ATLANTA (Reuters) - Health officials urged the United States on
Wednesday to battle the spread of HIV, the virus that causes
AIDS, by improving monitoring and funding, and embracing the
use of "proven strategies" such as condom distribution and
needle exchange programs.
A new report issued by the Institute of Medicine of the
National Academies in Washington and sponsored by the Centers
for Disease Control and Prevention (CDC), said the number of
new HIV infections could be significantly cut if the federal
government funded the most cost-effective prevention programs.
"Thousands of new HIV infections could be avoided each year if
we gave greater emphasis to prevention and were smarter in the
way we spent our prevention dollars," said Harvey Fineberg,
provost of Harvard University and a co-chair of the committee
that wrote the report.
The United States spent about $775 million on HIV and AIDS
prevention in fiscal 1999, which amounted to about 8 percent of
total federal spending on HIV and AIDS-related programs, the
The report said funding decisions should be based on preventing
as many new HIV infections as possible rather than by
allocating money based on the number of AIDS cases already
reported in specific populations and geographic areas.
It also criticized the federal government for appropriating
$250 million over five years to abstinence programs without any
evidence such an approach was effective in preventing HIV
The report maintained that "social and political pressures have
led to policy and legal obstacles that block the use of proven
(prevention) strategies," such as condom distribution and clean
needle programs for drug users.
"These laws and policies should be abolished ... including
elimination of federal, state and local requirements that
public funds be used for abstinence-only sex education," the
Efforts to combat the spread of HIV, including the use of
powerful drug cocktails, have slowed the rapid growth of the
AIDS epidemic in the United States in the two decades since its
During the first decade, the number of new AIDS cases increased
by 65 percent to 90 percent each year. In 1996 the number of
new AIDS cases and deaths fell for the first time in the
history of the disease, due in large part to the development of
new drug therapies.
Recent studies have suggested that the declining trends in AIDS
incidence and deaths may have stabilized. By the end of 1999, a
total of 733,374 AIDS cases and 430,411 AIDS-related deaths had
been reported in the United States.
The report, which said complacency about HIV could spark a
surge in new infections, urged federal agencies to increase
research funding to develop new or enhanced prevention methods,
such as female condoms and new antiretroviral drugs.
It also said health authorities should better use clinics and
doctors offices to deliver prevention messages and services to
those at high risk or already infected with HIV.
Helene Gayle, director of the National Center for HIV, STD and
TB Prevention at the Atlanta-based CDC, said the report was in
keeping with the CDC's desire to see the number of new
infections cut in half during the next five years.
"Prevention does work. It can make an incredible difference and
we've already had some successes that we can point to," Gayle
told reporters during a conference call.
"We need to do it (prevention of HIV infection) better but also
we need a greater investment to be able to make the difference
that we as a nation should be committed to," Gayle said.