White people.46 Further, HIV was the 6th leading cause of death for Black people ages 25-34 in 2019.47
Aids As A Metaphor For Emerging Infections And The New Global Health
Social and environmental change, increased public health awareness, and improved diagnostic tools led to the emergence and recognition of several new pathogens in the last third of the 20th century. After a prolonged period of complacency with regard to infectious diseases, in 1992 the Institute of Medicine published an influential report on emerging infectious diseases. This term referred to conditions that were increasing in incidence in human populations or threatening to do so, were newly introduced or detected, or were recognized as being linked to a chronic disease or syndrome. No agent and disease better exemplify this concept than HIV and AIDS.
HIV type 1, group M , the predominant cause of the AIDS epidemic, evolved from a virus that crossed the species barrier from chimpanzees to humans. The earliest retrospective diagnosis of HIV-1 infection was made from a serum specimen collected in 1959 in Kinshasa, capital of what is now the Democratic Republic of Congo. Two additional but rare groups of HIV-1 cause related zoonotic infections that are essentially restricted to central Africa. HIV-2, a second type of HIV rarely found outside western Africa, originated in sooty mangabeys.
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Origin And Distribution Of Sivgor
HIV-1 origins. The phylogenetic relationships of representative SIVcpz, HIV-1, and SIVgor strains are shown for a region of the viral pol gene . SIVcpz and SIVgor sequences are shown in black and green, respectively. The four groups of HIV-1, each of which represents an independent cross-species transmission, are shown in different colors. Black circles indicate the four branches where cross-species transmission-to-humans has occurred. White circles indicate two possible alternative branches on which chimpanzee-to-gorilla transmission occurred. Brackets at the right denote SIVcpz from P. t. troglodytes and P. t. schweinfurthii , respectively. The phylogenetic tree was estimated using maximum likelihood methods . The scale bar represents 0.05 nucleotide substitutions per site.
The Aids Epidemic Arises
Though HIV arrived in the United States around 1970, it didnt come to the publics attention until the early 1980s.
In 1981, the Centers for Disease Control and Prevention published a report about five previously healthy homosexual men becoming infected with Pneumocystis pneumonia, which is caused by the normally harmless fungus Pneumocystis jirovecii. This type of pneumonia, the CDC noted, almost never affects people with uncompromised immune systems.
The following year, The New York Times published an alarming article about the new immune system disorder, which, by that time, had affected 335 people, killing 136 of them. Because the disease appeared to affect mostly homosexual men, officials initially called it gay-related immune deficiency, or GRID.
Though the CDC discovered all major routes of the diseases transmissionas well as that female partners of AIDS-positive men could be infectedin 1983, the public considered AIDS a gay disease. It was even called the gay plague for many years after.
In September of 1982, the CDC used the term AIDS to describe the disease for the first time. By the end of the year, AIDS cases were also reported in a number of European countries.
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Aids And The Architecture Of Global Health
HIV/AIDS played a major role in shaping current global health architecture. The threat posed by HIV led WHO to establish a dedicated program in 1986. In 1996, the Joint United Nations Programme on HIV/AIDS was established to coordinate the multisectoral response. In 2001, the United Nations General Assembly Special Session on HIV/AIDS, the first high-level summit ever devoted to a disease, committed the world to specific targets. In 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria was created, and a year later, US President G.W. Bush announced the Presidents Emergency Plan for AIDS Relief, the largest bilateral health program ever undertaken. The scale-up of HIV/AIDS services has highlighted the need to focus on strengthening health systems and on other health-related Millennium Development Goals relating to maternal and child health.
A problem with the early response in the United States as well as globally was an overemphasis on universal vulnerability, the concept that everyone is at risk. Predictions of widespread, generalized HIV/AIDS epidemics among heterosexual persons outside Africa, especially in Asia, were not borne out. The concept of know your epidemic, highlighting the need to focus interventions where HIV transmission is most intense, came surprisingly late, along with acknowledgment of the fundamentally different nature of the epidemic in sub-Saharan Africa compared with elsewhere.
Aids And The Globalization Of Science Research And Practice
A positive development in the response to AIDS has been its effect on science and the globalization of research and practice. Retrovirology and immunology became well-supported disciplines whose practitioners interacted productively with workers in other subjects such as epidemiology. Cohorts of physicians and scientists built their careers in basic as well as applied and clinical research. The frequency with which tuberculosis occurs in HIV-infected persons has led to a resurgence of interest in the diagnosis and treatment of this ancient disease, especially in Africa. Advances in the treatment of HIV-associated OIs have benefited other immunosuppressed persons. In addition, sexual and reproductive health gained renewed prominence.
Scientific advances resulted in the development of lifesaving, albeit not curative, treatment for HIV. Beginning with the approval of AZT in 1987, the development of antiretroviral drugs and the design of simple and standardized approaches for therapy in the developing world constituted a public health triumph. By the end of 2009, > 5 million persons in low- and middle-income countries were accessing ART, unimaginable just a few years before and made possible through the use of generic drugs, price reductions for brand-name drugs, and efforts of international donors through initiatives such as the Presidents Emergency Plan for AIDS Relief and the Global Fund.
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Samples Collected From Wildlife In Thailand
While its true that most emerging diseases affecting humans come from wildlife, its often human behavior that is to blame for the spillover. Humans are tearing down forests and hunting, eating, and selling wild animals at unprecedented rates. Each exotic animal shipped across the ocean to be sold as a pet is an sveacasino opportunity for a new pathogen to take root in a new continent. Each tree ripped from its roots increases interactions between humans and wild animals, and thus the odds that viruses will find new populations to infect.
But the good news is: If were the ones causing the problem, were the ones who can stop it.
At EcoHealth Alliance, were striving toward a world where pandemics like the one caused by HIV/AIDS are a thing of the past. Join us.