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LETTERS TO THE TIMES

Shifting Prevention Efforts to HIV Carriers

October 11, 2003

Re "Prevention Effort on HIV Transfers Focus to Carriers," Sept. 29: There is nothing simple about employing new tactics to halt an epidemic. An increased emphasis on people with HIV is now urgently needed.

Today an estimated 850,000 to 950,000 Americans are infected with HIV -- the greatest number since the AIDS epidemic began. One in four is unaware of the infection and does not benefit from the medical treatment that can assure a longer, healthier life. Those who are infected may also be unknowingly passing the virus on to others. Most people reduce their risk behavior after learning that they are infected. What more evidence do we need to refocus our efforts to stop AIDS? HIV diagnoses among certain populations -- gay and bisexual men, in particular -- are on the rise in some states. The fact that the rate of new HIV infections has not substantially decreased since the mid-1990s demands that we consider new ways of controlling this epidemic.

The Centers for Disease Control and Prevention is not abandoning its support for effective interventions aimed at people who are HIV-negative. Rather, the new initiative adds strength to existing efforts by helping more people get tested and by helping those who are infected develop tools to stay healthy and to protect their partners from infection. Until there's a vaccine, breaking the chain of infection remains our only hope of defeating the AIDS virus.

Julie L. Gerberding MD

Director, CDC, Atlanta

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