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Each year in the U.S., about 50,000 people contract HIV, the virus that causes AIDS. That rate hasn’t changed much in the last decade, even though anti-retroviral therapy can effectively control the virus and dramatically lower the risk that people with HIV will transmit it.
If you want to understand why HIV continues to spread in the U.S., take a look at the chart below. It’s based on new estimates, published today in the journal JAMA Internal Medicine, of what stage of care people with HIV are in when they’re most likely to transmit the virus to others.
The chart describes what epidemiologists call the HIV "continuum of care." That’s a series of steps between when people contract the virus and when, with proper medical care, the virus in their bodies is suppressed. It includes getting diagnosed, getting into care, getting a prescription for anti-retroviral therapy, and ultimately lowering the amount of virus in the body to a level that allows people to live longer, healthier lives and reduces the risk that they’ll transmit HIV to others.
Almost half of the HIV-positive population in the U.S. has been diagnosed but isn’t getting medical care. This group accounts for the greatest number of new transmissions—more than 60 percent, by researchers’ estimates. Most new transmissions involve men who have sex with men. The estimates are based on data on the 2009 HIV-positive population in the U.S. of 1.15 million Americans. The Centers for Disease Control and Prevention’s latest estimates put the number at 1.2 million.
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