Big rise in testing, treating called for at AIDS parley

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WASHINGTON -- Jerome Smith said he never got tested for HIV until it was almost too late. By the time he was checked five years ago, his immune system was so weakened that he had developed AIDS. The doctor told Mr. Smith, a District of Columbia government worker, that he had probably been infected for at least a decade.

Mr. Smith, now 39, says he doesn't understand how his disease had been missed. In the two years before the diagnosis, he had been treated in local hospital emergency rooms for pneumonia, for unexplained fever and for a deadly bacterial infection. Each time, he underwent countless tests as doctors tried to figure out why he was sick. Not once, he said, did anyone test for HIV.

"I thought they were automatically testing me for everything," Mr. Smith said.

As the International AIDS Conference gets under way in Washington, organizers are calling for big increases in HIV testing and treatment. Testing-and-treating is now the central AIDS prevention strategy in the United States, providing a critical tool beyond condoms, behavior change, clean hypodermic needles and a safe blood supply. Experts say treatment-as-prevention has the potential to dramatically alter the landscape of the epidemic. Not only does treatment improve a person's health, but people treated with antiretroviral therapy can prevent the virus from being transmitted to others. The drugs prevent the virus from replicating, reducing the level of active virus in blood and other bodily fluids that are the usual vehicles for infection.

Yet about half of Americans, 51 percent, don't know that treatment helps prevent the spread of the disease, according to a new poll by The Washington Post and The Kaiser Family Foundation.

Nearly 20 percent of Americans with HIV don't know they are infected, according to the U.S. Centers for Disease Control and Prevention.

Most insurance plans are supposed to cover HIV screening in routine medical costs, health officials said. However, hospital emergency rooms usually do not, because a person arrives with a specific condition that may not be related to HIV.

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