Editorial: 40,000 a year and holding

Thursday, Aug. 17, 2006 | 7:34 a.m.

While HIV infection is declining in some of the African nations harmed most by the AIDS epidemic, statistics show that the number of new infections in the United States has not abated since 1990.

Uganda, Kenya and Zimbabwe all have reported a decline in the human immunodeficiency virus that causes AIDS, as have other parts of Africa and India, The Washington Post reports. However, roughly 40,000 new HIV cases have been reported each of the past 15 years in the United States - the nation that generally leads the world in developing new prevention techniques and drug therapies.

Some critics blame the government for having too little commitment to funding prevention strategies. The Centers for Disease Control and Prevention spends $720 million annually on prevention efforts, the Post reports. But one Johns Hopkins physician, who used to work at the CDC, said it would take another $415 million annually to give Americans at the highest risk of HIV infection a full complement of prevention interventions.

Such strategies include not only testing and the availability of free condoms, but also counseling that is done in small groups or one on one - an effective, yet highly overlooked, prevention strategy, the expert told the Post. Providing intravenous drug abusers access to clean needles, which has proved effective in the countries where new HIV cases are on the decline, also is not done in the United States as often as it could be, experts said.

CDC estimates show that contaminated needles account for about 17 percent of new infections, the Post reports, but federal law prohibits using federal money to provide access to clean ones. Most heterosexual transmissions occur between male drug users and their female sexual partners.

The Bush administration has drawn widespread criticism for its nearly exclusive promotion of abstinence as the favored U.S. AIDS prevention strategy. While changing sexual behavior is an important component for prevention, it is not realistic to promote it as the exclusive or solely best method.

It is heartening to note that new drug therapies have enabled many more people infected with HIV to live longer and better. But the United States must find ways to decrease the number of new infections. Old prevention strategies obviously are not doing the job.