Demonizing HIV

AIDS activists have been buzzing lately about a new German HIV awareness advertisement depicting a woman having sex with Adolph Hitler. By now, I am sure you are wondering: what does the Fuhrer have to do with AIDS? Well, in the ad, which is available online, a heterosexual couple is seen having sex. The man's face becomes that of Adolph Hitler followed by a slogan describing AIDS as a "mass murderer. Print versions of the campaign also use Saddam Hussein as well as other despots.
The company that created the campaign, Das Comitee, defended the advertisement stating that it was meant to show "the ugliness of the illness."

I understand the philosophy of using 'shock value' to get people's attention. Its discomforting to realize that in 2009, we have to 'shock' people to make them aware of HIV/AIDS. However, the designers of this campaign are obviously missing something and it underscores the danger of developing public awareness campaigns in a vacuum-with vetting them with a diverse audience, especially people living with HIV. Now, I don't know for sure if that was done. However, given the tremendous stigma associated with HIV, I would hope that someone would have realized that many people viewing the ad would associate the people living with HIV with these dictators. Despite good intentions, it's the wrong message!

HIV Testing

Few would argue that HIV testing is one of the most vital tools in addressing the HIV epidemic. But, does everyone feel that way, or even understand the significance of knowing his/her HIV status. A recent study conducted by the Kaiser Family Foundation (June 2009) found that despite efforts to encourage more HIV testing, including making it a part of routine medical care, "reported rates of HIV testing have remained flat over time." In fact, the share of non-elderly (ages 13-64) who report having been tested within the last year has not changed in over a decade. Although some groups, such as African Americans, Latinos and young adults are more likely to report having been tested, even their rates have remained virtually unchanged over the last several years. In 2009, less than one-half of the adults in the United States say that they have ever been tested.

Another study conducted by the Centers for Disease Control (Morbidity and Mortality Report-June 27, 2009) suggests that many people do not submit to HIV testing until late into the course of their infection. In the study, 45% of the testers progressed to a full blown AIDS diagnosis within 3 years of their positive HIV test. More troubling is that over a third (38%) progressed to full blown AIDS within a year. Moreover, minorities, especially African American men, were more likely to progress to full blown AIDS within 3 years of HIV diagnosis, e.g... were late testers.

The moral of the story, get tested: even if you do not think you are at risk. Too many people are apparently waiting until they get sick to get an HIV test. Consequently, they are giving HIV a head start and limiting the possibilities for successful treatment. HIV may be becoming a chronic disease, but the quality of life may be significantly improved by early testing and treatment. So, what are you waiting for?

Zoonoses

Confused? I had not heard of that word either, until I did a little research for this blog about animal to human disease transmission. Zoonoses are emerging infectious diseases that have transferred to humans from animal hosts. I embarked on this research after learning of the discovery of a new HIV strain thought to have originated from gorillas native to Cameroon. This makes the fourth documented strain of HIV: strain "M, the most common and "N," "O" and now "P." The latter three seem to manifest themselves primarily from the Cameroon region.

With so much evidence available that HIV is a Zoonose; ie..., that it originated from an animal host, in this case, chimpanzees, then why do so many people still believe that the HIV epidemic is a government conspiracy or some equally paranoid theory. In fact, most of the temperate diseases (found in temperate of tropical climates) such as measles, mumps, rubella, smallpox, influenza A and tuberculosis, are believed to have come from domestic animals. Moreover, most of the major infectious diseases also originated in animals: West Nile, Mad Cow, Cholera, Syphilis, Malaria, Ebola, Lyme Disease, Hantavirus, SARS, Swine Flu.

Clearly we need a little science lesson. Its time to jettison the conspiracy theories and understand that WE, our behavior, our ignorance, our intolerance and our apathy pose our greatest risk for HIV infection, not a government test tube!

Men are Driving The HIV Epidemic

That's right, I said it: its men who are driving this epidemic. For all of the talk about the disproportionate impact of HIV on minority women, who do we think are infecting them: men. By the way, the fastest growing population being infected with HIV is not women; its young black men who have sex with men (MSM) between the ages of 13-29. Overall, there are 30,000 new HIV infections annually among MSM. Now before you go into the "AIDS is a gay disease mode," we must remember that gay and bisexual men probably make up a small percentage of men overall. We have to stop focusing so much on labeling people: "gay," "straight," "down-low," etc.. Many people are resistant to accepting certain labels. A man who primarily has sex with women but occasionally also has sex with men, may consider himself straight. Likewise, the incarcerated man who see his sex with another man in prison, a partner who by the way, may be officially labeled in the prison as a "b***h," therefore making it more socially acceptable. The focus has to be on responsibility such as: knowing one's HIV status; prompt diagnosis and treatment of sexually transmitted infections and last but not least; safe and safer sex. So for the men reading this, the 'ball's in your court.' Man-up!

Adolescent Hopelessness and HIV

A new report published in Healthday News on Jun 29, 2009, has found that almost 15 percent of American adolescents believe that they will die before age 35, a belief that may be strongly linked to unsafe behavior. Greater than one in seven youths have a pessimistic view about their future mortality and are more likely to take risks. The findings, published in the July issue of Pediatrics, are based on a three-year study of attitudes and behaviors among 20,594 teens from the 7th through 12th grades. The teens were asked about their views on personal mortality as it related to behaviors such as attempting suicide, using illegal drugs, sustaining fight-related injuries that required medical care, engaging in unprotected sex, being arrested by the police and contracting HIV or AIDS. Other important findings included:
*Race and wealth were important variables. While 10 percent of
white teens expressed this pessimism, 21 percent of Hispanic teens and 26
percent of African American youth harbored this fatalistic view.
*Adolescents who predicted a short lifespan were more likely to engage in risky
behavior, and teens who engaged in risky behavior (throughout the first year of the
study) "were more likely to develop a pessimistic view of their future."

Clearly, more needs to be done to both assess these attitudes early on, especially for minority and low income children, and to make every effort to develop programs that help to instill a sense of optimism and hope. Without this new focus, we will continue to raise a generation of children who feel that "they have nothing to lose."

Obama and HIV

As with most things its a good news, bad news scenario. Clearly, Obama is more in tune with the AIDS epidemic than his predecessor. He has proposed a budget increase for domestic HIV prevention and direct services. Moreover, his administration will soon launch Act on AIDS, an ambitious 5 year social marketing campaign to raise awareness of HIV/AIDS and encourage people to get tested. Sadly, however, his 2010 budget cuts funding to fight AIDS globally, cuts funding for federal AIDS housing, and fails to lift the federal ban on syringe exchange.

What people, including AIDS activists, need to realize is that he is playing with a shaky hand. Our nation is mired in the deepest recession in years, he is constantly under siege by the Republican party and he is trying desperately to hold onto a shaky coalition of "Blue Democrats," ie.. conservative Representatives from formerly Republican controlled states. He also has very ambitious plans for climate control and health care. So the question is: what are our expectations? I too, am a little disappointed but, I understand that he has to pick his battles right now.

Will the recession increase HIV infection?

The answer is, probably. We all know that one of the first casualties of economic down times are programs that help those in the most need. Its hard enough to make ends meet when there is less money and rising prices. People who were living check to check can find themselves out on the street if that check stops coming. Now comes word that two states with the highest numbers of persons living with HIV/AIDS, California and Pennsylvania, may be making significant cuts in vital HIV prevention and direct care services. The Governator (Arnold Swarzenegger) is proposing 55.5 million in funding cuts to HIV prevention, education and treatment programs. The Republican version of the state budget proposes to cut PA State AIDS Programs by 25%. Sadly, some of the proposed cuts could jeopardize federal matching funds, further spreading the pain.

It s not to late to send a message to state government legislators that cutting HIV/AIDS funding as well as other services to the poor and disabled in the midst of a surging epidemic is penny wise and pound foolish and will only exacerbate the problem.