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US says million Americans living with HIV

ATLANTA -- For the first time since the height of the AIDS epidemic in the 1980s, more than a million Americans are believed to be living with the virus that causes AIDS, the government said yesterday.

The latest estimate is both good and bad news -- reflecting the success of drugs that keep more people alive and the failure of the government to ''break the back" of the AIDS epidemic by its stated goal of 2005.

The Centers for Disease Control and Prevention said that between 1,039,000 and 1,185,000 people in the United States were living with HIV in December 2003. The previous estimate from 2002 showed that between 850,000 and 950,000 people had the AIDS virus.

The jump reflects the role of medicines that have allowed people infected with the virus to live longer, said Dr. Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention. ''While treatment advances have been an obvious godsend to those living with the disease, it presents new challenges for prevention," Valdiserri said.

The challenges include overcoming a failure by the government to meet its 2005 goal of cutting in half the estimated 40,000 new HIV infections that have occurred every year since the 1990s. Then, Dr. Robert Janssen of the CDC pledged the government campaign would ''break the back" of the epidemic.

However, recent outbreaks of HIV and sexually transmitted diseases in major cities around the country offer a hint that new infections may be as high as 60,000 cases a year, rather than the government estimate of 40,000, said Dr. Carlos del Rio, an Emory University professor of medicine.

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