“One of the greatest achievements in modern medicine has been the transformation of HIV from an almost invariably fatal illness to a chronic, manageable infection,” said Dr. Timothy Friel, chairman of the Lehigh Valley Health Network’s Department of Medicine and infectious disease specialist. “This transition was driven by the discovery of excellent medications that have allowed us to successfully control HIV infections and reduce its complications.”
Today, 1.1 million people are living with HIV in the United States, the Centers for Disease Control and Prevention (CDC) reports. A 20-year-old diagnosed with HIV today can, with the proper treatment, expect to live until 78, according to a study published this year in The Lancet HIV. That’s a far cry from 1994, when AIDS was the leading cause of death for Americans ages 25 to 44.
HIV gradually destroys the body’s immune system by entering and taking over infection-fighting T cells. Untreated, HIV will attack the immune system until it progresses to AIDS. Friel said a combination of three antiretroviral medications is typically used to treat infected patients. Many of these combinations have been incorporated into a single pill that can be taken once daily to suppress replication of the viral infection.
Since their development in the 1990s, these drugs have been the main reason for the decline in AIDS-related deaths, according to HIV.gov.
“At present, none of these medications—whether taken alone or in combination—can cure HIV,” Dr. Friel said. “However, these medications have offered HIV-infected patients the opportunity to live much longer and healthier lives.”
Still, anyone can get HIV.
“Prevention remains our most powerful tools in combatting this epidemic,” Friel said. “Each and every new case is preventable.”
The Centers for Disease Control and Prevention website contains comprehensive resources about
HIV, including important prevention guidelines.
Ryan White HIV/AIDS Program
During 1990, Congress passed legislation that created The Ryan White HIV/AIDS Program, which provides a system of care that includes primary medical care and essential support services for people living with HIV who are uninsured or underinsured.
The Program is administered by the U.S. Department of Health and Human Services (HHS). HHS works with cities, states, and community-based organizations to provide HIV care and treatment services to more than half a million people each year, reaching 52 percent of all people diagnosed with HIV in the United States.
The majority of Ryan White HIV/AIDS Program funds support primary medical care and essential support services. A smaller portion of funds support:
- technical assistance
- clinical training
- development of innovative models of care
- access to HIV medication that helps people living with HIV to live close to normal lifespans
Pennsylvania
During 2014, the estimated adult and adolescent population living with diagnosed HIV infection was nearly 33,000. The number of cases of HIV disease diagnosed in Pennsylvania in 2016 was 991.
Each year, Pennsylvania providers receive funding from the Ryan White HIV/AIDS Program to implement several different initiatives. Providers include hospitals, community and mental health centers, community-based organizations, and health departments.
The state Department of Health receives an annual grant from the Ryan White HIV/AIDS Program for services provided to individuals including outpatient health services, oral health care, health insurance assistance, home health care, home and community based health services, hospice services, medical case management, and substance abuse and mental health services. Support services provided are emergency financial assistance, food bank and home delivered meals, housing, legal, linguistic, medical transportation, outreach, psychosocial support, respite care and treatment adherence counseling.
Other Initiatives:
One of the major advancements in the HIV/AIDS field is the development of pre-exposure prophylaxis. Studies show, if taken consistently, it can reduce the risk of HIV infection in high-risk individuals by up to 92 percent, according to the CDC.
Other long-term prevention efforts focus on developing a vaccine, with at least 33 in clinical development, according to the Pharmaceutical Research and Manufacturers of America.
Experts believe that, with continued advances in prevention, we will see better chronic disease management for HIV, and potentially, eradication of the disease.