Today is World AIDS Day- what are you doing?
December 1st is World AIDS Day
Posted Dec 01, 2008
While there has been much important attention on HIV/AIDS abroad, more attention is needed domestically. This year the CDC announced that it had been underestimating the cases of HIV/AIDS diagnosed each year by about 40%. The new numbers estimate that over 56,000 people were diagnoses with HIV/AIDs in 2006 or approximately one American every 10 minutes. Additionally, we know that HIV disproportionately affects some communities. Gay, bisexual, and other men who have sex with men but don't use these labels are disproportionately infected (CDC, 2008). We know they experience disparities both in infections rates, but also the governments' inadequate response to prevention and care for this population. We know that youth are one of the only groups showing an increase in infections, but within this population young men who have sex with men, are particularly infected. One of the largest studies of its kind showed that 7.2% of young men who have sex with men were HIV positive, with the majority of these young men not aware of their status until the study (Valleroy, MacKellar, & Karon, 2000). In other words, about one out of every 14 gay and bisexual youth may be infected. We also know African Americans show a disproportionate infection rate (CDC, 2008). Something must be done about this epidemic.
Throughout the history of the HIV epidemic we have know that mental health issues have been inextricably tied with HIV. Persons with mental health diagnoses are at increased risk for HIV and personal with HIV are at increased risk for mental health problems. Persons with HIV are at increased risk for mental health problems both because of the stigma and stressors of living with HIV, but also there can be neuropsychological complications associated with having the HIV virus. Persons with mental health problems are also at risk for a number of reasons (see an article by Donenberg and Pao (2005) for more information).
Over the last two and a half decades of the epidemic we have learned a lot about HIV risk and how to prevent it. We have identified the importance of key HIV risk factors like: HIV prevention and transmission knowledge, intentions to stay safe, motivation and peer norms for safer sex, attitudes, self-efficacy, situational influences (e.g. substance use, mood), family relationships, and health related resources or barriers. Of course these are just some of the important factors in a long list that has helped researchers develop HIV prevention programs that work. Check out the CDC's website for a list of just some of these effective programs (http://www.effectiveinterventions.org/).
The problem is that interventions that work haven't received enough resources to be fully implemented and some communities that are at the highest risk (like young gay and bisexual men) have been neglected.
I am hoping that with a new administration the federal response to our domestic HIV epidemic will be given the attention that it deserves and resources will be focused on those communities at the greatest risk. There is currently no effective HIV vaccine, and while further research is desperately needed in this area, we have behavioral approaches that we know work and should be supported to help prevent further infections.
In honor of World AIDS day, here are a few suggestions about things you can do to help change the epidemic and to support those who are currently infected.
1) Get informed. Learn how to prevent HIV transmission and differentiate myths from facts. Spread good information to your friends and family members so that they can help protect themselves. Help dispel myths that lead to stigma against people living with HIV. The Body is a great website to check out for information: http://www.thebody.com/
2) Advocate for more resources for HIV at every level. You can make donations to your local AIDS care and prevention organization and lobby your elected officials. Advocate for Obama to launch a national AIDS strategy similar to the strategies we require from other nations we fund. You can sign on for the strategy here: http://www.nationalaidsstrategy.org/
3) Do something to help prevent HIV or care for someone who is living with HIV. If you work at a mental health or other health organization, consider what your organization can do to help prevent your patient population from being infected. The CDC's list of effective interventions is a good place to start as they have been designed to be readily deployed (see http://www.effectiveinterventions.org/). Think about what your organization is doing to support the mental health needs of people living with HIV. If you are a mental health professional you are in a unique place to make a difference as you have been trained on how to help people make positive and health changes.
4) Know your status. If you are sexually active or use IV drugs, get tested. Knowing your status is an important part of protecting your health and the health of your partners. Visit http://www.hivtest.org/ to find a testing location close to you.
5) The Body website has a further list of things you can do to make a difference (http://www.thebody.com/content/art49412.html) If you have other ideas please post them here as comments.
Doing something about this epidemic can change World AIDS day from a memorial of the millions of people who have lost their lives to this terrible disease into a day of hope for the future.
CDC. (2008). Subpopulation estimates from the HIV incidence surveillance system--United States, 2006. MMWR Morb Mortal Wkly Rep, 57(36), 985-989.
Donenberg, G. R., & Pao, M. (2005). Youths and HIV/AIDS: psychiatry's role in a changing epidemic. J Am Acad Child Adolesc Psychiatry, 44(8), 728-747.
Valleroy, L. A., MacKellar, D. A., & Karon, J. M. (2000). HIV prevalence and associated risks in young men who have sex with men: Young Men's Survey Study Group. Journal of the American Medical Association, 284, 198-204.