Today is World AIDS Day

Today is the 20th anniversary of the first World AIDS Day back in 1988. Worldwide, around 33 million people are infected with the virus -- an earlier estimate of 40 million was downgraded by the United Nations in its most recent report, due to revised sampling methods.

There were 2.7 million new infections in 2007 (the stats on which the report is based), and 2 million died of the virus. More than 1 million people are infected with HIV in the United States.

Around the Web:

Read the UNAIDS 2008 report on the global AIDS epidemic here. (The reports are published every two years.)

Here, at cnn.com, are remarks by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci notes that on the first World Aids Day in 1988, there was only one drug for treating those infected with the virus -- AZT -- and HIV fast became resistant to it. Now, Fauci notes, there are two dozen drugs that are taken in various combinations (reducing the chances that HIV will develop resistance.) Fauci notes that this makes it possible for people to live normal lives for at least a decade and maybe even live normal lifespans.

But Fauci notes that the drugs must be made available to far more people throughout the world -- less than one-third of people infected with the virus "in low- and middle-income countries" are getting these drugs, he notes.

Another barrier to routine AIDS testing falls

Another obstacle to routine screening for HIV is about to fall, this time for the Department of Veterans Affairs, the nation's largest provider of HIV care. You may recall that in 2006, the Centers for Disease Control and Prevention issued revised recommendations for testing adults, adolescents and pregnant women for the virus that causes AIDS.

The new recommendations, while acknowledging that 38% to 44% of adults in the U.S. have been tested for HIV, are aimed at the approximately 25% of HIV-positive Americans who are unaware that they harbor the virus. So -- in bureaucratic lingo -- the CDC switched to an opt-out, rather than an opt-in, recommendation. What that means to people who go to hospitals, emergency rooms, clinics and other healthcare settings is that AIDS was to be treated like any other disease when it came to testing.

AIDS testing was to become more like Pap test screening for cervical cancer, or blood pressure readings to check out the heart. Patients have the right to say "no" to such screenings in a medical setting, but if they don't object -- or opt out -- a simple explanation from the physician acknowledged by the patient is enough to grant permission. The CDC said in 2006 that it was time to treat AIDS the same way. Specific signed consent for AIDS screening should no longer be required.

Since the early days of the AIDS epidemic in the 1980s, the disease had different rules from those of most others. Because of the stigma and potential for discrimination associated with the disease, along with the fact that until 1996, there was very little in the way of treatment to slow down the progression from HIV to AIDS to death, federal recommendations were that patients could not be subjected to testing for the disease unless they expressly asked to be tested -- or opted in.

But a CDC report found that of all HIV infections reported in 2004, 40% progressed from HIV-positive to AIDS within a year of diagnosis. That means they've been HIV-positive for a long time. Since the average time from infection with the virus to onset of the disease is about seven to nine years, a lot of infected people are out there, possibly spreading the disease without even knowing it. And the average survival rate is about 11 years longer when people with AIDS are diagnosed early.

The CDC wanted more people to know their HIV status, but that has meant that 20 states had to re-write their laws, eliminating a need for separate written consent for HIV testing. So far, 11 of the states with restrictive HIV-testing laws, including California, have passed new laws removing those barriers.

Now Congress has passed a law removing the barrier to opt-out testing from the VA, according to a news release from OraSure, maker of a rapid results HIV test. It's expected to be signed into law soon, meaning more veterans will be routinely screened.

It's been two years since the CDC recommended that adults 13 to 64 get routinely screened for HIV, according to an article in the Aug. 27 Journal of the American Medical Assn., and there are still problems. AIDS discrimination is still real, some insurers won't cover HIV-screening and many hospital emergency rooms simply don't have the time, personnel and resources to do routine screening on everyone who comes in the door.

But now there's one less barrier to identifying the 250,000 to 312,000 Americans who are HIV-positive and don't know it.

-- Susan Brink

-- Photo Illustration: Getty Images

AIDS in Africa. Exhibit offers a child's-eye view.*

Step out of your comfortable life and experience the devastation of AIDS in some of the hardest-hit areas in sub-Saharan Africa, from the point of view of a child.

That's the purpose  of a traveling exhibit featuring a 2,340-square-foot replica of an African village. Tour the village while listening on headsets to a personal audio track telling the true stories of four children -- Kombo, Babirye, Emmanuel and Mathabo -- whose lives have been affected by AIDS.

The exhibit was inspired by the U.S. Holocaust Memorial Museum In Washington, D.C. There, visitors can see the displays while reading the personal story of an individual Holocaust victim.

The AIDS exhibit, sponsored by World Vision, makes a stop in Los Angeles from now until Aug. 26 at two locations.  Until Aug. 18, you can "Step Into Africa" at the Holman United Methodist Church, 3320 W. Adams Blvd. in Los Angeles. And Aug. 22-26 you can experience it at Calvary Community Church, 5495 Via Rocas, Westlake Village.

The exhibit will travel to 80 cities, and some 200,000 people are expected to see it.

Be prepared to spend some time. As the voice says through the headset: "The pace is relaxed. Much like life in Africa."

And while the exhibit is moving, it is not hopeless. As you can see and hear, there is music, joy and hope in the people of Africa, where 25 million people are infected with the AIDS virus.

Short of getting on an airplane to see the continent for yourself, the exhibit gives you a sense of what it is like to be in a village "alive with activity, but people say it has the smell of death," as the gentle African voice will tell you.

-- Susan Brink

Photos: Robert Coronado, World Vision. Top: Faces of those affected by HIV and AIDS in a church in Babirye's village. *Earlier version said the scene was at the exhibit. Below: Bed in a one-room hut.