Development & Aid, Headlines, Health, North America

HEALTH-US: HIV/AIDS Messages Losing Punch, Experts Warn

Katherine Stapp

NEW YORK, Jul 31 2003 (IPS) - After years of modest but encouraging victories against AIDS, the disease is again rising in the U.S. population and experts say there are no easy answers to the problem.

The number of people in the United States diagnosed with full-blown AIDS spiked 2.2 percent in 2002, the first increase in new cases in a decade, according to new data from the federal Centres for Disease Control and Prevention (CDC).

The results did not include separate figures for men and women, but since 1985, the proportion of all AIDS cases reported among adult and adolescent women has more than tripled, from seven percent in 1985 to 25 percent in 1999.

”The increase could mean people are failing on treatment, or having difficulty adhering to complex treatment regimens. If someone is diagnosed late, drugs can also be less effective,” Jessica Frickley, a CDC spokesperson, said in an interview.

The growth in new AIDS cases was not the only troubling revelation by the CDC at a national HIV prevention conference this week.

About 40,000 new HIV diagnoses are made in the United States each year. In 2002, HIV infections among men who have sex with men surged 7.1 percent, according to data collected by the CDC from 25 states with HIV reporting since 1994.

This latest figure is part of an ominous trend. After stabilising in the nineties, new HIV cases among gay men have increased 17.7 percent in the last three years.

”Complacency is certainly an issue we’ve been facing for a long time, both among younger and older people,” Frickley said.

Advocates who work in the gay community say that many people have simply become numb to safe sex campaigns, or believe that with powerful new drug cocktails, the virus is not such a ”big deal”.

”There’s a phenomenon going around known as ‘prevention fatigue’,” said Lynn Schulman, communications director for the New York-based Gay Men’s Health Crisis. ”The epidemic has been around for 22 years now. We need to take a second look at exactly what the messages are.”

For example, many of the advertisements for HIV/AIDS drugs feature smiling, athletic, tanned young men who appear anything but ill.

”The reasoning was that you don’t want to stigmatise people who have AIDS,” Schulman told IPS. ”But I think what we’ve done is overstepped – not that we’ve glamorised it, but people don’t really understand what it means to be HIV-positive, the side effects from thhe medications, all the other problems.”

Two studies that made waves at this week’s conference explored the growing role of the Internet in fuelling the spread of the virus in gay communities.

An on-line survey by researchers at the Centre for AIDS Prevention Studies at the University of California, San Francisco found that 39 percent of 91 gay and bisexual men who said they met a sex partner on the Internet also reported having unprotected sex with that person.

In another study by the California Department of Health Services, 40 percent of men with syphilis interviewed said they surfed chat rooms, personal ads and party listings to find sex partners, making the Internet the most popular liaison site. Most of the men were also HIV-positive.

”For a lot of gay men, it’s really off the radar,” Dr. Ken Haller, president of the Gay and Lesbian Medical Association, told IPS. ”There’s a whole generation of gay men who knew what AIDS was before they knew what sex was. They’ve been living with it their whole lives so they’re very blasé about it.”

”Many also see HIV/AIDS as a disease of another generation,” he said. ”It’s a very complex set of factors leading up to this, and AIDS services and prevention organisations need to rethink their approach.”

Schulman also suggested that that ”people in communities with economic disadvantages may not have access to care”.

Prominent gay and lesbian groups also blame the administration of President George W. Bush for its retreat from sex education in schools, and a crackdown on prevention campaigns that use explicit sexual images.

”The federal government is now giving more than 100 million dollars a year to states to teach abstinence-only until marriage education. The percentage of public schools replacing comprehensive sex-ed with abstinence-only education has gone from 2 percent 10 years ago to 25 percent today,” Winnie Stachelberg, political director of the Human Rights Campaign, the largest gay and lesbian advocacy group in the United States, said in a statement.

”While abstinence should be taught as a viable option as part of a comprehensive sex-ed programme, we have a national obligation and a responsibility to provide our children with a broad base of knowledge so they can effectively protect themselves from HIV,” she added. ”Beyond that, abstinence-until marriage programs do not address the needs of gay and lesbian youth who are not currently permitted to marry in this country.”

Haller agreed. ”Condoms are downplayed, or portrayed as not terribly effective, so no matter what you do, you’ll get sick anyway,” he said, adding: ”There’s a lot they are going to have to answer for in coming years.”

CDC officials have warned that the rise in HIV diagnoses might simply be a by-product of more gay and bisexual men getting tested for the virus. The data did not include HIV ”hot spots” like New York and California because those states lack long-standing reporting systems – although excluding such epicentres of the virus would most likely skew the results downward.

Data from those states is expected soon, federal officials say.

In an attempt to get a clearer picture of how the epidemic is evolving, the CDC is introducing a new monitoring programme next year that will narrow down the timeframe of when a person contracted HIV to within the last six months.

”What it does is use a second test that gives us an indication of whether a person was recently infected,” Frickley explained. ”This new monitoring system will give us the most leading-edge picture so that prevention and treatment programmes can be targeted to the communities that most need them.”