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AIDS at 30: A new generation puts itself at risk

At the three-decade mark of HIV/AIDS, a vaccine against the disease is still but a dream, and drugs to treat it remain out of reach for many. Thus, as was the case when the disease was first identified, prevention is crucial. That amounts to changing the types of sexual and drug behavior that lead to new infections.

It won’t be easy. This Los Angeles Times article paints a portrait of AIDS at 30 and offers some perspective on the nature of today’s prevention obstacles:

“Today, most new infections occur among people under the age of 30, a generation that has never known a time without effective HIV therapy and may not understand the significant health threat HIV poses, said Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention.”

About 34 million people in the world, and 1.2 million in the US, are living with HIV. The article adds:

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“The challenge is made harder by the success of HIV/AIDS medications: As those with HIV live longer lives with treatment, the pool of people who can spread the virus expands yearly. Persistent religious objections to condom use, resurgent political opposition to needle-exchange programs, and stubborn health and economic disparities that keep many women, minorities and the poor from getting help exacerbate the difficulties.”

Crafting public policy about HIV prevention is messy, but taking personal steps to reduce risk is fairly clear-cut. For those who prefer to have a sex life (abstinence is safer), mutual monogamy is the way to go – but don’t even think about having sex without a condom unless you’ve both been tested for HIV (though condoms aren’t 100% effective at preventing HIV, or many other sexually transmitted diseases).

The basics of HIV and AIDS can be found at aids.gov. And the same website has tips on prevention for anyone who is sexually active, injects illegal drugs or has a job requiring contact with body fluids.

Prevention is most effective before HIV exposure. But that’s not always possible. In those cases, HIV drugs called antiretrovirals can be repurposed for reducing the chance of infection. That is, if they’re taken soon after exposure—the effectiveness of such post-exposure prophylaxis wanes after 72 hours.

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That’s an option we didn’t have 30 years ago.

healthkey@tribune.com

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