[Congressional Record Volume 152, Number 76 (Wednesday, June 14, 2006)]
[Extensions of Remarks]
[Pages E1143-E1144]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         HIV/AIDS TODAY CLAIMS A MORE DIVERSE GROUP OF VICTIMS

                                 ______
                                 

                         HON. CHARLES B. RANGEL

                              of new york

                    in the house of representatives

                        Wednesday, June 14, 2006

  Mr. RANGEL. Mr. Speaker, I rise today to enter into the Record an 
article, entitled The Changing Face of HIV/AIDS Epidemic, by Tony Best, 
published in the June 6, 2006 edition of New York Carib News, in the 
CaribHEALTH section. Mr. Best recalls the first time, twenty five years 
ago when the U.S. Centers for Disease Control informed the world about 
a disease that claimed the lives of five homosexual men in California. 
From then on, this mysterious disease became known as the ``gay 
cancer'' and was considered as an immediate sentence for death.
  Since then, HIV/AIDS has been responsible for over 25 million deaths 
worldwide, and the Caribbean Islands have had nothing short of a 
personal encounter with the disease, as HIV/AIDS claimed 20,000 lives 
in the region. The most affected countries in the Caribbean have 
consistently been Haiti, the Bahamas, Guyana, Barbados, Jamaica, 
Grenada, and Trinidad and Tobago.
  Mr. Best quotes U.S. HIV/AIDS expert Dr. Wayne Greaves as stating 
that ``Looking back on what has happened in the 25 years, the picture 
is still not a bright one.'' Despite all the innovative treatments that 
now prolong the lives of HIV/AIDS patients, there is still no cure or 
even a drug that prevents HIV in the first place.
  Another very noteworthy point that Mr. Best emphasizes is that HIV/
AIDS, while first distinguished as a homosexual, white, male disease, 
has now become blind to sexual orientation, gender, and race as it is 
alarmingly spreading and infecting increasing numbers of Blacks and 
heterosexual women. Although current census places Blacks as accounting 
for 12 per cent of the U.S. population, they also account for a 
whopping 51 per cent of the new HIV cases in the nation. Furthermore, 
the diagnosed HIV cases for women have tripled since first cases in 
1985.
  Mr. Best cites possible theories that may explain these surprising 
shifts in HIV infection such as low rate of uncircumcised Black males 
compared with whites, the large Black prison population, and poverty. 
In essence, the HIV/AIDS epidemic has completely transformed in nature 
with regards to who is primarily infected by the disease. Akin to the 
shift in the face of the HIV/AIDS epidemic exists the fact that the HIV 
virus is able to mutate so easily, making it virtually impossible for 
scientists to develop a vaccine against the disease.
  Nevertheless, Mr. Best cites Dr. Greaves as commenting that while the 
cure to HIV is a ``far way off,'' in the meanwhile, scientist can still 
continue to develop medications that can prolong life. This point is 
well taken in light of the fact that there is no cure for diabetes and 
hypertension, and yet, science has been able to treat people with these 
diseases to the point where the public no longer sees them as terminal 
conditions. Dr. Greaves underscores education and access to beneficial 
drugs as key elements in the fight against HIV/AIDS.

Twenty-Five Years After the First Cases--the Changing Face of HIV/AIDS 
                                Epidemic

                              (Tony Best)

       To some, it was the disease from hell, the ``gay cancer,'' 
     that brought death. To others, it was an unfathomable plague 
     whose origins were first believed to be in Haiti. That was a 
     discredited medical theory scarred a nation, forcing millions 
     from the Caribbean country to fight back to clear their name. 
     To yet another group, the lethal virus that terrorized 
     communities in North America, Europe, the Caribbean and Latin 
     America, is still wreaking havoc, especially in Africa, but 
     much less so in North America and the Caribbean.
       The disease: HIV/AIDS.
       Twenty five years after the U.S. Centers for Disease 
     Control first told the world in a 1981 report about the 
     deaths of five homosexuals in California from a rare form of 
     pneumonia, few countries, if any have been spared the 
     ferocity if this deadly disease. Some 25 million deaths 
     later, at least 20,000 of them in Haiti, the Bahamas, Guyana, 
     Barbados, Jamaica, Trinidad and Tobago, Grenada, and their 
     neighbors, the world is grappling with the devastation HIV/
     AIDS has left behind. The Bahamas and Barbados, for instance, 
     are considered success stories in dealing with it, have had 
     more than its fair share of deaths. ``Looking back on what 
     has happened in the 25 years, the picture is still not a 
     bright one,'' said Dr. Wayne Greaves, a Caribbean scientist 
     and an HIV/AIDS expert in the U.S.
       For one thing, asserts Dr. Greaves who heads a research 
     laboratory at a large U.S. pharmaceutical firm, ``we can 
     argue it is brighter than before, because there are newer and 
     more effective drugs.'' Even more important, scientists know 
     how to block some, not all, infections that attack the immune 
     functions within the body. Still, there is no drug, which 
     prevents HIV infection in the first place.
       ``From the epidemiological standpoint it is particularly 
     disconcerting, particularly among Blacks and Hispanics,'' he 
     said. ``In the early days of the epidemic, 95 per cent of the 
     total cases were among men. Two-thirds of those cases were 
     among Caucasians. Blacks made up 20 per cent of the cases. 
     Today, although Blacks account for 12 per cent of the U.S. 
     population they account for 51 per cent of the new HIV cases. 
     For women, the story today isn't very good. The cases 
     diagnosed in the U.S. have increased dramatically among 
     women, tripling among women. From eight per cent in 1985 
     women accounted for 29 percent of all the cases. It is even 
     higher today.''
       The hard part is that the pattern of the diseases in 
     Caribbean countries mirrors the trend in the U.S. Globally, 
     more than three million died in 2004 and of the 40 million 
     who succumbed to the disease since 1981, Africa accounted for 
     half of them. In sub-Sahara Africa alone 25.8 million are 
     living with HIV, a 75 per cent jump in the last decade. Sub-
     Sahara Africa has the world highest rate of infection 
     followed by the Caribbean. In Asia, 8.3 million are living 
     with the disease, an increase of almost 300 per cent since 
     1981. Indeed, 25 per cent of the new worldwide cases were in 
     Asia last year. In Latin America and the Caribbean an 
     estimated 2.1 million now have the disease, a 75 per cent 
     increase from 1995.
       ``What is really very troubling in the United States is the 
     high rate of infection among Black men, who are having sex 
     with other men and many are also having sex with women,'' 
     said Dr. Greaves. ``'This is really very troubling.'' How 
     come such growing infections among Black men? ``It's not 
     really quite clear what's happening,'' Greaves said.

[[Page E1144]]

       For instance, the causes range from a lack of knowledge 
     about their own HIV status and then having sex with other 
     people; low rate of uncircumcised Black males compared with 
     whites; the prevalence of sex workers in Africa and the 
     Caribbean; and the large Black prison population; to mistrust 
     of the medical community; poverty and conspiracy theories.
       ``In summary, we are now talking about a different epidemic 
     than the one first reported in 1981,'' Greaves, explained. 
     ``It is more heterosexual transmission than before; less 
     homosexual; transmission through injection drug use remains 
     the same; and a lot more women infected than in the early 
     days of the epidemic.'' But what about treatment?
       If there is a bright spot, it is that HIV positive 
     individuals are living longer, many are leading normal lives, 
     and infection is no longer seen as a death sentence, and 
     that's true if you are in New York, Los Angeles, Toronto, New 
     York, Nassau or Port of Spain where retroviral drugs.
       ``I am optimistic from the medical and scientific 
     standpoint in terms of the new medicines and drugs but I am 
     not optimistic at all about the behavioral response to the 
     messages which have been put out there in the public arena,'' 
     he said.
       On the horizon, some promising categories of drugs. One is 
     entry-inhibitors, which block the virus from being able to 
     enter the cells of the body, thus causing infections. The 
     other is an enzymes used by the virus to infect the cell. By 
     blocking the enzymes scientists interrupt the process of the 
     virus multiplying and causing destruction of the cell, 
     spawning new viruses.
       ``These are being developed and they look very promising,'' 
     he reported. ``If these successes continue, they would be 
     useful additions to the existing drugs that we use to treat 
     AIDS.'' Unfortunately, though, current research is unlikely 
     to lead to a class of drugs anytime soon that would prevent 
     infection. In essence, a cure is a far way off.
       The problem is that the HIV virus is able to mutate so 
     easily that scientists have been virtually unable to develop 
     a vaccine that stimulates the right antibodies or cells that 
     would prevent infection. ``In the meantime, though, we will 
     continue to develop better drugs and we can still prolong 
     life,'' Greaves said. ``We may not be able to cure the 
     infection but we can keep people alive.'' After all, there's 
     no cure for diabetes and hypertension but ``'we have 
     effective drugs where people can go living virtually a normal 
     life span,'' he says.
       Dr. Greaves gives several Caribbean nations high marks for 
     their efforts in fighting HIV through education and the 
     provision of drugs to victims.

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