[Congressional Record Volume 144, Number 99 (Wednesday, July 22, 1998)]
[Extensions of Remarks]
[Pages E1378-E1379]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                                  AIDS

                                 ______
                                 

                          HON. LEE H. HAMILTON

                               of indiana

                    in the house of representatives

                        Wednesday, July 22, 1998

  Mr. HAMILTON. Mr. Speaker, I would like to insert my Washington 
Report for Wednesday, July 22, 1998 into the Congressional Record.

                            AIDS in America

       Recent legal and medical developments concerning the 
     Acquired Immune Deficiency Syndrome (AIDS) have renewed 
     interest in the disease around the world. Since the discovery 
     of the disease in 1981, much has changed. Here are some 
     frequently asked questions regarding AIDS:
       What is AIDS? AIDS is a fatal disease that attacks the 
     immune system, destroying the body's ability to fight off 
     infections and cancers. The disease is believed to be caused 
     by a virus called human immunodeficiency virus (HIV) which is 
     spread through bodily fluids. AIDS is the syndrome that 
     develops after someone is infected with HIV and the immune 
     system is unable to fight off common infections. After 
     initial infection with HIV, it takes an average of eight to 
     ten years for the virus to develop into full-blown AIDS. The 
     life expectancy of AIDS victims varies in accordance with 
     availability of various drug therapies, but typically ranges 
     from one to four years. No cure currently exists for HIV/
     AIDS.
       What is the extent of the problem? HIV/AIDS is one of the 
     greatest threats to public health in America, especially 
     among youth. AIDS is currently the second leading cause of 
     death among Americans between the ages of 25 and 44. The 
     greatest threat can be seen in the rising HIV infection rates 
     among minorities, women, and teenagers.
       Nearly 370,000 Americans have died from AIDS-related 
     illnesses. An estimated 650,000 to 900,000 Americans have 
     been infected with HIV since 1981. Approximately 5,200 cases 
     of AIDS have been reported in Indiana since

[[Page E1379]]

     1982. As of April 1998, 2,955 Hoosiers have died from AIDS.
       AIDS is certainly a global crisis, as almost every country 
     has reported cases. The problem is particularly bad in 
     developing nations. In certain regions of Africa and India, 
     one out of four adults in infected. Lack of medical 
     facilities and AIDS education make it unlikely that the rapid 
     rate of infection will curb within the near future.
       Can AIDS be prevented? According to the Surgeon General, 
     the most certain way to control the AIDS epidemic is through 
     using condoms, monogamous sexual relationships, and avoiding 
     illegal intravenous drug use. There is no evidence that HIV 
     can be transmitted through casual contact. With no cure for 
     AIDS, educating those at risk of infection is currently the 
     only way to halt the spread of the disease. Because needle 
     sharing among intravenous drug users leads to the spread of 
     HIV, some public health officials advocate the distribution 
     of clean needles as part of drug abuse treatment programs.
       What is the government doing? Since the 1980s, Congress has 
     steadily increased funding for research, improving access to 
     health care for AIDS patients and supporting public education 
     initiatives. In 1998, the federal government will spend close 
     to $9 billion on HIV/AIDS programs, compared to the $22 
     billion spent on cancer programs and the $43 billion for 
     heart disease.
       State and local governments are also fighting the epidemic. 
     Indiana will spend approximately $1.2 million in state tax 
     dollars on HIV/AIDS related prevention and health care 
     services in 1998.
       How are HIV/AIDS cost financed? HIV/AIDS cases are an 
     enormous financial strain for individuals, insurance 
     companies, and the government. The average cost of caring for 
     an HIV/AIDS patient from infection to death is approximately 
     $150,000 or an average $12,000 per year, largely spent on 
     costly new drugs.
       Private health insurance covers an average of 50% of the 
     cost for caring for persons with HIV/AIDS. Medicaid also 
     covers a sizeable amount of the cost of patient care. The 
     Ryan White Comprehensive AIDS Resources Emergency (CARE) Act 
     is the centerpiece of federal programs serving AIDS-related 
     health care needs. CARE Act programs, implemented through 
     public-private coalitions, are aimed at cutting the cost of 
     care, reducing the need for expensive hospitalization, and 
     developing support services across the nation.
       Should there be mandatory testing? All donated blood is now 
     screened for HIV, and testing is mandatory for military 
     personnel and federal prisoners. There is broad agreement 
     that individuals at high risk of contracting HIV should seek 
     testing.
       Due to costs, it is unlikely that sweeping mandatory tests, 
     such as for medical practitioners, will be implemented. A 
     preliminary HIV screening costs approximately five dollars 
     per person. Each person who tests positive would require a 
     follow-up test which would cost approximately fifty dollars. 
     To implement nationwide tests would place a significant 
     strain on government resources.
       How are HIV/AIDS victims treated under the law? Americans 
     with HIV/AIDS have often been targets of various forms of 
     discrimination, although laws have been established to 
     protect against discrimination. Under the Americans with 
     Disabilities Act of 1990, HIV/AIDS is considered a handicap, 
     therefore making it illegal to discriminate against HIV/AIDS 
     victims in hiring practices and in providing access to public 
     facilities.
       A recent Supreme Court decision declared that HIV infection 
     without present symptoms is a disability due to the fatal 
     nature of the disease. Thus, it is illegal for medical 
     providers to refuse treatment to HIV-infected individuals on 
     the basis of their medical condition.
       What progress has been made? A great deal of progress has 
     been made on AIDS research in the past decade. For example, 
     drug ``cocktails'', which involve a combination of as many as 
     ten different medications, are allowing HIV-infected people 
     to live longer with a higher quality of life.
       In June, the first human trials were begun in the study for 
     an AIDS vaccine. However, experts still have serious concerns 
     as to the effectiveness of any vaccine in stopping the spread 
     of the disease.
       Conclusion: Much still needs to be learned and done about 
     HIV and AIDS. An aggressive strategy to combat the disease is 
     urgently needed. A heavy emphasis must be placed on 
     prevention through grassroots education. Research to develop 
     treatment, cures and vaccines must be continued and expanded. 
     Help must be given to developing countries where HIV/AIDS is 
     spreading at a staggering rate. All of this could save 
     millions of dollars and millions of lives. It is a battle 
     worth fighting.

     

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