As we reflect on World AIDS Day, Dec. 1, we will come to reaffirm that we have work yet to be done, whether we are people living with AIDS, clinicians, seniors, young people, politicians or anybody else. We are not through with this yet.
If there is a challenge to be offered, it is, "Think globally and act locally."
Definitions are in order: The Human Immunodeficiency Virus is a virus that causes Acquired Immunodeficiency Syndrome, whereby the immune system fails. HIV/AIDS is pandemic in the world.
There are currently 33 million people in the world who are living with HIV. In 2008, 2 million children and adults died as a result of AIDS. More than 2.7 million adults and children were newly infected.
That's the world situation. Let us bring this closer to home. Consider North America in 2008. There were 1.4 million people living with HIV. During that year, 55,000 adults and children were infected with HIV. Sadly, there were 25,000 adult and child deaths secondary to AIDS.
Of the HIV positive people in our country, 25 percent are people older than 50. The fastest growing age group of people who contract HIV are those younger than 25. Among women who have contracted HIV, 80 percent acquired this infection from an infected male partner. About 25 percent of all HIV positive people are women.
Forty percent of HIV-infected infants are born to women unaware of their HIV status until after delivery. HIV/AIDS is the number one cause of death for black women 25-34 years of age. It is the fifth most common cause of death among all women 35 or older.
Alaska has not escaped this scourge. Since the beginning of record keeping for HIV/AIDS, 690 people have been diagnosed with AIDS (seven of these were children). There have been 347 deaths in people with AIDS, and these deaths have occurred among all of the racial and ethnic groups in Alaska.
The cruel truth of what we do know is that 25 percent of people who carry the HIV virus do not have a clue that they have it. That's a quarter of all carriers. What do we do?
There is this concept of HIV testing. The test can be a swab taken from the mouth, a finger stick blood test or a regular blood test. It can be arranged at a health care provider's office, at the Juneau Public Health Department, at Alaskan AIDS Assistance Association (4A's), and at Planned Parenthood. If you have never had a test, consider taking at least one. If you are an "at risk" person with sexuality and/or intravenous drugs, consider a yearly test. There also is this concept of prevention. A wealth of credible information is available locally and on the Web.
The United Nations AIDS Program and the World Health Organization have provided a framework for 2009-2011 with nine priority areas:
We can reduce sexual transmission of HIV.
We can prevent mothers from dying and babies from becoming infected with HIV.
We can ensure that people living with HIV receive treatment.
We can prevent people living with HIV from dying of tuberculosis.
We can protect drug users from becoming infected with HIV.
We can remove punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS.
We can stop violence against women and girls.
We can empower young people to protect themselves from HIV.
We can enhance social protection for people affected by HIV.
I believe this represents thinking globally and acting locally. I believe we really can do this for ourselves and for each other if we choose to do so.
Carolyn V. Brown, MD MPH, is a physician in Juneau.
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