Preventive measures are failing to stem the rising rate of HIV infection

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Preventive measures are failing to stem the rising rate of HIV infection, warn two senior doctors in an editorial in this week's BMJ.

An estimated 38 million people worldwide, including over 2 million children, are now infected with HIV, and a record 4.8 million became infected in 2003.

The underlying reason for this continuing increase is socioeconomic, but the increase also represents a failure of prevention, write the authors.

For instance, the search for a vaccine against HIV has so far produced only negative results, while microbicides have proved disappointing. Although the ABC message (abstinence, be faithful, use a condom) is popular with the American government, its application in other parts of the world may not have the impact required.

In the face of this global catastrophe, the epidemic in the United Kingdom seems both small and parochial, say the authors. Nevertheless, the latest figures show a 20% increase in the prevalence of HIV in 2003 and 2004 compared with 2002, partly because of infections acquired abroad.

Furthermore, each newly diagnosed HIV patient consumes £12,500 in healthcare costs each year, while the lifetime costs of care for the current 50,000 infected individuals in the United Kingdom, with a life expectancy of 20 years, is at least £12.5bn.

"Prioritisation of sexual health with substantial investment is essential to avoid continuing deterioration in services, rising HIV transmission, and costly consequences for tax payers," they conclude.

Contact:
Brian Gazzard, Consultant Gastroenterologist, Kobler Centre, Chelsea and Westminster Hospital, London, UK
Tel: +44 (0)20 8746 8239

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