[Congressional Record (Bound Edition), Volume 151 (2005), Part 9]
[Senate]
[Page 12854]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                  AIDS

 Mr. SMITH. Mr. President, I discuss the recent announcement by 
the Centers for Disease Control and Prevention that the number of 
Americans living with HIV has now surpassed 1 million. An estimated 
1.039 million to 1.185 million people nationwide were HIV-positive as 
of December 2003, an increase over the estimated 850,000 to 950,000 
cases at the end of 2002. While the number of persons with HIV in my 
state of Oregon is small relative to other states, Oregon still saw an 
85 percent increase in the number of cases between 2002 and 2003. Not 
since the height of the AIDS epidemic in the 1980s has there been so 
many Americans living with this terrible disease.
  The latest estimate reveals both our success and failure at combating 
this disease. On a positive note, the increase reflects the significant 
advances in antiretroviral drug therapy that have allowed persons 
diagnosed with HIV to live longer, healthier lives. On the other hand 
it also reflects our shortcomings in preventing the spread of this 
disease. Despite the Federal government's goal to cut in half the 
number of new HIV cases each year, the figure continues to hold steady 
at about 40,000--the same rate of infection as in the 1990s. Moreover, 
some researchers believe that the number of new infections may actually 
be as high as 60,000 a year.
  To be fair, responsibility for reducing the spread of HIV does not 
rest solely with the Federal government. According to the CDC, those at 
highest risk of contracting HIV have become far too complacent in their 
behavior, particularly as it relates to the practice of safe sex. 
Nevertheless, there is much the Federal government can do to help stem 
the spread of HIV.
  One way to reduce the number of new HIV cases is to ensure that those 
infected with HIV have access to treatment. Such treatments not only 
prevent individuals from developing full-blown AIDS, but also 
significantly lower the risk of transmitting the disease to others. 
Unfortunately, the cost of these treatments is prohibitive, especially 
for those who are uninsured or underinsured. For this reason, it is 
critical that Congress reauthorize and bolster the Ryan White Care Act 
this year. Among other things, the act includes the vitally important 
AIDS Drug Assistance Program, ADAP, which helps low-income and 
uninsured HIV/AIDS patients afford their costly drug treatments. An 
estimated 150,000 people--30 percent of all Americans receiving 
treatment for HIV currently receive their care through ADAP. Even with 
this program, however, States and local communities are overwhelmed. 
That is why I am requesting that Congress provide an additional $300 
million for ADAP for the 2006 fiscal year.
  As successful as ADAP has been, critical gaps in our approach to HIV 
treatment and prevention remain. For example, HIV positive individuals 
have access to treatment under Medicaid only after they have developed 
full-blown AIDS. To remedy this flaw, I introduced the Early Treatment 
for HIV Act, ETHA, S. 311, with Senator Hillary Clinton. By providing 
access to HIV therapies before such persons develop AIDS, ETHA would 
reduce overall Medicaid costs and, as important, reduce the likelihood 
of additional infection.
  By reducing the amount of virus in the bloodstream, early access to 
HIV therapies is a key factor in helping curb infectiousness and 
reducing HIV transmission. Strengthening ADAP and enacting ETHA will 
help put us on the right track to providing both adequate treatment for 
those with HIV, as well as reducing the number of new HIV 
cases.

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