HIV In the United States

FAST FACTS

• More than 1.2 million people in the United States are living with HIV infection, and almost 1 in 7 (14%) are unaware of their infection.
• Gay, bisexual, and other men who have sex with men (MSMa), particularly young black/African American MSM, are most seriously affected by HIV.
• By race, blacks/African Americans face the most severe burden of HIV.

CDC estimates that 1,201,100 persons aged 13 years and older are living with HIV infection, including 168,300 (14%) who are unaware of their infection1. Over the past decade, the number of people living with HIV has increased, while the annual number of new HIV infections has remained relatively stable. Still, the pace of new infections continues at far too high a level— particularly among certain groups.

HIV Incidence (new infections): The estimated incidence of HIV has remained stable overall in recent years, at about 50,000 new HIV infections per year2. Within the overall estimates, however, some groups are affected more than others. MSM continue to bear the greatest burden of HIV infection, and among races/ethnicities, African Americans continue to be disproportionately affected.

HIV Diagnoses (new diagnoses, regardless of when infection occurred or stage of disease at diagnosis): In 2012, an estimated 47,989 people were diagnosed with HIV infection in the United States. In that same year, an estimated 27,928 people were diagnosed with AIDS. Overall, an estimated 1,170,989 people in the United States have been diagnosed with AIDS3.

Deaths: An estimated 13,834 people with an AIDS diagnosis died in 2011, and approximately 648,459 people in the United States with an AIDS diagnosis have overall3. The deaths of persons with an AIDS diagnosis can be due to any cause—that is, the death may or may not be related to AIDS.

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Reduce Your Risk

In the United States, HIV is mainly spread by having sex with someone who has HIV. There are several steps you can take to reduce your risk of getting HIV through sexual contact, and the more of these actions you take, the safer you can be. These actions include:

• Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex. Anal sex is the highest-risk sexual activity for HIV transmission. If you are HIV-negative, insertive anal sex (“topping”) is less risky for getting HIV than receptive anal sex (“bottoming”). Remember: HIV can be sexually transmitted via blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluid, and vaginal fluid. Sexual activities that do not involve the potential exchange of these bodily fluids (e.g. touching) carry no risk for getting HIV. For more details, see Sexual Practices and HIV Risk, below.

• Use condoms consistently and correctly. When used consistently and correctly, condoms are highly effective in preventing HIV. For more details, see Using Condoms, below.

• Reduce the number of people you have sex with. The number of sex partners you have affects your HIV risk. The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission. Remember: one in six people living with HIV in the U.S. are unaware of their infection.

• Talk to your doctor about pre-exposure prophylaxis (PrEP). PrEP is taking HIV medicine daily to prevent HIV infection. PrEP should be considered if you are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner. PrEP also should be considered if you are HIV-negative and have had a sexually transmitted disease (STD) or any anal sex (receptive or insertive) with a male partner without condoms in the past six months and are not in an exclusive relationship with a recently tested, HIV-negative partner. For more information, see our page on PrEP.

• Talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable. Starting PEP immediately and taking it daily for 4 weeks reduces your chance of getting HIV. For more information, see our page on PEP.

• Get tested and treated for other sexually transmitted diseases (STDs) and encourage your partners to do the same. If you are sexually active, get tested at least once a year. STDs can have long-term health consequences. They can also increase your chance of getting HIV or transmitting it to others. Find an STD testing site.

• If your partner is HIV-positive, encourage your partner to get and stay on treatment. ART reduces the amount of HIV virus (viral load) in blood and body fluids. If taken consistently and correctly, ART can keep people with HIV healthy for many years, and greatly reduce their chance of transmitting HIV to sex partners.

Of course, you can also reduce your risk of getting HIV by not having sex. If you aren't having sexual contact, you are 100% protected from getting HIV in that way. Alternatively, if you are having sex, you can reduce your risk if you and your partner have both been tested and know that you are both HIV-negative and you practice monogamy. Being monogamous means: 1) You are in a sexual relationship with only one person and 2) Both of you are having sex only with each other. However, monogamy won't protect you completely unless you know for sure that both you and your partner are not infected with HIV.

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Immune System 101

HOW DOES YOUR IMMUNE SYSTEM WORK?

Your immune system works because your body is able to recognize "self" and "non-self." This means that your body is able to tell if an invader (virus, bacteria, parasite, or other another person's tissues) has entered it—even if you aren't consciously aware that anything has happened. Your body recognizes this invader and uses a number of different tactics to destroy it.

THE IMMUNE SYSTEM IN ACTION

Your immune system has many different ways of fighting off foreign invaders. When confronted with a virus, your body responds by activating specific processes of the immune system. First your body recognizes a foreign antigen and delivers it to the lymph system, where it is ingested by a macrophage.

Then the macrophage processes the virus and displays the antigens for that particular virus on its own exterior. This antigen then signals a helper T- cell.

Next the T-cell reads this signal and sounds the alarm for other parts of your immune system to respond.

The B-cell responds to this call and comes to read the antigen from the surface of the macrophage.

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America's AIDS Miracle

By Michael Elliott

Originally published by Time on November 20, 2014

How the U.S. fought the disease by thinking big and staying smart

At my home in Washington, D.C., placed so that I see it every morning, is a photograph of Princess Adeyeo, a young Liberian woman I met in 2012. Princess had been a refugee during Liberia's civil war; when she returned there, she found that she was HIV-positive. But in Monrovia's John F. Kennedy Hospital she was put on a course of antiretroviral drugs (ARVs), which prevent mother-to-child transmission of the virus, and a few months before our visit she gave birth to a beautiful baby boy. He was HIV-negative, healthy.

Right now, of course, people associate Liberia with Ebola. It's right that we get mad about Ebola-mad that the world waited so long to tackle the outbreak; mad that poor, vulnerable societies don't have the resources needed to tackle infectious diseases. But we should remember too that in the past few years, Liberia-in fact, every country, rich or poor-has seen small miracles like the story of Princess and her son, and sees more of them each year.

In 2003, across all of sub-Saharan Africa, just 50,000 people were on ARVs, now more than 9 million are. There is no reason, in the next few years, that we cannot virtually end mother-to-child transmission of HIV in even the most challenging environments. Unheralded, we just passed a tipping point: in 2013, more people were added to the rolls of those on lifesaving treatment for HIV/AIDS than the number who were newly infected. That crossover of trend lines should mark the beginning of the end of AIDS.

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World AIDS Day

What is World AIDS Day?

World AIDS Day is held on 1 December each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. World AIDS Day was the first ever global health day and the first one was held in 1988.

Why is World AIDS Day important?

Around 100,000 are currently living with HIV in the UK and globally an estimated 34 million people have HIV. More than 35 million people have died from the virus, making it one of the most destructive pandemics in history.

Today, many scientific advances have been made in HIV treatment, there are laws to protect people living with HIV and we understand so much more about the condition. But despite this, people do not know the facts about how to protect themselves and others from HIV, and stigma and discrimination remain a reality for many people living with HIV. World AIDS Day is important as it reminds the public and Government that HIV has not gone away – there is still a vital need to raise money, increase awareness, fight prejudice and improve education.

What should I do on World AIDS Day?

World AIDS Day is an opportunity for you to learn the facts about HIV and put your knowledge into action. Find out how much you know by taking our online quiz: Are you HIV aware? Test your knowledge and awareness by taking the quiz and act aware by passing the quiz on and sharing it with your friends on Twitter and Facebook.

If you understand how HIV is transmitted, how it can be prevented, and the reality of living with HIV today - you can use this knowledge to take care of your own health and the health of others, and ensure you treat everyone living with HIV fairly, and with respect and understanding. Click here to find out the facts.

You can also show your support for people living with HIV on World AIDS Day by wearing a red ribbon, the international symbol of HIV awareness and support.

World AIDS Day is also a great opportunity to raise money for NAT (National AIDS Trust) and show your support for people living with HIV. If you feel inspired to hold an event, bake sale or simply sell red ribbons, click here to get started. If you'd like to see what other events are taking place — click here and find out more.

But what about after World AIDS Day?

Although World AIDS Day is a great opportunity to get the public talking about HIV and fundraise, we need to remember the importance of raising awareness of HIV all year round. That's why NAT has launched HIVaware — a fun, interactive website which provides all the information everyone should know about HIV. Why not use what you have learnt on World AIDS Day to Act Aware throughout the year and remember, you can fundraise at any time of year too — NAT is always here to give you suggestions and ideas.