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HIV/AIDS Complacency in USA
  from Jules: when HIV money went global domestic focus was lost. Everyone was so self satisfied that HIV was under control due to HAART they didn't think other issues not yet uncovered might emerge. The politicalization of HIV/AIDS, a deathly health epidemic, is the cause. We didn't think that other health concerns might emerge: aging, HCV coinfection, but we also didn't care about these issues, and they re haunting us. And to some degree the focus on these issues still is not there, politics. The Ōbiggest little secretÕ remaining essentially unaddressed in domestic HIV is the worsening situation blacks and latinos face in the USA, not to mention that HCV/HIV coinfection affects these groups much more disproportionately, but all their issues receive much less attention and funding than global HIV, what a disgrace. Under the radar discrimination against American people of color is I think the culprit, global HIV appears more attractive, more compelling, more glamorous. Undiagnosed HIV in the USA is a big problem that requires much more attention, the quality of medical care in the USA frankly stinks. The quality of medical care at major inner city hospitals is subpar, the clinics are overcrowded, the hospitals re underfunded, the poor uneducated patients need extra attention but we can't afford it. Reimbursement for doctors and care providers has ruined our care system as care providers receive horribly underpaid reimbursement. Private insurers are raising copays for medications to unaffordable levels, and many patients stop taking their medications. In many cases doctors are ill equipped to properly manage patients, and the worst case scenario is patients who are poor and uneducated and who have the least skills to negotiate their own care; who sugffers the most-- blacks and latinos, the so-called disparities of care. Don't just blame domestic politics the Federal government makes choices, in response to political pressure they decided to ignore these domestic issues, but so did politically active Americans working in HIV/AIDS. HCV coinfection was several years ago the leading cause of death and morbidity in the USA striking mostly blacks, latinos and IDUs, except for AIDS, and it remains the same. The new problem of aging completely went under the radar, no one thought this might happen. But so-called non-AIDS comorbidities are increasing and associated deaths are increasing due to several factors including that HIV accelerates the aging process and HAART does not appear to prevent this. Research initiatives to address this are needed, as is further discussion about this crucial concern. Global funding is good, but not at the expense of ignoring our problems.
AIDS at Home
The Obama administration starts to combat complacency in the United States.

Wash Post
Tuesday, April 14, 2009; Page A16
WHEN IT comes to fighting the HIV/AIDS epidemic in the United States, there is an alarming complacency among Americans. Perhaps it's the success of antiretroviral drug treatments. In the eyes of many, those drugs have transformed the disease from one with no cure to a manageable ailment. Or maybe it's the view that AIDS is more of a worry in Africa or Southeast Asia. But it's not just happening "over there." And the Obama administration took a first step last week to remind people that it's happening right here, right now.
"Act Against AIDS" is a five-year endeavor announced last Tuesday with the mission to snap us out of our somnolence as the epidemic rages around us.. The $45 million effort by the Centers for Disease Control and Prevention and the Department of Health and Human Services will highlight the fact that every 9 1/2 minutes, someone in the United States becomes infected with the human immunodeficiency virus, which causes AIDS. A multimedia ad campaign will direct people to the Web site, which is a portal to a wealth of information on the epidemic, how people can protect themselves and their partners, and where they can seek testing and treatment.
The initial targets of this focus are African Americans. According to the CDC, while blacks make up just 12 percent of the population, they account for "roughly half" of all new HIV infections and AIDS deaths. The agency reports that the disease is the No. 1 killer of black women age 25 to 34 and the second-leading cause of death among black men age 35 to 44. Those frightening statistics are part of a troubling larger story of AIDS in America. Last year, the CDC estimated that 56,300 people became infected with HIV in 2006. The previous estimate was 40,000. The agency defines the epidemic as "generalized and severe" when HIV/AIDS affects 1 percent of the overall population. Last month, the District's HIV/AIDS Administration announced that 3 percent of the city's population has HIV/AIDS.
We applaud the administration for bringing together 14 African American civic organizations to help highlight the importance of testing and treatment among their memberships. But more needs to be done. Many, most notably Robert C. Gallo, one of the scientists who uncovered HIV as the cause of AIDS, have called for a domestic version of the President's Emergency Plan for AIDS Relief, which has been successful in sub-Saharan Africa. President Obama has charged Jeffrey S. Crowley, his director of the Office of National AIDS Policy, to craft a national AIDS strategy over the next year with three goals: lowering the rate of HIV infections, increasing the number of people in care and reducing disparities in care. For the sake of the nation, we hope the administration maintains its focus on this domestic challenge.
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