David Mixner
Author, Political Strategist

As the nation debates reforming our health care system, there is one topic I'm not hearing enough about – how the fight against HIV/AIDS will remain a national priority and how the prevention of such costly diseases such as this will become a foundational element of our health system.

Phenomenal progress has been made against HIV/AIDS since it first appeared in the United States a quarter-century ago. But this very progress has dulled our sense of urgency about preventing the disease and finding a cure. Today is World AIDS Day and we should take a moment to reflect on how we've made progress and why there is a bubbling fear that the worst of the crisis may lie ahead. To finally put a stop to the epidemic, we need to re-energize our commitment and pass smart health care reforms now.

A critical moment in the fight against HIV/AIDS occurred a decade ago, when powerful new protease inhibitor drugs showed remarkable effectiveness in treating the disease and raised hope that the epidemic's end was around the corner. Unfortunately, our progress led to overconfidence in science – a perception that the protease inhibitor regimen guarantees quality of life for people living with HIV/AIDS, and thus that contracting the disease is no longer a big deal.

Patients tell a different story. In this month's New York magazine, author David France reports on the disturbing health complications afflicting people on long-term HIV/AIDS treatment. Men and women in their 40s and 50s are experiencing premature aging, dementia, bone weakness, insulin resistance, and susceptibility to a range of cancers. According to France, in "one large-scale multi-city study, more than half of the HIV-positive population is suffering some form of cognitive impairment." The result is substantial deterioration in quality of life, memory loss and associated difficulty interacting with other people, genuine fear about whether men and women in their working prime can hold onto a job, and potentially shortened lives.

Scientists are trying to understand why people on anti-retroviral drug regimens are experiencing these ailments, but at the very least, it is no longer a foregone conclusion that protease inhibitors are a magic bullet.

But the burgeoning problems are not limited to people on treatments. We may soon learn that HIV infection is once again on a dramatic, even frightening rise. Why would that happen? As sad as it may be, we are seeing more careless behavior despite what is now widely known about how the disease is transmitted. The stigma of HIV/AIDS has subsided because people now can live longer, relatively normal lives with HIV.

Plus, with the progress we've made with retroviral drug regimens, people can once again live in the closet as an HIV-positive person. That means fewer people believe they know someone who is living with HIV, even though they most likely do. The CDC estimates that as many as 21% of the 1.1 million Americans living with HIV don't even know they're HIV-positive. The dynamic means they view the fight against the disease as less of an urgent priority. The disease is spreading at an alarming rate entirely under the radar.

We certainly don't want to re-stigmatize HIV/AIDS, but we do need to stop assuming that HIV/AIDS is just another chronic disease and get serious again about ending it. Affected communities – gay people, African Americans, doctors, drug companies, inner city support networks, faith communities, and others – need to honor the work already done and gear up to confront what may be the biggest challenge yet in this national and global health crisis.

Congress can play a pivotal role by passing health care reform with key provisions, including:

· Increasing the portability of insurance and killing preexisting condition requirements that force HIV-positive individuals to stay with the same insurance provider – and usually the same employer – to pay for expensive treatment regimens;

· Funding smart prevention efforts that will stop what I believe is now a silent but staggering rise in the transmission of the disease;

· Continuing to protect the patents and long-term data exclusivity of medical innovators so they remain incentivized to conduct research into innovative drugs and procedures to combat HIV/AIDS more precisely and with fewer debilitating side effects. That environment is the reason for our progress thus far, and it must be carefully cultivated.

These reforms need to be implemented this year. With more than 50,000 new infections in the United States annually – one every nine and a half minutes – AIDS continues to quietly devastate communities, particularly inner city and minority communities where quality health services are hard to come by. Any delay consigns more people to facing the indignity of this disease with limited resources and few options.

As recent evidence shows, we are nowhere near the end of this fight. AIDS is a nasty and adaptable adversary that preys on our complacency. It's time to reignite our nation's sense of urgency, recognize AIDS as the debilitating health crisis it continues to be, and commit ourselves to finally putting a stop to it.

Editor's Note: David Mixner is an author, political strategist and civil rights activist.

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Program Note: For more ways to make a difference, visit Impact Your World.

Mayo Foundation for Medical Education and Research

AIDS is a chronic, life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight off viruses, bacteria and fungi that cause disease. HIV makes you more susceptible to certain types of cancers and to infections your body would normally resist, such as pneumonia and meningitis. The virus and the infection itself are known as HIV. "Acquired immunodeficiency syndrome (AIDS)" is the name given to the later stages of an HIV infection.

An estimated 39.5 million people have HIV worldwide. And though the spread of the virus has slowed in some countries, it has escalated or remained unchanged in others. The best hope for stemming the spread of HIV lies in prevention, treatment and education.

Learn more about the virus here...

Researchers found those who received the vaccine combination were 31 percent less likely to contract HIV.

Miriam Falco
CNN

A vaccine to prevent HIV infection, the virus that leads to AIDS, has shown modest results for the first time, researchers have found, raising hopes that a disease that kills millions every year may someday be beaten.

In what is being called the world's largest HIV vaccine trial ever - involving more than 16,000 participants in Thailand - researchers found that people who received a series of inoculations of a prime vaccine and booster vaccine were 31 percent less likely to get HIV, compared with those on a placebo.

"Before this study, it was thought vaccine for HIV is not possible," Colonel Jerome Kim, who is the HIV vaccines product manager for the U.S. Army, told CNN.

HIV is the human immunodeficiency virus, which is the virus that causes AIDS - acquired immune deficiency syndrome.

Keep Reading...

Joy Behar says Ukranian officials are wrong to try to block Elton John from adopting a 14-month-old boy.

Joy Behar
HLN

On a recent tour of a Ukrainian orphanage, Elton John and his partner met Lev, a 14-month old HIV-positive boy.

They immediately fell in love with the child, but their possible bid to adopt the adorable tiny dancer was rejected by Yuriy Pavlenko, Ukraine's Family, Youth and Sports Minister.

Mr. Pavlenko, here are some tips about family, youth and sports. Family doesn't mean a huddle of orphans sharing a few soiled mattresses, it's not youth if you die of AIDS before you reach kindergarten, and wrestling over dinner scraps is not a sport.

Keep Reading...

Henry Samuel
The Daily Telegraph

France's First Lady said that the Church's teachings had left her feeling "profoundly secular".

She departed from her post's traditional religious neutrality to accuse the Pope of "damaging" countries in Africa with his stance on birth control.

The Italian-born former supermodel risked angering believers in France and beyond by declaring that the Pontiff's proclamations showed that the Church needed to "evolve".

In March, the Pope sparked controversy while on an Africa tour by saying that the AIDs pandemic which has crippled the continent "can't be resolved with the distribution of condoms; on the contrary, there is the risk of increasing the problem".

Mrs Bruni-Sarkozy said: "I was born Catholic, I was baptised, but in my life I feel profoundly secular.

"I find that the controversy coming from the Pope's message – albeit distorted by the media – is very damaging.

"In Africa it's often Church people who look after sick people. It's astonishing to see the difference between the theory and the reality.

"I think the Church should evolve on this issue. It presents the condom as a contraceptive which, incidentally, it forbids, although it is the only existing protection," she told Femme Actuelle, the women's magazine.

Read more...

Singer-songwriter Elton John sits down with Dr. Sanjay Gupta to talk about the global AIDS epidemic.

Bill Frist
Special to CNN

A legacy of President George W. Bush will be that he saved 10 million lives around the world.

His critics ignore it, but name another president about whom one can say that with such certainty. It is what historians will say a decade from now looking back. Not bad for a president who leaves office with the lowest approval rating in recent memory.

The bottom line is: George Bush is a healer.

First, a surprise proclamation came on January 29, 2003.

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Erica Hill | BIO
AC360° Correspondent

Thanksgiving wasn’t the same this year. It was a wonderful day – my husband’s family was in town, and it’s rare we have everyone together more than once a year. It was a beautiful day here in NY; we took in our first live Thanksgiving Day Parade, enjoyed a wonderful feast and created new memories. We made up for lost time and were reminded how lucky we are to be blessed with a family we all like. Yet, I couldn’t help but think of Mumbai and the families forever torn apart by these senseless terrorists.

I take some comfort in the vigils being held worldwide, uniting people across oceans and continents, bringing together different faiths, united in one belief: the 179 people killed and the 300 injured last week in Mumbai should still be here.

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December 1 is World AIDS Day…another good reason to reflect. Dec 1 was first set aside as a day to highlight the disease 20 years ago. The good news: Progress, and lots of it, on both the medical and social fronts.

There are now more than two dozen anti-HIV drugs, which have given those living with HIV an incredible chance at life. People around the globe have come to realize this is not a “black disease” or a “gay disease”, as so many thought years ago. That alone is an amazing and important step forward. But despite the advances in the past two decades, there is still much to do.

Like so many diseases, HIV/AIDS does not discriminate, which also means there is a chance you know one of the millions affected by this cruel disease. World AIDS Day is just one of the many ways people around the globe are keeping this disease top of mind. Many local communities have wonderful organizations who work with those affected by HIV/AIDS everyday – offering support, meals, medical help and hope… one of the most powerful medicines available.

A close look at an HIV-free sperm being injected into the woman’s egg.

Kyung Lah | BIO
CNN International Correspondent

They are a couple in their 30’s trying to get pregnant and have a child. Their doctor believes they’re good candidates for in-vitro fertilization.

But they are also both HIV-positive. If they successfully give birth to an HIV-negative baby, they would be the first HIV-positive couple in the world to give birth using IVF.

The question is: should they? The couple says they deserve to live as normal a life as possible, after they each lost that chance as children. They were among 2000 Japanese citizens infected in the 1980’s through HIV-tainted blood.

They grew up, met at the hospital, fell in love and married. Being parents, they say, is the natural next step.

Dr. Hideji Hanabusa of Ogikubo Hospital says he and his team have developed a way to remove 100% of the virus from the husband’s sperm. The mother’s viral level is low, says Dr. Hanabusa, so low that the risk of transmitting to the infant is less than 0.5%.

But that risk is enough to raise opposition from an unexpected source: the HIV community in Japan. Katsumi Ohira with the Habataki Welfare Project was also infected in the 1980’s through HIV-tainted blood. Ohira says history has taught the HIV community that any medical process carries risk.

“We can’t create new victims or tragedies,” says Ohira. “I think it’s necessary to think about the risks of this procedure."

Japan’s government is leaning toward allowing the couple’s first I-V-F attempt this month. Dr. Hanabusa says he’s confident he’ll help bring a healthy child into the world and help turn this couple into a family. A natural progression made possible only through medical technology.

A protester stands at the opening ceremony of the XVII International AIDS conference in Mexico City

Harris Whitbeck
CNN Correspondent

MEXICO CITY, Mexico
Twenty-two thousand people from all over the world, gathered in one conference center for a week. All of them have different takes on the AIDS epidemic, and all of them are keen on making their points of view known.

It’s like being a kid in a candy store for a journalist. All these people, all eager to talk to you, all vying for your attention as a representative of the global media.

But that’s what makes covering an AIDS conference so difficult: How do you sort through all the information, all the public relations pitches, all of the staged events to get to the story?

Keep reading

Daquan Smith rubs his gums with a Rapid HIV test swab at the Iris House November 2007 in New York City

Kai Wright
TheRoot.com

America likes to consider itself exceptional, a nation blessed with unshakable good fortune and driven by unyielding ambition. I think that sentiment explains why we so often get caught with our pants down. Our self-absorbed exceptionalism breeds a lazy arrogance that consistently confuses just getting started with finishing the job: Iraq. Al Qaeda. Katrina. It's a long list to which we can now officially add AIDS.

The U.S. Centers for Disease Control and Prevention announced this weekend that the American AIDS epidemic is at least 40 percent larger than we have believed for more than a decade. The announcement drew front-page stories, shocked many everyday Americans and prompted those of us working on AIDS in black communities to sigh a collective, "I-told-you-so."

Since the mid-1990s discovery of "combination therapy"—popularly known as the "AIDS drug cocktail," a tellingly cavalier moniker—America has embraced the notion that it beat AIDS. We've certainly made strides. Combination therapy drastically slowed the funeral march we once thought inevitable, prompting national news media to offer a string of breathless stories examining "when plagues end," as an infamous 1996 New York Times Magazine cover blared.

But that success was tenuous and uneven from the start. The treatments were then and still are expensive and challenging. And African Americans never bounced back as robustly as the rest of the nation. Indeed, 1996 was significant for two reasons: It was the first year America saw a decrease in AIDS death rates and the first year in which more blacks died than whites. By 2004, blacks represented 38 percent of all AIDS deaths. So much for plagues ending.

Read more

Watch: A new report says blacks are eight times more likely than whites to be HIV infected. CNN's Dr. Sanjay Gupta reports.

I have logged hundreds of thousands of miles, looking at the burden of AIDS around the world. I have been with the Partners in Health teams in Rwanda and the Clinton Foundation in Kenya. I have seen the work being done in Haiti, to name a few. Today, I would like to draw some comparison with what is happening right here at home.

Yesterday the Black AIDS Institute reported that if African-Americans with HIV/AIDS were their own country, they would make up more HIV/AIDS cases than seven of the countries currently receiving emergency funding for… AIDS. Think about that. There are almost 600,000 African-Americans living with HIV, and there are still 30,000 newly infected cases every year. As things stand now, AIDS remains the leading cause of death among African-American women between the ages of 25 and 34, and the second-leading cause of death among African-American men between 35 and 44 years of age.

As Jesse Milan, board chair of the institute, said, “When the world wasn’t looking, the AIDS epidemic refused to go away.” AIDS has always been a disparate African-American problem. Even at the beginning of this epidemic in the United States, when there were only a few thousand cases, more than a quarter of them were among African-Americans.

Read more...