Nearly four in 10 US HIV infections from people unaware of infection

This electron microscope image made available by the U.S. National Institutes of Health shows a human T cell, in blue, under attack by HIV, in yellow, the virus that causes AIDS. (AP)
Updated 19 March 2019
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Nearly four in 10 US HIV infections from people unaware of infection

  • The Trump administration has said it will invest $291 million in the next financial year to fight HIV/AIDS, which has plateaued since 2013 to around 39,000 annual transmissions

WASHINGTON: Almost 40 percent of new HIV cases in the US occur because people do not know they are infected, while a similar proportion know but are not in treatment, according to a study released Monday.
The report by the Centers for Disease Control and Prevention (CDC) is based on 2016 data and aims to bolster a strategy outlined by President Donald Trump to end the epidemic within 10 years.
The strategy has two main strands: far more widespread screening, and enabling the infected better access to treatment from the moment they test positive.
The study found that 38 percent of infections came from HIV-positive people who were unaware of their status, and 43 percent from people who knew they were infected but took no anti-retroviral drugs.
The remaining infections came from people who were receiving HIV treatment but were not yet “virally suppressed.”
The CDC blamed financial, social and other reasons for people not using medication, which these days typically comes in the form of a daily pill with minimal side effects.
The study said that the infection rate from the half million people in the United States who take medication and are virally suppressed — meaning they cannot pass on the disease to others — was zero.

The most at-risk group remains homosexual men, with almost three-quarters of new infections coming from men having sex with men, the report said.
Five percent of infections came from intravenous drug abuse among homosexual men, while 10 percent came from injecting drugs among the rest of the population.
Twelve percent of infections were among heterosexuals. Overall, the highest rate of transmission was among 13 to 24-year-olds.
The Trump administration has said it will invest $291 million in the next financial year to fight HIV/AIDS, which has plateaued since 2013 to around 39,000 annual transmissions.
The goal is to reduce that number by 75 percent within five years and by 90 percent in 10 years.
Questioned about the relatively small amount of money earmarked for the multi-billion dollar task of treating HIV carriers, CDC head Robert Redfield said he was “confident that the resources that are required to accomplish this mission are in the long term plan.”
The CDC, based in Atlanta, Georgia, wants doctors to make HIV screening a routine procedure.
“Everyone between the ages of 13 and 64 should get tested for HIV at least once in their lifetime,” said Eugene McCray, the head of the CDC’s Division of HIV/AIDS Prevention.
“Those at higher risk should get tested at least annually,” he said.
“The key to controlling is helping those with HIV to control the virus,” said the CDC’s Jonathan Mermin, who focuses on preventing the spread of the HIV as well as other sexually transmitted diseases, tuberculosis and hepatitis.
“Time spent working closely with patients who are having trouble paying for, picking up or taking their daily medications is time well spent“


North Korea’s Kim inspects new submarine, signals possible ballistic missile development

Updated 12 min 6 sec ago
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North Korea’s Kim inspects new submarine, signals possible ballistic missile development

  • The new data and combat weapon systems of submarine was built under Kim’s “special attention”
  • Experts said the size of the new submarine suggests it would eventually carry missiles

SEOUL: North Korean leader Kim Jong Un inspected a large newly built submarine, state news agency KCNA reported on Tuesday, potentially signaling continued development of a submarine-launched ballistic missile (SLBM) program.
Kim inspected the operational and tactical data and combat weapon systems of the submarine that was built under “his special attention,” and will be operational in the waters off the east coast, KCNA said.
KCNA said the submarine’s operational deployment was near.
“The operational capacity of a submarine is an important component in national defense of our country bounded on its east and west by sea,” Kim said.
KCNA did not describe the submarine’s weapon systems or say where and when the inspection took place.
North Korea has a large submarine fleet but only one known experimental submarine capable of carrying a ballistic missile.
Analysts said that based on the apparent size of the new submarine it appears designed to eventually carry missiles.
“We can clearly see that it is a massive submarine — much larger than the existing one that’s been well known since 2014,” said Ankit Panda, senior fellow at the US-based Federation of American Scientists.
“What I find significant about the political messaging here is that this is the first time since a February 2018 military parade that he has inspected a military system clearly designed to carry and deliver nuclear weapons.”
“I take that as an ominous signal that we should be taking Kim Jong Un’s end-of-year deadline for the implementation of a change in US policy with the utmost seriousness.”
A South Korean defense ministry spokesman said they were monitoring developments but could not confirm if the submarine was designed to carry missiles.
Kim Dong-yub, a military expert at Kyungnam University’s Institute of Far Eastern Studies in Seoul, said Kim likely also wanted to reassure North Koreans of his commitment to national defense at a time when he is focusing more on the economy.
“Announcing his inspection of the new submarine is also to build internal solidarity, to dispel people’s concerns about national security, reassure them, and boost military morale,” he said.
Submarine development
Kim has declared a moratorium on testing ICBM’s and nuclear weapons while engaging in denuclearization talks with the United States and South Korea.
The North’s submarine report comes amid another delay in dialogue between the United States and North Korea after Kim and US President Donald Trump agreed at a meeting at the Panmunjom Korean border on June 30 to working-level nuclear talks.
Trump said such talks could come in the following two to three weeks. His national security adviser, John Bolton, arrives in South Korea on Tuesday to meet security officials.
A summit between Trump and Kim, in Vietnam in February, broke down after they failed to narrow differences between a US demand for North Korea’s denuclearization and a North Korean demand for sanctions relief.
In April, Kim said he would wait until the end of the year for the United States to be more flexible.
North Korea maintains one of the world’s largest submarine fleets, but many vessels are aging and there are doubts over how many are operational, according to the Washington-based Nuclear Threat Initiative (NTI).
Most of North Korea’s fleet consists of small coastal submarines, but in recent years it has made rapid progress in the SLBM program, NTI said in a report released late last year.
In 2016, after a few years of development, North Korea successfully test-fired a ballistic missile from a submarine, while pursuing an intercontinental ballistic missile program (ICBM).
During the submarine inspection Kim was accompanied by Kim Jong Sik, an official who played a major role in North Korea’s missile program.
Another official on the tour was Jang Chang Ha, president of the Academy of the National Defense Science, which the US Treasury has said is in charge of the secretive country’s research and development of its advanced weapons systems, “including missiles and probably nuclear weapons.”
H.I. Sutton, a naval analyst who studies submarines, said judging by the initial photos the hull could be based on old Romeo Class submarines, which were originally acquired from China in the 1970s before North Korea began producing them domestically.
North Korea is believed to have about 20 Romeo submarines in its fleet, the newest of which was built in the mid 1990s, according to NTI.
Sutton told Reuters that the North Koreans appeared to have raised the deck on a Romeo-type design, possibly even modifying an existing Romeo to make a submarine larger than previous indigenous designs.
“I’d bet that this is indeed a missile submarine,” he said.
US-based monitoring group 38 North said in June 2018 that North Korea appeared to be continuing submarine construction at its Sinpo Shipyard of possibly another Sinpo-class ballistic missile submarine, based on commercial satellite imagery.
“This, to my eye, is the submarine that the US intelligence community has been calling the Sinpo-C, a successor to North Korea’s only known ballistic missile submarine,” Panda said.