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U.S. Health Officials Call for New HIV Strategy


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 group said.

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 infections.

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 report said.

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 emergence.

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.


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Information in this article was accurate in September 27, 2000. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.