The Center For Disease Control estimates that more than one million people are living with HIV in the United States and that one in five (20 percent) of those people living with HIV are unaware of their infection.

As of 2012, there are 1,664 people in Maine living with HIV/AIDS and approximately 450 are living with undiagnosed HIV in the state. For such a small state, that number is alarming.

In 2007, the Maine Legislature recommended routine testing in medical settings, but we have seen that it is not happening regularly. There are several reason for that, all related to fear.

The first is that people fear discrimination, stigma and social acceptance simply for being tested. Some people believe that they will be better off if they do not know.

The reality is that people who does not know their HIV status will likely harm their own health and also pose a risk to others with whom they are sexually active.

Advancing from a HIV-positive diagnosis to an AIDS diagnosis deducts an average of 15 years from a person’s life expectancy. Since HIV attacks the immune system, those who do not get treatment immediately run the risk of a severely compromised immune system resulting in an AIDS diagnosis. Forty-four percent of those who test positive in Maine get an AIDS diagnosis within 12 months of that test, indicating that they have been living with the infection for many years already.

Another reason that people are not getting tested is because of complacency. They believe they are either magically immune to the disease or that if they do get it, they will just take medication and it will be manageable. They don’t consider that HIV medications can easily cost $50,000 per year, putting access to health care ahead of every other priority in their lives.

HIV does not discriminate and can be spread through sexual intercourse or through injection drug use (sharing needles). By risk group, gay, bisexual and other men remain the population most severely affected by HIV in the United States (this is not true in all other parts of the world). The CDC uses the term MSM, men who have sex with men, to define this group.

It is important to note that HIV is spread because of risky behaviors, not because of identity.

In 2009, MSM accounted for 61 percent of all new HIV infections in the U.S, as well as 49 percent of people living with HIV in 2008. CDC estimates that MSM account for just 2 percent of the U.S. male population aged 13 and older, but accounted for more than 50 percent of all new HIV infections annually from 2006 to 2009. In 2010, MSM accounted for 61 percent of HIV diagnoses.

Heterosexuals and injection drug users also continue to be affected by HIV. Individuals infected through heterosexual contact accounted for 27 percent of estimated new HIV infections in 2009 and 28 percent of people living with HIV in 2008.

As a group, women accounted for 23 percent of estimated new HIV infections in 2009 and 25 percent of those living with HIV in 2008.

Injection drug users represented 9 percent of annual new HIV infections in 2009 and 17 percent of those living with HIV in 2008. In Maine, as of 2012, 56 percent of those living with HIV were MSM, 28 percent reported no risk, 8 percent identified as heterosexual, and the rest were injection drug users.

Many people who are considered high risk are not getting tested regularly and often wait until their disease is at a stage where treatment is more difficult. Additionally, they increase the risk of exposure to others during the time that they don’t know they are positive and consequently have a high viral load.

We have solid evidence that an undetectable viral load, which can be the result of getting treatment for HIV, means a greatly reduced chance of passing on the virus.

While the proper use of condoms and other barriers (such as clean needles) is effective in preventing the spread of HIV, there is always room for error. HIV prevention begins with getting tested. By getting tested, a person can know their status and get treatment sooner.

Many people will not ask for an HIV test from their physician, fearing discrimination or stigma. Because of this, there are non-profit agencies around the state that provide free and anonymous oral HIV testing to individuals with high risk. All About Prevention is one of these agencies. It is located in downtown Lewiston at 60 Pine St. For more information or to get tested, call 782-7000, or go to: http://www.allaboutprevention.org.

David L. Curtis is the men’s health program manager for All About Prevention and is certified by the state of Maine to do HIV testing and counseling. He has also served on the Materials Review Committee of HIV/STD Prevention of the state of Maine’s Department of Education for eight years.

Go and do:

What: Open house for National HIV Testing Day

When: 11 a.m. to 7 p.m., Thursday, June 27

Where: All About Prevention, 60 Pine St., Lewiston

FMI: Call 782-7000; Web site http://www.allaboutprevention.org