What's up with AIDS these days? Have rates declined? Are drug therapies working?

I was reading about this scary new strain of AIDS discovered in NYC, and I was curious about the overall picture for AIDS. It’s been off the news radar of dire social issues for a bit now, and I was just curious.

Have infection rates declined? Are the latest drug therapies holding it back?

It’s estimated that 38 million people worldwide are living with HIV, including 2 million children. In 2003 a record 4.8 million people became infected. The drugs help keep people with HIV healthy longer, but the vast majority of infected people in the world don’t have access to those drugs. In the US, infection rates for HIV are rising. There has been a big jump in syphilis cases in some US populations too; a disease that is easily diagnosed and curable.

Here’s some more info: HIV/AIDS Insite

Overall, yes. Among gay men and some other focus groups (I think black women are among them), infection rates are still climbing.

The thing about this new strain is that it is resistant to many of the latest drug therapies. It’s particularly notable because there’s a misconception out there that if you and your partner are both positive, that it’s safe and okay to have unsafe sex. This new strain blows that theory out of the water.

Overall what? In the world, or in the U.S.? In the West infection rates are reasonably stable, chance for infection if you’re not too careless is pretty low, and new medication is keeping HIV at bay better and better, so that people with HIV infections have ever increasing life expectencies (note that it’s still not much fun to be infected).

But looking at the world overall it’s not going all that well. Africa is a nightmare with millions infected and it’s just going on, and Asia is becoming a very dangerous new spreadingground for the disease.

And this new strain … not good. Never mind what it will do to New York or the rest of the West, if that gets exported to Africa or Asia, millions will die. I can see a small advantage of that, only in that some of the leaders there who are to date persisting in denying the existence of AIDS (why on earth?), will be confronted with something even less denyable. But I highly doubt that’s going to be worth the price.

I was watching a doco on this once, where the strain was first starting to appear, and what they were thinking about starting to do was to take the patient off most meds, then administer them all at once.

Also, heard that 1/100 people (of european descent) is immune to the HIV virus. Is this true still?


Oh and this was in the hope that the resistant strains would mutate to something less resistant, in which of course it could be ‘killed’. I was rather dubious of this.

I think I know what you two may be referring to. There are different types of drugs that help cut down certain strains (obviously, the non-resistant ones). Unfortunately, once these are cut back, new strains are allowed room to develop themselves, among which ones that are as yet resistant to most medication. What they recently discovered is that temporarily easing off the repressants allows the non-resistant, more common strains to take over again and push the resistant ones away almost or even completely. This is because the resistant strains are often specialist strains that can only survive when the more effective strain is held back by medication.

So the best way to combat the non-resistant strain appeared to be to allow the resistant one to push away the non-resistant one, and then combat the non-resistant one again.

Is that true? I would suspect that the quicker incubation time would actually mean that those infected would have less time to infect others. That’s part of what has made HIV so rampant in much of the world - you’re symptomless for years, so you pass it on a lot of times before you become too ill to do so.

Hard to tell. It’s still 8 weeks, and then when AIDS starts it may still take a while before symptoms are clear enough. But it does become more visible, that’s partly my point, I’m just not sure that this will help sufficiently. But it might. It’s hard to describe something like this, which also cannot currently be cured, as a good thing. But it might be, if and only if it kills faster than it spreads.

Well, at risk of sounding like a monster, it’s probably because it was blown out of proportion to begin with.

Only 3 million people die of HIV/AIDS worldwide, per year. 38 million are living with it.

Compare this to something like say… heart disease, where 17 million die each year from it, almost 1/2 the total that are infected with HIV/AIDS.

Cancer deaths worldwide were 6 million in 2000, and projected to be 10 million by 2020.

Or diabetes, where by 2030, there will be 30 million Americans with the disease, not counting the rest of the world.

These diseases are on the rise in developing countries at an alarming rate as well. Personally, I think that all the hubbub about HIV/AIDS is taking funding and focus from what’s really killing people, namely the diseases I just mentioned.



bump, isn’t malaria pretty high up there too? That’s what I’ve heard.

Yes, but “Heart Diesese” or “Cancer” is actually an umbrella for a whole host of different illnesses so it would be more accurate to compare them to something like “infectious diseses” rather than just aids.

The right treatment could concievably cure all AIDS or at least a single stran whereas cancer treatments are designed to treat a specific cancer so the cost/benifit ratio isn’t as simple as just looking at the numbers.

What difference would it make if they caught the drug resistant strain in Africa? They don’t have the drugs anyway.

I just realized this sounds incredibly callous. I don’t mean to disregard the importance of African lives lost to AIDS. However, practically speaking, does anything change if they catch this strain instead of another?

I did some looking, and malaria only kills 1/3 of the people HIV/AIDS does, but they’re almost all in Africa and Asia. I have no idea on the number of people who are infected, and whose quality of life suffers greatly from this though. I’m sure it’s huge- I’d guess more than HIV/AIDS infected people.

Except that in the places where AIDS is truly rampant, it’s causing life expectancy to decline. Places that had life expectancies in the 50s or 60s are now dropping to around 40. Parts of subsaharan Africa where a third of the population has AIDS, and dies young from it, make heart disease (which gets a lot of people too, but not those in the prime of their life) look pretty insignificant.

I don’t really believe that HIV/AIDS is needlessly taking money from heart disease and cancer research, which are well funded. Once again, the world health experience differs from the American one. In countries like South Africa, where 30% or so of folks have AIDS, the disease clearly lowers life expectancy, but the government refuses to acknowledge this as a serious problem or seriously try to obtain helpful medicines. This is tragic – more cases are in heterosexuals than otherwise, due largely to prostitution and babies born to mothers with HIV (which can often be cured completely by early treatment). If you are a baby born with HIV, or if you get it from an infected transfusion, HIV is in no way a complication of lifestyle choice, not that this makes much difference from an ethical perspective. Cardiovascular disease is a lifestyle disease in a much higher percentage of cases.

So no, rates are increasing despite more effective drug therapies. Undertanding how HIV works and curing it gives us much power to cure similar and future viral diseases and it is not correct to assume that HIV research will not or has not furthered our understanding of other pandemics.

In Africa (although, curiously, not in the US or other parts of the world; the component disease lists for AIDS are completely different when you move), malaria is a disease which can mark you as an AIDS patient if you have it. That, and, presumably, a positive HIV test. Keep in mind that AIDS isn’t a disease at all, but a “syndrome” diagnosed by any disease on your local list plus an HIV+ test result.

Here’s the rub: the HIV test is somewhat expensive at the scale of healthcare costs in the area, so many patients who are ill with or die of malaria are presumptively diagnosed as AIDS patients. Considering that we in the West now provide a heck of a lot of funding for AIDS patients - much more than for malaria victims or any of the wasting and stunting maladies of the continent - it’s really not in anyone’s interest to spend the cash on determining who actually has HIV and who doesn’t, especially as no one seems to be suggesting that a disease like malaria takes a different course if you are or aren’t HIV+. If I were working at a health clinic in Africa, I’d be marking down everyone with component diseases as AIDS patients too; it could mean the difference between your funding coming through or not, and lacking the tests you just don’t know. (Also lacking the meds one can ask “Would it matter?”)

Most of the Africa figures aren’t reported stats at all, but projections from a small number of reported stats, themselves in large part presumptive diagnoses.

Thus I believe that the African AIDS figures and those from other parts of the Third World are somewhat inflated, especially as the projected AIDS cases numbers for Africa and the world have consistently been higher than the reported ones for those projections’ target years for well over a decade.