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More than half of the people diagnosed with the HIV virus in the U.S. aren’t getting treatment for their infection, the U.S government said today.

African-Americans and younger people are least likely to be receiving regular treatment, meaning that programs to keep them under a doctor’s care aren’t working or aren’t plentiful enough, according to a report by the Centers for Disease Control and Prevention.

While 81% of those African Americans estimated to be infected are diagnosed, only 29% get ongoing care, and just 21% are “virally suppressed,” or have their virus controlled by a regular regimen of antiretroviral, or ARV, drugs. Among Americans ages 25 to 34, 72% of those infected are diagnosed, but 28% get care and a mere 15% are virally suppressed.

Overall, an estimated 1.1 million Americans are infected with HIV. Only 46% of those who are diagnosed with HIV get regular treatment, while a quarter of all those estimated to be infected are virally suppressed.

“We’ve got to do better,” says Jonathan Mermin, director of the CDC’s division of HIV/AIDS Prevention.

The data were released at the XIX International AIDS Conference in Washington, D.C.

The challenge is to find ways to make HIV testing more widespread, and then make it easier to link those who are diagnosed directly into care — and to make sure they stay there, says Mermin.  “I want to make the healthy choice the easy choice,” he says.

One possible solution is to import programs or ideas from Africa and other developing nations that have sharply stepped up their battle against the disease, including putting millions of people on ARV drugs over the past few years. Some retain as many of 90% of their patients in ongoing care.  “We need to reverse engineer; we understand how many other countries are doing this better and often with U.S. tax dollars,” says Nancy Mahon, global executive director of the MAC AIDS Fund and chair of President Barack Obama’s Advisory Council on HIV/AIDS.

The MAC AIDS Fund, which donated $38 million to AIDS programs in 2011, this week, said it is supporting some initiatives with the U.S. Department of Health and Human Services to improve retention in HIV care. They include a two-year mobile texting pilot program in the southern U.S. called UCARE4LIFE to help patients get reminders and tips about managing their disease. The MAC AIDS Fund is also supporting a forum to explore other successful programs from the U.S. President’s Emergency Plan for AIDS Relief program and others.