AIDS: After 30 years, battle is far from over

There is a dramatic arc to the three-decade history of AIDS as an epidemic and social phenomenon. Since it was first reported 30 years ago this month, the disease has evolved from an unnamed and mysterious illness to a diabolical killing machine to a chronic condition that can be managed with drugs.

Overall, AIDS has killed 25 million people worldwide. But the successful campaign to transform it — and HIV, the virus that causes it — from a sentence of sure death to a diagnosis that comes with a treatment plan is a medical triumph.

And there are more hopeful signs. Studies show that new drugs, including a gel that women can use, have been effective in reducing transmission of HIV. There is also new research into a cure. After a man with HIV and leukemia underwent a stem-cell transplant for his cancer several years ago, he ended up freed of both diseases. Such a procedure is too expensive and dangerous a treatment for HIV. But his apparent cure has spurred several studies on gene therapy — including one at USC — that could replicate the results.

According to UNAIDS, the Joint United Nations Program on HIV/AIDS, the global rate of new HIV infections has been steadily decreasing, and so has the number of deaths. The largest number of new cases continues to be in sub-Saharan Africa, where there were 22.5 million people living with HIV in 2009, according to the U.N. There are more than 33 million people living with HIV worldwide, about 1.2 million of them in the United States.

Also of concern, the rate of new infections in the U.S. has remained at 50,000 a year for the last 12 years. African Americans in this country and women worldwide are disproportionately affected. Expensive anti-retroviral drugs remain out of reach for millions of people who should be taking them.

AIDS has been with us for so long, and the gains have been so dramatic, that many people have been lulled into carelessness or nonchalance. It’s time to get back to the basics, the preventive steps that have been available for years. Condom use is one. Needle exchange programs are another. Worldwide, there should be new public service campaigns to remind people of the remaining dangers.

In this country, federal and state governments need to fund more fully the national assistance program for people with HIV who don’t have insurance to cover the anti-retroviral drugs they need. Though there is no vaccine or over-the-counter cure yet, the spread of HIV can be stopped.