In the U.S., the HIV prevention fight has stalled.Posted by Harold Pollack

From: "The Washington Post" (Excerpts bellow, for full article click on link at left)

Almost 640,000 Americans have died after being diagnosed with AIDS. Remarkable treatment advances have reduced the death toll. Yet 20,000 Americans living with HIV still die every year, an annual toll that exceeds the rate of U.S. combat deaths in Vietnam. Many of these deaths could be prevented or delayed if people living with HIV were identified and treated earlier, and had more treatment and care.

But the HIV prevention effort has yet to match the scale of this problem. The annual number of new HIV infections has remained basically unchanged since the early 1990s, with roughly 50,000 Americans newly infected every year.
An estimated 208,000 Americans carry the HIV virus but don’t know it. These men and women form an epicenter of all new HIV infections. The majority of infected young gay men don’t know their status. Rates of undetected infection are especially high among African American and Latino gay and bisexual youth.


Effective prevention costs money. David Holtgrave, a professor of health policy at Johns Hopkins who researches AIDS prevention, estimated that the national HIV/AIDS strategy required about $15 billion between 2010 and 2015 in dedicated expenditures. Certainly nothing close to that was made available by the federal government. Meanwhile, state and local public health agencies have lost tens of thousands of positions since 2008. There are fewer boots on the ground to perform HIV testing, to trace sex partners of infected people, to provide counseling on how to avoid risks.


HIV is by no means the most neglected public health concern. It’s just one area in which the human consequences of under-funding and neglecting policy are obvious and acute. Our medical economy expends $2.8 trillion on so many activities of dubious utility or cost-effectiveness. Yet it’s inordinately difficult to find 0.1 percent of this amount to support basic public health work.

Harold Pollack is Helen Ross professor at the School of Social Service Administration. He is also co-director of the University of Chicago Crime Lab and an executive committee member of the Center for Health Administration Studies (CHAS) at the University of Chicago. He has published widely on the connections between poverty policy and public health.