Richard Presnell has seen drugs change the face of the HIV/AIDS epidemic in the United States, but he knows who is still at risk from the disease.
"Anyone who is sexually active, no matter how you define the sexual behavior," said Dr. Presnell, of Infectious Diseases Consultants in Augusta.
With today designated as World AIDS Day, experts say it is a good time to re-examine the impact the disease is having. The image of HIV/AIDS as a gay man's disease has not been true for a long time, and the rate of heterosexual transmission is having a disproportionately heavy impact on some segments of the community, particularly black women, Dr. Presnell said.
Part of that problem is men who are "on the down low," having sex with other men but not disclosing it to female partners, said Sandra Wimberly, a health educator with the East Central Health District.
"The other thing that I find is we have women that suffer from low self-concept and they just want to be in a relationship with someone but are not strong enough to make some good choices about the relationship they're in," she said.
Better drug therapies and more knowledge about the disease have reduced AIDS death rates dramatically during the past decade, Dr. Presnell said.
In 1994, 1,436 people died of AIDS in Georgia, 89 in the Augusta area, according to the Georgia Division of Public Health.
Last year, fewer than 700 died in Georgia, including 34 in the Augusta health district.
"They've dropped rather dramatically," Dr. Presnell said.
But that success has also brought with it some problems, said Mike Mullet, a spokesman for the Division of Public Health.
"You have a generation of people now, young adults, older teenagers who are at risk for HIV but who have never seen anyone die of AIDS because they're living so long with this disease, or who think, if I get HIV, I can just take these drugs and it will be OK," he said. "So the drugs and our knowledge have been a good thing, but at the same time they've also provided some new educational challenges for us as well."
That also means a concerted effort to push testing, Dr. Presnell said.
"The only reasonable way to know for sure is to get tested," he said. "We're very much encouraging testing because this is a disease that from time of infection until the time you may otherwise know about it may be as much as a decade. Early testing and diagnosis actually give you the opportunity to have not a cure, but certainly a longer and healthier life."
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