The recent 30th anniversary of the first documented HIV/AIDS case offers a reminder of how the public health community can help shape the prevention conversation.
“In terms of prevention efforts, I’m not sure we’ve really gotten to where we need to be as a nation,” said Michael Reece, PhD, MPH, immediate past-chair of the APHA HIV/AIDS Section and director of the Center for Sexual Health Promotion at Indiana University. “HIV is still one of the most easily preventable infections that we have, and the tools are readily available and so cost-effective.”
Yet while an HIV diagnosis was once a certain death sentence, treatment advances have allowed people to live longer, healthier lives than ever thought possible. That also means more than 1 million people in the United States and more than 60 million worldwide live with HIV, and as the number rises, “so does the risk of HIV transmission,” said Centers for Disease Control and Prevention Director Thomas R. Frieden, MD, MPH.
One of Frieden’s concerns is that the majority of new infections are among people younger than 30, “a new generation that has never known a time without effective HIV treatment and who may not fully understand the significant health threat HIV poses.”
And as with so many health conditions, alarming disparities persist. Gay and bisexual men of all races remain the group hardest hit by HIV. They make up just 2 percent of the U.S. population but more than half of all new HIV infections. The rate of new HIV infections for black men is about six times the rate for white men, and the rate for black women is nearly 15 times as high as the rate for white women. Among Hispanics, the rate of new HIV infections is two to four times higher than the rate among white Americans.
Public health advocates also remain troubled over disparities in treatment. Expensive drug regimens often do not reach the underserved. Yet the prevention message, Reece and his colleagues showed in a 2010 study on condom use that found some of the highest rates are among black men in their 30s and 40s, often does reach those who most need to hear it.
“This remains such a core public health issue,” Reece said about HIV/AIDS prevention and treatment. “We still treat this as a separate disease, when in fact we may need to think more creatively about our public health responses to epidemics like this. We have to be more creative, and maybe we need to fully integrate messages around prevention and overall human well-being.”
As Richard Wolitski, deputy director of behavior and social science for the CDC’s Division on HIV/AIDS Prevention said recently in a blog post commemorating the past three decades of AIDS awareness, “Our work is far from over.”
“We can, and we will, win the battle against HIV and AIDS,” said Wolitski, who lost a partner to AIDS when they both were 29 years old. “We owe it to ourselves, our families, our communities and future generations to keep on fighting this battle until it’s over.”
After three decades of HIV/AIDS, are we doing enough on prevention? Let us know what you think by leaving a comment below.