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The impact of the HIV/AIDS epidemic in the United States and throughout much of the world has been enormous. By the mid-1990s, over a third of a million Americans had died of AIDS, but the Centers for Disease Control and Prevention (CDC) had revised their estimate of living persons with HIV/AIDS downward from about a million to a more conservative estimate of 650,000 to 900,000 people. On the other hand, the World Health Organization (WHO) was continually increasing its estimate of persons living with HIV/AIDS throughout the world up to over 20 million and were expecting over 40 million in less than five years. By the end of 1997, the United Nations revised their estimate of persons with HIV upwards to 30.6 million.

In the United States, even with a cumulative total of about 1.1 million HIV/AIDS infections and AIDS deaths in a nation of some 260 million, the social fabric has been irrevocably altered in ways that we may never fully understand. With AIDS disproportionately taking the lives and affecting the health and thoughts of so many Americans in the arts (visual, theater, dance, photography, writing, film, television, and others), it is difficult to imagine how the various artistic fields would have evolved since 1981 without the profound influence of AIDS. How the world has been changed by the untimely deaths due to AIDS of Peter Allen, Howard Ashman, Michael Bennett, Brad Davis, Perry Ellis, Halston, Keith Haring, Robert Mapplethorpe, Freddie "Mercury " Bulsara, Vito Russo, Sylvester, and many others will never be truly known.

This reading summarizes the status of the HIV epidemic in the United States and points to some areas of concern. One such area is the increasing number of AIDS cases among injecting drug users, women, blacks, and Hispanics. Although there is still no cure for AIDS, there are some extremely positive developments in treatment with new drugs and in the reduction of HIV transmission to newborns through pregnant women 's treatment with AZT (the first federally approved medicine to work against AIDS). In an important study, only 8 percent of pregnant HIV-positive women who took AZT (also known as zidovudine) had an HIV-positive child, while 25 percent of pregnant HIV-positive women who did not take AZT had an HIV-positive child. And while there is not yet a vaccine that has proved to be effective for humans, much success has been achieved in animal studies, and dozens of preventive vaccine trials are ongoing. Amazingly, despite all the publicity about AIDS, more than half of all HIV-positive persons in the United States still do not know that they are infected.

The HIV epidemic is a multifaceted national and international problem. Without treatment, about 50 percent of all people with HIV develop AIDS within ten years after becoming infected. Groups at special risk have been identified and include: injecting drug abusers and their sex partners, people with large numbers of sex partners, men who have sex with men and their female partners, and people who exchange sex for money or drugs. The most rapid increases are occurring among injecting drug abusers, women, and babies born to women in high risk groups. An estimated 20 to 35 percent of infants of infected mothers develop HIV infection. Approximately 60 percent of AIDS patients are white, 25 percent are black, and 15 percent are Hispanic. The development of a safe and effective HIV vaccine is a high priority for the coming decade. Other prevention and control strategies are vital to stopping the spread of HIV infection. Most HIV-infected people in the United States do not know they harbor the virus, and increased counseling, testing, and follow-up services are needed. Public education efforts on risks and precautions are essential to slowing the spread of the disease. . .

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