A New AIDS Crisis for N.Y.C.?

A new wave of HIV infections is about to hit New York, and we had all better get ready for it - from AIDS service providers like us to all New Yorkers at risk. It is not just that many people have let their guard down when it comes to practicing safer sex or not sharing needles, but thousands of people are living with HIV without knowing it and are about to find out.

In June our state legislature passed ground-breaking legislation requiring HIV testing to be offered routinely in medical settings. The law will go into effect on September 1. Previously, patients were required to sign a separate written consent form in order to get tested for HIV. Now, if you agree to a quick swab test, you will only have to give oral consent. When undergoing routine medical procedures or checkups, you will be offered a standard HIV blood test to sign off on along with the battery of tests that most patients receive. Once you give your consent, it stays in effect for all your future blood tests.

The federal Centers for Disease Control and Prevention estimates that 100,000 people in New York City alone are currently living with HIV infection, but more than 25,000 of them do not know it. After all, HIV can take 10 years or more to progress to AIDS, the syndrome that destroys your immune system and leaves you vulnerable to all manner of opportunistic infections.

Most of these unknowing carriers of HIV feel and look healthy - and are in most respects. But they are missing out on treatments that could prevent them from progressing to AIDS. Plus, they are in danger of transmitting the virus to others, continuing to fuel the epidemic.

Yes, researchers have made enormous progress in treating HIV with antiretroviral drugs that have extended the lifespan of people with HIV by decades. HIV prevention was once driven in part by the fear of the horrible, disfiguring diseases that preceded the untimely deaths of our friends and loved ones. Now, the number of older people living with AIDS is skyrocketing as new infections rise among the young.

Today, fewer people even acknowledge having HIV because they are experiencing relatively good health (if they have access to treatment) and do not want to complicate their employment or community lives. That has made HIV prevention much, much harder in 2010, especially among young people who are under the illusion that there is a cure for HIV that involves just taking a few pills. It in fact involves taking drugs almost daily that can have very debilitating side effects for the rest of your life.