HIV prevention: Entering mainstream medicine

A new CDC initiative seeks to launch a broader attack against the spread of this deadly disease.

Editorial. Sept. 22/29, 2003.

The AIDS virus is not going away. After more than two decades of prevention messages, about 40,000 people are still infected with HIV each year. An estimated 900,000 people in the United States live with the virus, and of those, 180,000 to 280,000 are unaware of their serostatus.

That's why the Centers for Disease Control and Prevention this year launched a new initiative to make greater strides against the disease's spread. The objective is to look beyond those groups traditionally considered most at risk, to make HIV testing a part of mainstream medical practice, and to step up prevention messages aimed at those already infected. Ultimately, physicians will play a critical role in making the initiative a success, and the AMA is committed to helping medical professionals achieve these purposes.

The CDC effort relies on the idea that people tend to take action in response to advice from their physicians. Whether it be a gentle suggestion to be tested or a reminder to an HIV-positive patient to take precautions against transmitting the virus to others, physicians have the power to influence patients' behavior, and the CDC would like them to exercise it at every appropriate opportunity.

The agency's blueprint for action, "Advancing HIV Prevention: New Strategies for a Changing Epidemic," provides specific details on exactly how to do so. It outlines a broader attack against HIV that combines proven public health approaches -- screening, new case identification, partner notification, and increased availability of treatment and prevention services -- with a greater awareness that not everyone who is HIV-positive fits into a high-risk category.