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Routine AIDS Testing Pays Off:Meeting in Wash DC
  AIDS experts convene ahead of World AIDS Day
Last Updated: 2006-11-29 18:45:35 -0400 (Reuters Health)
By Megan Rauscher
NEW YORK (Reuters Health) - Ahead of World AIDS Day on December 1, nearly 300 medical, government, and community HIV/AIDS experts have gathered in Washington, D.C. for a 2-day summit in which they will examine ways to expand HIV testing in the United States. They will also assess the impact that an increased number of individuals diagnosed with the disease will have on the health care system.
It's estimated that some 40,000 new HIV infections continue to occur each year in the United States. "It is humbling," summit co-chair Dr. John G. Bartlett said, "that the rate of new infections has not changed in 16 years despite such great progress in other facets of the disease."
"It is unacceptable that we have so many new cases of an entirely preventable disease every year in this country," added Dr. Bartlett, who is from Johns Hopkins University School of Medicine in Baltimore.
"Equally troubling," Dr. Bartlett noted, is the fact that roughly 250,000 Americans are living with HIV but are unaware of their infection. These individuals "are not benefiting from life-extending treatments and may unknowingly be transmitting HIV to other people."
"There are a number of preventive strategies that are now available and only need to be implemented," Dr. Bartlett said. In September, the CDC recommended that all Americans between the ages of 13 and 64 years be tested for HIV as part of routine medical care.
Scaling up HIV testing, prevention and care is the key to ending the country's HIV/AIDS epidemic, added summit co-chair Dr. Kenneth H. Mayer from Brown University, Providence, Rhode Island, noting that HIV screening rates remain low in physicians' offices, emergency rooms and STD/family planning clinics.
A recent study found that more than 60% of people with regular access to health care who were newly diagnosed with HIV were in an advanced stage of disease, suggesting that prior opportunities for diagnosis had been missed.
"If voluntary, routine HIV testing is to become a reality in doctors' offices, emergency rooms and other health care settings around the country, we need to address a number of social, economic, and logistical issues," Dr. Mayer said.
Universal AIDS tests will pay off, experts say
Last Updated: 2006-11-30 10:05:14 -0400 (Reuters Health)
By Maggie Fox
WASHINGTON (Reuters) - Routine, universal testing for the AIDS virus as recommended by a federal agency will likely cost the United States $900 million, but will pay off in terms of lives and money, experts said on Wednesday.
They said the federal government will need to allocate more money to programs that pay for treating uninsured HIV patients, and said cities, states and groups that run clinics will have to hire more staff.
Treatment must be available to everyone who is tested, or else much of the incentive to get the test is gone, the researchers told a conference on AIDS testing in Washington.
"We are talking about a little more than $900 million a year," said Dr. David Holtgrave of Johns Hopkins University in Baltimore.
But two experts said their experiences show the effort is worthwhile. "The data scream that we need to be doing this," said Dr. Michael Saag of the University of Alabama at Birmingham Center for AIDS Research.
In September the U.S. Centers for Disease Control and Prevention recommended near-universal testing for the AIDS virus, saying too many people are missed by the current practice of focusing on people who seem to be at high risk.
HIV infects more than 1 million people in the United States and the CDC estimates that 40,000 people become newly infected every year. But many do not know it because at first HIV causes mild symptoms, quietly destroying the immune system over time.
"When we have good therapy that works best when people start early, that is inappropriate," Dr. John Bartlett of Johns Hopkins University in Baltimore told a news conference.
The CDC estimates that between 16 million and 22 million HIV tests are conducted in the United States every year. President George W. Bush's 2007 budget request to Congress allocates $70 million for HIV testing.
Dr. Marsha Martin of the Washington, D.C. HIV/AIDS Administration said the city began a universal testing policy last June that has already paid off.
"We have the highest AIDS rate in the country -- 179 per 100,000 (population)" she said.
"Since June we have screened more than 16,000 individuals," Martin added. Of these, 580 have been positive, giving an infection rate of 3.5 percent -- far above the estimated U.S. national rate of between 0.8 percent and 1.2 percent.
Tests are being given at student clinics at universities, in hospital emergency wards and hospital walk-in clinics, as well as at free clinics across the city, she said.
Saag said at his clinic, people who come in after their immune systems are already damaged -- as measured by a count of immune cells called CD4 T-cells -- die sooner.
Just 35 percent to 50 percent live eight years, as opposed to 75 percent of people who seek testing and treatment while their CD4 counts are above 350, a level considered fairly healthy.
Saag said to care for a person whose CD4 count is more than 350, it costs $12,000 a year but it costs $40,000 a year to treat someone whose CD4 count has fallen below 50.
Cocktails of HIV drugs can keep patients from developing AIDS, although there is no cure for the infection.
"They stay healthy. They stay active in society. It's a win-win-win proposition, well worth the investment," said Saag.
Churches, communities and organizations now have to encourage people to get tested, said Phill Wilson, chief executive officer of the Black AIDS Institute. An estimated 50 percent of all new HIV infections across the United States are in blacks.
"AIDS today is a black disease, plain and simple," Wilson said. "For me, the answer is simple -- marshal black folks."
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